What does it take? Comparing intensive rehabilitation to outpatient treatment for children with significant pain-related disability
Open accessAbstract
OBJECTIVES: This study compared outcomes between day hospital pain rehabilitation patients and patients engaged in outpatient multidisciplinary pain treatment. METHODS: This study included 100 children who presented for an initial tertiary care pain clinic evaluation. 50 patients enrolled in intensive day hospital pain rehabilitation and 50 patients pursued outpatient multidisciplinary treatment. Across 2 time points, children completed measures of functional disability, pain-related fear, and readiness to change and parents completed measures of pain-related fear and readiness to change. RESULTS: Across both treatment modalities, patients and parents reported improvements. Patients enrolled in intensive pain rehabilitation had significantly larger improvements in functional disability, pain-related fear, and readiness to change. Parents of day hospital patients reported larger declines in child pain-related fear and increased readiness to change compared with their outpatient counterparts. Discussion For patients with high levels of pain-related disability and distress, intensive pain rehabilitation provides rapid, dramatic improvements in functioning.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Under the primary power calculation assumptions (improvement 21.5 in GET Living and 5 in MPM, difference 16.5, SD 18.8), the trial will have 91% power with 58 participants (29 per arm) at end of study.
“In our primary power calculation, we assumed that the improvement in adolescent pain-related fear avoidance at 3-months would be 21.5 in Get Living and 5 in MPM, a difference of 16.5, with a standard deviation for change of 18.8 derived from our prior work [65]. Under this scenario we will have power of 91% with 58 (29 in each arm) at end of study.”
From Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design (2019) · cites this paper as [65]
Table III (Within-group Analyses, p. 6) reports a reduction in fear-of-pain scores from 48.0 to 25.6 in the intensive-rehabilitation group, supporting the use of this prior work to inform an improvement assumption. It does not report an SD of 18.8 for change, and its comparison group’s reported means imply an improvement of 1.6 rather than 5. The 91% power calculation is the citing authors’ own calculation, not a result attributed to this source. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPatients enrolled in the intensive day rehabilitation program had significantly larger improvements in functional disability, pain-related fear, and willingness to adopt a self-management approach to treating pain compared to standard outpatient treatments.
“While there were improvements noted across both treatment groups, patients enrolled in the intensive day rehabilitation program had significantly larger improvements in functional disability, pain-related fear, and willingness to adopt a self-management approach to treating pain [117].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [117]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
The Transtheoretical Model of Health Behavior Change.
Prochaska, J. O., & Velicer, W. F. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.38 · Cited by 7,782 · see citing works
The biopsychosocial approach to chronic pain: Scientific advances and future directions.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.4.581 · Cited by 3,392 · see citing works
The epidemiology of chronic pain in children and adolescents revisited: A systematic review
King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011) · Pain · doi:10.1016/j.pain.2011.07.016 · Cited by 1,688 · see citing works
Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.
Flor, H., Fydrich, T., & Turk, D. C. (1992) · Pain · doi:10.1016/0304-3959(92)90145-2 · Cited by 1,227 · see citing works
The functional disability inventory: Measuring a neglected dimension of child health status
Walker, L. S., & Greene, J. W. (1991) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/16.1.39 · Cited by 881 · see citing works
McGrath, P. J., Walco, G. A., Turk, D. C., Dworkin, R. H., Brown, M. T., Davidson, K., Eccleston, C., Finley, G. A., Goldschneider, K., Haverkos, L., et al. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2008.04.007 · Cited by 851 · see citing works
Pain Among Children and Adolescents: Restrictions in Daily Living and Triggering Factors
Roth-Isigkeit, A., Thyen, U., Stöven, H., Schwarzenberger, J. C., & Schmucker, P. (2005) · PEDIATRICS · doi:10.1542/peds.2004-0682 · Cited by 818 · see citing works
von Baeyer, C. L., Spagrud, L. J., McCormick, J. C., Choo, E., Neville, K., & Connelly, M. A. (2009) · Pain · doi:10.1016/j.pain.2009.03.002 · Cited by 575 · see citing works
Wetherell, J. L., Afari, N., Rutledge, T., Sorrell, J. T., Stoddard, J. A., Petkus, A. J., Solomon, B. C., Lehman, D. H., Liu, L., Lang, A. J., et al. (2011) · PAIN · doi:10.1016/j.pain.2011.05.016 · Cited by 508 · cited 1× · see citing works
“Psychological therapy follows a cognitivebehavioral model, an effective approach for pain rehabilitation (Wetherell et al., 2011).”
