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  4. A six-participant pilot single-subject study of an individualized pain management program for people with spinal cord injury

A six-participant pilot single-subject study of an individualized pain management program for people with spinal cord injury

Spinal Cord Series and Cases, 2023 · DOI: https://doi.org/10.1038/s41394-022-00557-z · Published: January 1, 2023

Spinal Cord InjuryPain ManagementRehabilitation

Simple Explanation

This study explores a new pain management program for people with spinal cord injuries. The program is designed to meet each person's specific needs and includes various therapies like cognitive behavioral therapy and physical exercise. Six participants completed a program consisting of an intensive ten-week intervention followed by a six-month consolidation phase. Researchers tracked their progress using measures of occupational performance, pain self-efficacy, pain intensity, anxiety, and depression. The study found that most participants experienced improvements in their ability to perform daily tasks, manage pain, and reduce anxiety. These results suggest that personalized pain management programs can be helpful for individuals with spinal cord injuries.

Study Duration
36 weeks
Participants
Six persons having sustained a spinal cord injury and experiencing chronic pain
Evidence Level
Single-subject repeated measures design

Key Findings

  • 1
    For five out of the six participants, a majority of outcomes improved during either of the intervention phases or both.
  • 2
    Improvements in occupational performance were clinically significant for three participants.
  • 3
    Pain interference and anxiety improved significantly in five participants, while pain self-efficacy and depressive symptoms improved in four participants.

Research Summary

This pilot study assessed the impact of a novel pain self-management program (PSMP) for persons living with chronic SCI pain, inspired by previously conducted programs, but with a specific focus on individualization, and weaning intervention more gradually in order to help maintain gains over time. The interventions included CBT, and physical and pharmacological interventions. The CBT sessions were made up of psychoeducation, self-management skills development and training, training for the management of pain peaks and relapse prevention. Findings suggest that the pain self-management program could be effective in improving pain interference in daily life, pain self-efficacy, as well as mood in people living with SCI and chronic pain.

Practical Implications

Personalized Pain Management

Tailoring pain management programs to individual needs may lead to better outcomes for people with SCI.

Interdisciplinary Approach

Combining cognitive behavioral therapy, physical therapy, and medication adjustments can address multiple aspects of chronic pain.

Extended Consolidation Phase

A gradual reduction in intervention intensity and ongoing support may help maintain improvements over time.

Study Limitations

  • 1
    Small sample size limits generalizability
  • 2
    Missing baseline data for some participants
  • 3
    Single-subject design does not allow for strong causal inferences

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