Psychological predictors of performance-based physical functioning among pediatric pain program participants

Author:

Bourchtein Elizaveta12ORCID,McLaughlin Alix13ORCID,Walainis Kimberly4,Hughes Amanda4,Scott Eric L.12ORCID,Foxen-Craft Emily12ORCID

Affiliation:

1. Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA

2. Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA

3. Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA

4. Ambulatory Rehabilitation Therapies Department, Michigan Medicine, Ann Arbor, MI, USA

Abstract

PURPOSE: The purpose of the present study was to evaluate changes in performance-based physical functioning and investigate psychological predictors of physical functioning over time in pediatric patients with chronic pain who completed an interdisciplinary rehabilitation intensive outpatient program (IOP). METHODS: Participants (N = 55; mean age = 14.92 years; 12.7% male, 87.3% female; 83.6% White, 5.6% African-American/Black; 9.1% Latinx) completed baseline measures assessing pain intensity and modifiable psychological factors (i.e., pain catastrophizing, kinesiophobia, anxiety and depressive symptoms). Participants were administered performance-based assessments of physical functioning (i.e., physical endurance, high-level motor abilities) before and after IOP completion. RESULTS: Pain intensity was not significantly associated with physical functioning at either timepoint. There was significant improvement on measures of physical functioning after completion of the IOP when controlling for the effects of sex, race, and ethnicity. Depressive symptoms were associated with baseline physical endurance, β = − .28, p = .047, while pain catastrophizing was associated with baseline gross motor abilities, β = − .28, p = .032. CONCLUSION: Participation in an IOP led to significant improvement in physical endurance and high-level motor ability. Depressive symptoms and pain catastrophizing were associated with physical functioning at baseline but not post-program completion. Integration of pain psychology and physical therapy in an IOP can help address the interrelated psychological and physical factors impacting physical functioning to improve outcomes for children with chronic pain.

Publisher

IOS Press

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