BackgroundClaar, R. L., & Walker, L. S. (2006) · Pain · doi:10.1016/j.pain.2005.12.002 · Cited by 421 · see citing works
Eccleston, C., Crombez, G., Scotford, A., Clinch, J., & Connell, H. (2004) · Pain · doi:10.1016/j.pain.2003.11.008 · Cited by 418 · see citing works
Forgeron, P. A., King, S., Stinson, J. N., McGrath, P. J., MacDonald, A. J., & Chambers, C. T. (2010) · Pain Research and Management · doi:10.1155/2010/820407 · Cited by 381 · see citing works
Depression and functional disability in chronic pediatric pain
Kashikar-Zuck, S., Goldschneider, K. R., Powers, S. W., Vaught, M. H., & Hershey, A. D. (2001) · The Clinical Journal of Pain · doi:10.1097/00002508-200112000-00009 · Cited by 357 · see citing works
Sherry, D. D., Wallace, C. A., Kelley, C. A., Kidder, M., & Sapp, L. R. (1999) · Clinical Journal of Pain · doi:10.1097/00002508-199909000-00009 · Cited by 345 · see citing works
Kashikar-Zuck, S., Flowers, S. R., Claar, R. L., Guite, J. W., Logan, D. E., Lynch-Jordan, A. M., Palermo, T. M., & Wilson, A. C. (2011) · Pain · doi:10.1016/j.pain.2011.02.050 · Cited by 337 · see citing works
Self-citationEccleston, C. (2003) · Archives of Disease in Childhood · doi:10.1136/adc.88.10.881 · Cited by 276 · see citing works
Pfingsten (1997) · doi:10.1016/s0304-3959(97)00038-9 · Cited by 272 · see citing works
Gauntlett-Gilbert, J., & Eccleston, C. (2007) · Pain · doi:10.1016/j.pain.2006.12.021 · Cited by 236 · see citing works
Simons, L. E., Sieberg, C. B., Carpino, E., Logan, D., & Berde, C. (2011) · The Journal of Pain · doi:10.1016/j.jpain.2010.12.008 · Cited by 235 · see citing works
Self-citationCaes, L., Vervoort, T., Eccleston, C., Vandenhende, M., & Goubert, L. (2010) · Pain · doi:10.1016/j.pain.2010.10.037 · Cited by 178 · see citing works
Too sick for school? Parent influences on school functioning among children with chronic pain
Logan, D. E., Simons, L. E., & Carpino, E. A. (2012) · Pain · doi:10.1016/j.pain.2011.11.004 · Cited by 174 · see citing works
Self-citationLogan, D. E., Carpino, E. A., Chiang, G., Condon, M., Firn, E., Gaughan, V. J., Hogan, M., Leslie, D. S., Olson, K., Sager, S., et al. (2012) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182457619 · Cited by 152 · see citing works
Self-citationMartin, A. L., McGrath, P. A., Brown, S. C., & Katz, J. D. (2007) · Pain Research and Management · doi:10.1155/2007/897395 · Cited by 137 · see citing works
Sieberg, C. B., Williams, S., & Simons, L. E. (2011) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsr043 · Cited by 128 · see citing works
Simons, L. E., Logan, D. E., Chastain, L., & Cerullo, M. (2010) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181cf59fb · Cited by 127 · see citing works
Self-citationLogan, D. E., Simons, L. E., & Kaczynski, K. J. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn143 · Cited by 123 · see citing works
Self-citationThe Impact of Adolescent Chronic Pain on Functioning: Disentangling the Complex Role of Anxiety
Cohen, L. L., Vowles, K. E., & Eccleston, C. (2009) · Journal of Pain · doi:10.1016/j.jpain.2009.09.009 · Cited by 105 · see citing works
Children’s catastrophic thinking about their pain predicts pain and disability 6 months later
