Cleveland Clinic Children's Hospital for Rehabilitation

Pediatric Pain Program: Functional Outcomes

2023

The Pediatric Pain Rehabilitation Program at Cleveland Clinic Children’s Hospital for Rehabilitation is a unique and innovative program designed for children and adolescents with chronic pain that interferes with normal activities. As a result of their pain, these children do not attend school, interact with peers or participate in normal activities. Our program focuses on helping children manage their pain and restore their daily activity. The program consists of inpatient and day treatment components; it blends pediatric sub-specialty care, behavioral health, and rehabilitation therapies into an individualized but coordinated manner. The program was a recipient of the American Pain Society Clinical Centers of Excellence in Pain Management award and is the first pediatric interdisciplinary pain rehabilitation program accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF).

https://my.clevelandclinic.org/pediatrics/departments/pain-rehabilitation

Population for 2023

  • 21 patients (N) had full data at admission and discharge
  • Mean age: 15.8 (2.34)
  • Gender distribution: 61.9% female (23.8% nonbinary or transgender)
  • Ethnicity: 9.5% Hispanic/Latino; 0.0% Biracial/Multiethnic; 4.8% prefer not to report
  • Comorbid Psychological Conditions: 95.2% (most common were Anxiety/PTSD, Depression, ARFID, Functional Neurological Disorder, and Sleep)
  • Lag time to first appointment to Pain Assessment Clinic (PAC): 33.1 days
  • Lag time from referral to first appointment: 58.6
  • Lag time from referral to admission: ***

In 2023, several scales from the Patient-Reported Outcomes Measurement Information System (PROMIS) were utilized to assess functional outcomes related to pain. The Patient-Reported Outcomes Measurement Information System (PROMIS) tool was utilized to assess pain interference, fatigue, mobility, anxiety, and depression among patients. This tool was administered to patients prior to admission and again at discharge from the program.

HealthMeasures. (n.d.). PROMIS®. (https://www.healthmeasures.net/score-and-interpret/interpretscores/promis#:~:text=For%20PROMIS%20measures%2C%20higher%20scores,upon%20the%20concept%20being%20measured.)

Pain, Pain Interference, Fatigue, Anxiety, and Depression

2023 (N=21)

PROMIS scores that are higher in numerical value indicate that there is more of the outcome that is being measured (i.e. more fatigue, more pain interference). A lower score for indicates lower pain and associated impairment.

Mobility and Upper Extremity

2023 (N=21)

A higher score for mobility and upper extremity is preferred, as it indicates improved functioning.

Functionally Relevant Physical Exercises

2023 (N=21)

These exercises serve as good objective measures of strength and mobility for children with chronic pain, used to measure change over time. The first six exercises are measured in repetitions performed over 60-second period. The plank test is time (seconds) the plank position is held. The 6-minute walk test is measured in hundreds of feet walked in 6-minutes.