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Article

Functional Disability in Adolescents with Chronic Pain: Comparing an Interdisciplinary Exposure Program to Usual Care

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Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
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Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands
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Department of Clinical Psychological Sciences, Experimental Psychology, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
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Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands
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Rijndam Rehabilitation, Westersingel 300, 3015 LJ Rotterdam, The Netherlands
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Adelante Center of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands
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Author to whom correspondence should be addressed.
Children 2020, 7(12), 288; https://doi.org/10.3390/children7120288
Received: 30 October 2020 / Revised: 4 December 2020 / Accepted: 7 December 2020 / Published: 11 December 2020
(This article belongs to the Special Issue Pediatric Pain Management)
(1) Background: Chronic musculoskeletal pain (CMP) in adolescents can negatively affect physical, psychological, and social functioning, resulting in functional disability. This randomized controlled trial (RCT) aimed to evaluate the effectiveness of an outpatient rehabilitation program based on graded exposure in vivo (EP) compared with care as usual (CAU: interdisciplinary outpatient rehabilitation care). Both EP and CAU aim to improve functional ability in adolescents with CMP. (2) Methods: Pragmatic multicenter RCT with 12-month follow-up. Adolescents (12–21 years) with CMP were invited to participate. Primary outcome: functional disability; secondary outcomes: perceived harmfulness; pain catastrophizing; pain intensity. Data analysis: intention-to-treat linear mixed model. (3) Results: Sixty adolescents (mean 16 years) were randomized; data for 53 were analyzed. Adolescents in EP showed relevant and significant decreases in functional disability (estimated mean difference at least −8.81, p ≤ 0.01) compared with CAU at all times. Significant differences in favor of EP were found for perceived harmfulness at all times (p ≤ 0.002), for pain catastrophizing at 2 months (p = 0.039) and for pain intensity at 4 and 10 months (p ≤ 0.028). (4) Conclusion: EP leads to a significant and clinically relevant decrease in functional disability compared with usual care. View Full-Text
Keywords: chronic musculoskeletal pain; adolescents; functional disability; multidisciplinary rehabilitation chronic musculoskeletal pain; adolescents; functional disability; multidisciplinary rehabilitation
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MDPI and ACS Style

Dekker, C.; Goossens, M.; Winkens, B.; Remerie, S.; Bastiaenen, C.; Verbunt, J. Functional Disability in Adolescents with Chronic Pain: Comparing an Interdisciplinary Exposure Program to Usual Care. Children 2020, 7, 288. https://doi.org/10.3390/children7120288

AMA Style

Dekker C, Goossens M, Winkens B, Remerie S, Bastiaenen C, Verbunt J. Functional Disability in Adolescents with Chronic Pain: Comparing an Interdisciplinary Exposure Program to Usual Care. Children. 2020; 7(12):288. https://doi.org/10.3390/children7120288

Chicago/Turabian Style

Dekker, Carolien, Mariëlle Goossens, Bjorn Winkens, Silvia Remerie, Caroline Bastiaenen, and Jeanine Verbunt. 2020. "Functional Disability in Adolescents with Chronic Pain: Comparing an Interdisciplinary Exposure Program to Usual Care" Children 7, no. 12: 288. https://doi.org/10.3390/children7120288

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