title: Pain and its impact on inpatient rehabilitation for acute traumatic spinal cord injury: analysis of observational data collected in the SCIRehab study.
abstract: OBJECTIVE
  To describe pain during inpatient rehabilitation and its impact on delivery of inpatient rehabilitation services for persons with spinal cord injury (SCI).
  
  
  METHODS
  Prospective observational study and retrospective chart review.
  
  
  METHODS
  Six inpatient rehabilitation facilities participating in the SCIRehab Study.
  
  
  METHODS
  Patients (N=1357) receiving initial rehabilitation after traumatic SCI, for whom pain data were available.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Self-reported rating of pain intensity (0-10), pain locations, and treatment time by various rehabilitation disciplines.
  
  
  RESULTS
  The vast majority of patients (97%) reported pain at least once during the rehabilitation stay, with an average pain intensity ± SD of 4.9 ± 2.4. Average pain intensity over the stay was severe (rated 7-10) for 30% of patients, moderate (4-6) for 42%, and mild (1-3) for 25%. Pain prevalence at admission was greater than at discharge (87% vs 74%), as was pain intensity (6.0 vs 4.6). Most (79%) of the 177 participants who did not have pain at admission reported pain at least once later in the rehabilitation stay, but their average high pain intensity over the stay was lower than that of the full sample (1.9 vs 4.9). Nearly half (47%) of patients reported pain at ≥ 3 locations during the stay, with the back, neck, and shoulder commonly reported. Patients with severe pain spent fewer days in rehabilitation, received less rehabilitation treatment time (hours per week and total hours), and had more treatment sessions altered in objective or content because of pain than those with lower pain levels.
  
  
  CONCLUSIONS
  Pain is a common problem for persons receiving inpatient rehabilitation for traumatic SCI and adversely impacts delivery of therapy services.
authors.affiliation: Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA. jzanca@kesslerfoundation.org
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Zanca
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014481:United States