Pediatric Pain Rehabilitation Program

Pain Rehabilitation Outcomes

2018

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 restoring their daily activity. It consists of inpatient and day hospital components, and blends pediatric subspecialty care, behavioral health, and rehabilitation therapies in 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).

In 2018, a total of 130 patients were seen. 58% of our patients were from out-of-state.

To assess improvement in functioning, four rating scales, the PROMIS Pain Interference, Fatigue, and Mobility measures and the Bath Adolescent Pain Questionnaire (BAPQ) Pain-Specific Anxiety subscale were administered at the beginning of the program and at its completion. The Pain Interference measure is used to assess the consequences of pain on relevant aspects of one’s life, and the Fatigue measure inquires about a range of fatigue symptoms. The Mobility scale is a measure of activities of physical mobility, and the Pain-Specific Anxiety measure assesses the extent to which one worries about pain. Pain intensity ratings were assessed at the time of admission and again at discharge. For all metrics, patients showed improvement in the average score at completion of the program.

PROMIS Interference (N = 44¹)

In 2018, patients reported an average 38% decrease in the extent to which pain hinders their daily functioning.

PROMIS Fatigue (N = 44)

In 2018, patients reported an average 36% decrease in symptoms of fatigue.

PROMIS Mobility (N = 44)

In 2018, patients reported an average 42% increase in activities of physical mobility.

BAPQ Pain-Specific Anxiety (N = 44)

In 2018, patients reported an average 36% decrease in the extent to which they worry about their pain.

Pain Intensity (N = 44)

Patients are asked to rate the pain they experienced during the past 7 days on a scale of 0 (no pain) to 10 (worst pain ever). Pain intensity ratings are obtained at the beginning of the three-week pain rehabilitation program and at discharge.

¹The discrepancy between admission and discharge N-size represents three patients who did not complete discharge evaluations.

Discharge assessment for 2018 revealed an average 15% decrease in pain intensity.