(311) Relationships between Objective Physical Performance with Pain Anxiety and Self-Efficacy during Intensive Pediatric Pain Rehabilitation

Abstract

Intensive interdisciplinary pain rehabilitation programs (IIPRP) are typically recommended for youth with chronic pain conditions who do not respond to outpatient pain clinic treatment. A growing body of literature has shown that IIPRP are associated with improvements in functioning, pain, and distress. However, little is known about treatment mechanisms for IIPRP. A few studies have documented improvements in physical functioning within IIPRP, but how these improvements contribute to other areas of functioning remains unexplored. Existing conceptual models (fear-avoidance model of chronic pain, self-efficacy model) suggest that pain-related anxiety and self-efficacy may be important treatment mechanisms for youth undergoing IIPRP. For this study, we hypothesized that improvements in physical functioning (measured via objective measures of gait speed and core and upper strength) would be associated with changes in self-report measures of pain-related anxiety and self-efficacy. For this preliminary analysis, 10 participants, ages 10-16, completed measures prior to and upon completion of an IIPRP where they received physical and occupational therapy, pain psychology, and medical services for 1-3 weeks. Measures included the Fear of Pain Questionnaire, Self-Efficacy Scale, 100-Foot Walk, and the Sit-Up and Push-Up subtests of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition. Regression analyses produced standardized residuals for change scores. Preliminary results indicate improvements in gait speed and core strength were related to improvements in fear of pain (rs > 0.60, ps