Easily Administered Patient-Reported Outcome Measures: Adolescents' Perceived Functional Changes After Completing an
Heidi Kempert1, Ethan Benore2, Rachel Heines1
1Therapy Services, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, OH.
Objective:
To determine whether patient-reported measures would be clinically sensitive and useful for identifying functional change within an intensive chronic pain program setting by examining 2 patient-reported measures administered as part of physical and occupational therapy for chronic pain.
Design:
A retrospective data analysis of children and adolescents with chronic pain treated over a single calendar year. Paired t tests evaluated change in perceived function measures and pain over time. Standardized residual change scores were used in subsequent regression to assess associations between change scores.
Setting:
An interdisciplinary pediatric pain rehabilitation program that supports children and adolescents with chronic pain by increasing strength, flexibility, and endurance; facilitating a return to daily life activities; and using appropriate self-directed coping and pain management skills.
Participants:
Children and adolescents (N=109; age range, 8-19y; 83% girls) with various chronic pain diagnoses who were admitted to a 3- to 4-week intensive pain rehabilitation program.
Interventions:
Participants were involved in physical and occupational therapy for 3 hours daily, as well as recreation therapy, psychology, school, aquatics, art therapy, and music therapy for a total of 8 hours daily. Parents were involved in parent education with therapists from all disciplines in conjunction with their child's programming.
Main Outcome Measures:
Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI), and self-reported pain severity rating on 0-to-10 numerical rating scale.
Results:
Data demonstrated significant gains in LEFS and UEFI during the program. Improvement in perceived functioning was significantly correlated with a reduction in pain.
Conclusions:
The LEFS and UEFI provide a meaningful way to track progress in chronic pain rehabilitation. Using self-perceived measures, children and adolescents noted significant functional improvement, associated with less pain intensity. These findings increase our understanding of the rehabilitation process and point to goals for clinical improvement.
