Objective and self-report outcomes of intensive interdisciplinary pain treatment for youth with chronic pain with and without functional neurological disorder
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Introduction: Intensive interdisciplinary pain treatment (IIPT) is effective for youth with chronic pain (CP). Many from this population also experience functional neurological disorder (FND). Treatment outcomes for patients with CP and FND during and after IIPT have not been thoroughly examined, and studies utilizing objective physical and occupational therapy measures are particularly lacking. Methods: 301 adolescents (M age=15.34 years, 84.4% girls, CP only: 187, CP and FND: 114) participated in individualized physical, occupational, psychological, and other therapies. Self-report (COPM, functioning) and objective (BOT-2, 6-minute-walk) measures were administered pre-IIPT, post-IIPT, 6-months-post, and one-year-post. Results: Overall, there were strong and statistically significant improvements from baseline to all other time points (all p’s<.01) for those with CP only and those with CP and FND. From pre-IIPT to post-IIPT, there were statistically significant group differences indicating less improvement for those with FND on coordination, strength, and agility tasks of the BOT-2 (F(1,255)=6.08, p=.014; F(1,255)=9.03, p=.003); on COPM satisfaction (F(1,258)=6.31, p=.013); and 6-minute walk test distance (F(1,217)=5.08, p=.025). Significant group differences from baseline to all follow-up timepoints indicated those with FND had less improvement on COPM performance (F(1, 258) =14.16, p <.001; F(1,150)=5.95, p=.016; F(1,96)=6.394, p=.013) and overall functional disability F(1,262)=15.43, p <.001; F(1,172)=4.250, p=.041; F(1,119)=5.44, p=.021). However, the BOT-2, 6-minute-walk and COPM satisfaction did not differ significantly at follow-ups, indicating no significant difference between those with and without FND. Conclusions: This study suggests that objective and self-report outcomes differ significantly between IIPT participants with CP and FND compared to those with only CP. However, both groups improved significantly overall, and some differences weakened in magnitude over time.
Zaugg, Kelsey; Wallace, Dustin; Friesen, Kayla; and Hoffart, Cara M., "Objective and self-report outcomes of intensive interdisciplinary pain treatment for youth with chronic pain with and without functional neurological disorder" (2023). Posters. 315.
Presented at Society of Pediatric Psychology Annual Conference;. Chicago, Illinois; March 2023.