title: Pain in postsurgical orthopedic rehabilitation: a multicenter study.
abstract: OBJECTIVE
  The aim of this study was to quantify and characterize pain in patients undergoing lower limb postsurgical orthopedic rehabilitation and to investigate the impact of pain in slowing or interrupting their rehabilitation.
  
  
  METHODS
  The study was designed as a multicenter cross-sectional study.
  
  
  METHODS
  The study was set in rehabilitation departments of the Don Gnocchi Foundation.
  
  
  METHODS
  The study subjects were the inpatients attending rehabilitation.
  
  
  METHODS
  There were no interventions used in the study.
  
  
  METHODS
  Pain intensity was measured with a numeric rating scale (NRS); pain characteristics were assessed with the McGill Pain Questionnaire and the ID Pain (able to discriminate nociceptive from neuropathic pain). Quality of life (QoL) was measured with the Short Form 36 Health Status Survey. A semi-structured questionnaire on pain occurrence, impact, and management was administered by the physiotherapist in charge of the patients and by the physician.
  
  
  RESULTS
  We studied 139 patients, 82% of whom complained of at least moderate pain (NRS ≥ 3). According to ID pain, 45.6% patients complained of probable (33.8%) or highly probable (11.8%) neuropathic pain. A higher pain intensity was significantly related to the probability of having neuropathic pain (P < 0.001). Patients with more severe pain reported lower physical and mental QoL scores. In 38.6% of cases, pain interfered with the rehabilitation process, and in 18.5% it was the cause of physical therapy discontinuation.
  
  
  CONCLUSIONS
  In light of the high occurrence and intensity of pain in the sample, and of the significant impact on the rehabilitation program, clinicians should pay more attention to pain, especially neuropathic pain, in postsurgical patients. Tailored pain pharmacological therapy could possibly improve patient compliance during the rehabilitation process and enhance long-term outcomes.
authors.affiliation: Department of Neurosciences, UCSC University, Rome, Italy. lpadua@rm.unicatt.it
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.forename: Irene
authors.initials: I
authors.lastname: Aprile
authors.forename: Francesca
authors.initials: F
authors.lastname: Cecchi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Molino Lova
authors.forename: Maria Felice
authors.initials: MF
authors.lastname: Arezzo
authors.forename: Costanza
authors.initials: C
authors.lastname: Pazzaglia
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D009437:Neuralgia / Q000453:epidemiology*; D059226:Nociceptive Pain / Q000453:epidemiology*; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000534:rehabilitation*; D011788:Quality of Life