Pediatric Pain Rehabilitation Center

Those considering receiving treatment at the PPRC or in the midst of treatment often wonder what the future holds. We are still learning, but we can give you some answers from the research we have done over the past 10 years. Here’s what we know so far.

• At PPRC discharge: When we compared participants treated at the PPRC with youth who were in outpatient treatment for their pain, both groups showed improvements after receiving treatment. However, children receiving intensive interdisciplinary treatment at the PPRC benefited more (were more functional).
• One-year outcomes: After PPRC treatment, participants’ pain and disability level reduced, as did their use of pain medications and assistive devices. They were moving faster and able to do more self-care, school-related, and leisure activities. They described feeling emotionally better too. These improvements were maintained when assessed 10 months later. Most participants (88 percent) were totally functional, and 73 percent of participants reported mild-to-no pain within their first year after discharge from the PPRC.
• Five-year outcomes: Our PPRC participants do well in the long-term. For example, 80 percent of PPRC graduates reported having no pain-related functional difficulties five or more years after PPRC treatment.

Much like the interdisciplinary approach that we take to treatment, PPRC staff members collaborate on many of the research projects described below:

• Medicine is conducting an ongoing investigation on the overall cost efficiency of management of chronic pain disorders in children at the PPRC. In addition, the Pain and Analgesia Imaging Neuroscience Group is conducting translational research for defining pain pathways, networks, and mechanisms of pediatric chronic pain disorders with the use of fMRI and Quantitative Sensory Testing paradigms. There are several ongoing National Institutes of Health-funded studies underway focusing on migraine headaches, complex regional pain syndrome, and post-concussive headaches.
• Psychology research generally focuses on assessing the effectiveness of the PPRC’s intensive, interdisciplinary approach to pain treatment. More specifically, we are interested in understanding how the PPRC affects participant’s pain, functioning, and psychological well-being in the short and long term. We also aim to understand factors that may affect participant and family treatment response and treatment length in order to inform continued program development and improvement. We recently received a grant to develop and evaluate a telehealth intervention that helps prepare youth and families for their PPRC admission.
• Physical therapy research is currently focused on examining the effectiveness of physical therapy treatments provided at the PPRC through measure validation and outcome assessment for participants with chronic pain. Ongoing research within the pediatric chronic pain population includes assessing the clinical utility of physical fitness tests, exploring the role of pain interference in physical activity, examining measures of central sensitization, and exploring barriers to treatment success and adherence.
• Occupational therapy research is focused on measure validation and outcomes studies to examine the effectiveness of occupational therapy treatments provided at the PPRC. Ongoing research includes developing and validating a measure to assess photophobia and phonophobia symptoms in youth with chronic headaches, exploring the role that virtual and augmented reality interventions can play in the PPRC setting, examining chronic school avoidance and interventions that support a successful school reintegration after the PPRC, and developing a measure to assess allodynia symptoms amongst PPRC participants with CRPS.
• Recreational therapy research is currently focused on and collecting data about peer relationships, attitudes towards recreation, and current time usage patterns for preferred activities among PPRC patients. There is very little research about the effect of recreational therapy on outcomes among youth with chronic pain, and this is innovative work.
• Music therapy research currently involves collecting data on the frequency PPRC patients are using music for relaxation, coping, and distraction. We also plan to explore the effectiveness of songwriting on self esteem with the pediatric chronic pain population, as well as the effects of individual/group music therapy in a pediatric day treatment rehabilitative program. There is very limited research on music therapy and pediatric chronic pain, so research supporting the effects of MT on PPRC outcomes is important.