Vervoort, T., Eccleston, C., Goubert, L., Buysse, A., & Crombez, G. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2009.03.001 · Cited by 95 · see citing works
Maynard, C., Amari, A., Wieczorek, B., Christensen, J. R., & Slifer, K. J. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp038 · Cited by 95 · see citing works
Jensen, M. P., Nielson, W. R., Turner, J. A., Romano, J. M., & Hill, M. L. (2004) · Pain · doi:10.1016/j.pain.2004.06.003 · Cited by 83 · see citing works
Hechler, T., Blankenburg, M. R., Dobe, M., Kosfelder, J., Hübner, B., & Zernikow, B. (2009) · European Journal of Pain · doi:10.1016/j.ejpain.2009.03.002 · Cited by 78 · see citing works
Pain coping profiles in adolescents with chronic pain
Claar, R. L., Baber, K. F., Simons, L. E., Logan, D. E., & Walker, L. S. (2008) · Pain · doi:10.1016/j.pain.2008.09.007 · Cited by 76 · see citing works
Self-citationLogan, D. E., Conroy, C., Sieberg, C. B., & Simons, L. E. (2012) · Pain · doi:10.1016/j.pain.2012.05.027 · Cited by 61 · see citing works
Self-citationAnxiety, Coping, and Disability: A Test of Mediation in a Pediatric Chronic Pain Sample
Kaczynski, K. J., Simons, L. E., & Claar, R. L. (2011) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsr024 · Cited by 61 · see citing works
Self-citationGuite, J. W., Logan, D. E., Simons, L. E., Blood, E., & Kerns, R. D. (2011) · Pain · doi:10.1016/j.pain.2011.06.019 · Cited by 51 · see citing works
Self-citationMelchert, T. P. (2011) · Elsevier eBooks · doi:10.1016/b978-0-12-385079-9.00005-9 · Cited by 14 · see citing works
Clinch, J. (2008) · CRC Press eBooks · doi:10.3109/9781420021103-10 · Cited by 3 · see citing works
Hooten, W. M. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.00872.x · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Systematic review on intensive interdisciplinary pain treatment of children with chronic pain
Hechler, T., Kanstrup, M., Holley, A. L., Simons, L. E., Wicksell, R., Hirschfeld, G., & Zernikow, B. (2015) · Pediatrics · doi:10.1542/peds.2014-3319 · Cited by 230 · see citing works
Self-citationPielech, M., Ryan, M., Logan, D., Kaczynski, K., White, M. T., & Simons, L. E. (2014) · Pain · doi:10.1016/j.pain.2014.08.035 · Cited by 185 · see citing works
Self-citationBest-evidence for the rehabilitation of chronic pain part 1: Pediatric pain
Harrison, L. E., Pate, J. W., Richardson, P. A., Ickmans, K., Wicksell, R. K., & Simons, L. E. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091267 · Cited by 140 · see citing works
Self-citationPediatric pain management: The multidisciplinary approach
Odell, S., & Logan, D. (2013) · Journal of Pain Research · doi:10.2147/jpr.s37434 · Cited by 126 · see citing works
“In a study by Simons et al, researchers examined 100 matched participants, 50 of whom were enrolled in an intensive day hospital pain rehabilitation program and 50 of whom pursued standard outpatient treatments following initial multidisciplinary evaluation of their pain problem.(24) Intensive intervention included da…”
BackgroundSelf-citationWren, A., Ross, A., D’Souza, G., Almgren, C., Feinstein, A., Marshall, A., & Golianu, B. (2019) · Children · doi:10.3390/children6020033 · Cited by 115 · see citing works
Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints
