Archives of Physical Medicine and Rehabilitation
Original articlePain and Its Impact on Inpatient Rehabilitation for Acute Traumatic Spinal Cord Injury: Analysis of Observational Data Collected in the SCIRehab Study
Section snippets
Study design and participating organizations
Data analyzed herein were collected as part of the SCIRehab Study18, 19—a multicenter study that uses practice-based evidence research methodology, an observational approach in which detailed data are collected on rehabilitation interventions, patient characteristics, and medical, functional, and psychosocial outcomes.20, 21, 22 Six clinical centers participated in the study: The Rocky Mountain Regional Spinal Injury System at Craig Hospital (lead center), Rehabilitation Institute of Chicago,
Sample characteristics
The sample was predominantly men, white, spoke English as a primary language, worked at the time of injury, and had private insurance coverage (table 1). More than one third of the patients had paraplegia (36%). Average age at injury was 41 years, and average LOS was 57 days.
Presence, intensity, and locations of pain
High and low pain intensity at admission, discharge, and over the entire stay are presented in table 2. The majority of patients (97.2%) reported pain at some point during the rehabilitation stay, with an average high pain
Discussion
The SCIRehab Study is one of the largest prospective studies of SCI inpatient rehabilitation ever undertaken and provides a unique opportunity to examine the prevalence and intensity of pain reported by persons with acute traumatic SCI during inpatient rehabilitation and to assess the impact of pain on delivery of inpatient rehabilitation services. This investigation supports the assertion that pain is highly prevalent in persons with SCI, with the vast majority (97%) of patients reporting pain
Conclusions
Pain is highly prevalent among persons with SCI receiving acute inpatient rehabilitation. Persons with SCI report multiple locations of pain, and a substantial percentage experience severe pain. Persons with severe pain receive less treatment time, but this does not appear to be because of missing scheduled therapies. PT, OT, and NU pain management activities took up relatively little of their discipline's total treatment time, but this may not be true for PSY. Further studies are needed to
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2023, Archives of Physical Medicine and RehabilitationCitation Excerpt :The prevalence of pain reported in this study is lower than reported in the current literature. One study performed in Switzerland on pain during inpatient rehabilitation reported a pain prevalence of 87% at admission and 74% at discharge.17 This study did not make a distinction between different types of pain.
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2019, Archives of Physical Medicine and RehabilitationGait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project
2018, Archives of Physical Medicine and RehabilitationCitation Excerpt :Pain data were recorded during the first 3 days of the stay, the 3 days before discharge, and on the 1st, 10th, and 20th calendar day of each month during the IPR stay. Pain was globally assessed by the patients reporting their highest and lowest score to nursing between 0 (no pain) and 10 (severe pain) for the period of days.29 The maximum pain score recorded throughout the length of stay and the mean of all highest pain scores were used in our analysis.
Brain changes after spinal cord injury, a quantitative meta-analysis and review
2018, Neuroscience and Biobehavioral ReviewsCitation Excerpt :Pain is also associated with great costs to both society and the individual patient (Mann et al., 2013). For example, in a study including 1357 SCI patients receiving initial rehabilitation, those with severe pain spent less time in rehab, and had more treatment sessions adjusted in goal or content because of pain (Zanca et al., 2013). Chronic pain in SCI patients has a cascading effect on other aspects relating to an individuals’ well being such as general functioning (Turner et al., 2001a), increased depression and anxiety (Avluk et al., 2014; Tran et al., 2016), sleep quality (Avluk et al., 2014) and daily activities (Widerström-Noga et al., 2001).
Spinal Cord Injury-Related Neuropathic Pain
2018, Challenging Neuropathic Pain Syndromes: Evaluation and Evidence-Based Treatment
Supported in part by the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, U.S. Department of Education (grant nos. H133N060027 and H133A060103).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.