Pediatric pain rehabilitation during the COVID-19 pandemic: exploring the effectiveness of a hybrid intensive interdisciplinary pain treatment model

Abstract

Purpose This study aimed to (1) examine improvements in rehabilitation outcomes after participation in a pediatric hybrid intensive interdisciplinary pain treatment model (50% in-person and 50% video-based telehealth) and (2) compare magnitude of hybrid model improvements to patients treated in a traditional, 100% in-person model prior to the pandemic. Materials and methods Rehabilitation outcomes for 33 youth with chronic pain from the model were compared to 33 youth with chronic pain who completed a traditional, in-person model. Improvements between admission and discharge in both models were examined using paired student t-tests. Independent samples t-tests compared change scores for the hybrid and traditional models. Results Participants in both models experienced significant improvements on all rehabilitation outcomes, including cardiovascular endurance, pain interference, functional disability, and occupational performance (p < 0.001), except for pain intensity (p = 0.15). Change scores for rehabilitation outcomes did not significantly differ between models. Conclusions Quantitatively, hybrid model rehabilitation outcomes appeared clinically equivalent to the traditional, in-person model. Qualitative and psychosocial outcome comparisons of each model are warranted to better understand challenges and barriers associated with hybrid pain treatment models. The feasibility and impact of tools to enhance telehealth, such as actigraphy or virtual reality, should also be explored. IMPLICATIONS FOR REHABILITATION This study supports the efficacy of video-based telehealth interventions for children and adolescents with chronic pain syndromes. Disability outcomes for a hybrid (50% in-person, 50% video-based telehealth) intensive interdisciplinary pain treatment program appear to be equivalent to patients treated within a fully in-person program.