Use of Complementary and Integrative Health Therapies Before Intensive Functional Restoration in Active Duty Service Members with Chronic Pain
| Autor: | Tyler Snow, Honor McQuinn, Alana Steffen, Ardith Z. Doorenbos, Diane M Flynn, Larisa A. Burke, Alexandra Fairchok |
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| Rok vydání: | 2021 |
| Předmět: |
Complementary Therapies
Male medicine.medical_specialty Active duty media_common.quotation_subject Population Anger Intervention (counseling) medicine Humans Pain Management education Depression (differential diagnoses) media_common education.field_of_study business.industry Chronic pain General Medicine medicine.disease Clinical trial Military Personnel Anesthesiology and Pain Medicine Physical therapy Neurology (clinical) Chronic Pain business Psychosocial |
| Zdroj: | Pain Medicine. 23:844-856 |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pnab326 |
| Popis: | Objective Psychosocial factors are known to predict chronic pain, and the use of complementary and integrative health (CIH) therapies to address pain is emerging among the military population. However, conflicting results on pain outcomes warrant additional research. This study aimed to 1) evaluate the benefit of adding a CIH pain management program to standard rehabilitative care (SRC), as compared with SRC alone, as a precursor to an intensive functional restoration (FR) program; 2) identify factors that predict improvement in pain outcomes after treatment; and 3) determine the proportion of participants who experience a clinically meaningful response. Design Pragmatic randomized controlled clinical trial. Participants were randomized to a 3-week course of either SRC alone or SRC+CIH (stage 1), followed by a 3- to 6-week course of FR (stage 2). Subjects Active duty service members with chronic pain. Methods Participants completed either SRC alone or SRC+CIH (stage 1), followed by a course of FR (stage 2). Patient-reported and provider-determined outcomes were collected at baseline, after stage 1, and after stage 2. A covariance pattern model with an unstructured residual covariance matrix was used to compare treatment arms while accounting for dependency due to repeated measurements. Results A total of 210 service members participated. Most were in the Army (82%) and were male (84%). Participants randomized to the SRC+CIH intervention had greater improvement in the pain impact score than did those in the SRC-alone group. Predictors of outcomes were baseline impact score, anger, depression, and educational status. Conclusions This study found that military service members with the highest pain impact benefit the most from interdisciplinary pain care. |
| Databáze: | OpenAIRE |
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