title: The CONECSI trial: results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury.
abstract: Many people with spinal cord injury (SCI) rate chronic neuropathic pain as one of the most difficult problems to manage. The aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain) trial was to evaluate a multidisciplinary cognitive behavioral treatment program for persons with chronic neuropathic pain after SCI. The intervention consisted of educational, cognitive, and behavioral elements. A total of 61 people were randomized to either the intervention group or the waiting list control group in 4 Dutch rehabilitation centers. Primary outcomes were pain intensity and pain-related disability (Chronic Pain Grade questionnaire), and secondary outcomes were mood (Hospital Anxiety and Depression Scale), participation in activities (Utrecht Activities List), and life satisfaction (Life Satisfaction Questionnaire). Measurements were performed at baseline, and at 3, and 6 months follow-up. The primary statistical technique was random coefficient analysis. The analyses showed significant changes over time on both primary (t1-t2), and 2 out of 4 secondary outcomes (both t1-t2 and t1-t3). Significant intervention effects (Time*Group interactions) were found for anxiety and participation in activities, but not for the primary outcomes. Subsequent paired t tests showed significant changes in the intervention group that were not seen in the control group: decrease of pain intensity, pain-related disability, anxiety, and increase of participation in activities. This study implies that a multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic SCI pain.
authors.affiliation: Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, PO Box 85238, 3508 AE Utrecht, The Netherlands Adelante Zorggroep, PO Box 88, 6430 AB Hoensbroek, The Netherlands Rehabilitation Center De Hoogstraat, PO Box 85238, 3508 AE Utrecht, The Netherlands Rehabilitation Center Het Roessingh, PO Box 310, 7500 AH Enschede, The Netherlands Rijndam Rehabilitation Center, PO Box 23181, 3001 KD Rotterdam, The Netherlands.
authors.forename: Matagne
authors.initials: M
authors.lastname: Heutink
authors.forename: Marcel W M
authors.initials: MWM
authors.lastname: Post
authors.forename: Helma M H
authors.initials: HMH
authors.lastname: Bongers-Janssen
authors.forename: Catja A
authors.initials: CA
authors.lastname: Dijkstra
authors.forename: Govert J
authors.initials: GJ
authors.lastname: Snoek
authors.forename: Dorien C M
authors.initials: DCM
authors.lastname: Spijkerman
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D011615:Psychotherapy, Group; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology; D016896:Treatment Outcome
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