Simons, L. E., Smith, A., Ibagon, C., Coakley, R., Logan, D. E., Schechter, N., Borsook, D., & Hill, J. C. (2015) · Pain · doi:10.1097/j.pain.0000000000000199 · Cited by 89 · see citing works
Simons, L. E., Vlaeyen, J. W. S., Declercq, L., Smith, A. M., Beebe, J., Hogan, M., Li, E., Kronman, C. A., Mahmud, F., Corey, J. R., et al. (2020) · Pain · doi:10.1097/j.pain.0000000000001735 · Cited by 56 · see citing works
Self-citationRandall, E. T., Smith, K. R., Conroy, C., Smith, A. M., Sethna, N., & Logan, D. E. (2018) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000616 · Cited by 37 · see citing works
Self-citationFlack, F., Stahlschmidt, L., Dobe, M., Hirschfeld, G., Strasser, A., Michalak, J., Wager, J., & Zernikow, B. (2018) · Pain · doi:10.1097/j.pain.0000000000001321 · Cited by 28 · see citing works
Simons, L. E., Harrison, L. E., O'Brien, S. F., Heirich, M. S., Loecher, N., Boothroyd, D. B., Vlaeyen, J. W. S., Wicksell, R. K., Schofield, D., Hood, K. K., et al. (2019) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2019.100448 · Cited by 24 · see citing works
Self-citationDekker, C., Goossens, M. E. J. B., Bastiaenen, C. H. G., & Verbunt, J. A. M. C. F. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-1178-5 · Cited by 23 · see citing works
Simons, L. E., Harrison, L. E., Boothroyd, D. B., Parvathinathan, G., Van Orden, A. R., O'Brien, S. F., Schofield, D., Kraindler, J., Shrestha, R., Vlaeyen, J. W. S., et al. (2024) · Pain · doi:10.1097/j.pain.0000000000003010 · Cited by 19 · see citing works
Self-citationCeledon, X., Amari, A., Ward, C. M., Prestwich, S., & Slifer, K. J. (2014) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-014-0047-0 · Cited by 17 · see citing works
Holm, S., Ljungman, G., Åsenlöf, P., Linton, S. J., & Söderlund, A. (2016) · European Journal of Pain · doi:10.1002/ejp.780 · Cited by 15 · see citing works
Weiss, K. E., Junghans-Rutelonis, A. N., Aaron, R. V., Harbeck-Weber, C., McTate, E., Luedtke, C., & Bruce, B. K. (2019) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000737 · Cited by 14 · see citing works
Guite, J. W., Russell, B. S., Pantaleao, A., Thompson Heller, A., Donohue, E., Galica, V., Zempsky, W. T., & Ohannessian, C. M. (2018) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000244 · Cited by 13 · see citing works
- Authors
- Simons, L. E., Sieberg, C. B., Pielech, M., Conroy, C., & Logan, D. E.
- Affiliations
- Boston Children's Hospital (US)
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-10-26
- Volume
- 38
- Issue
- 2
- Pages
- 213-223
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- PMC
- PMC3695659
- OpenAlex
- W2097768836
- Cited by
- 94
- References
- 41
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 5 · 2022: 10 · 2021: 4 · 2020: 10 · 2019: 11 · 2018: 5 · 2017: 8 · 2016: 6 · 2015: 8 · 2014: 7 · 2013: 6
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD067202, HD067202)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pediatric chronic pain, pain-related disability, intensive rehabilitation, fear of pain, readiness to change, functional disability, parent-reported outcomes, treatment comparison
- MeSH terms
- Adolescent, Ambulatory Care, Child, Day Care, Medical, Fear, Female, Persons with Disabilities, Disabled Persons, Humans, Male, Occupational Therapy, Outpatients, Pain, Severity of Illness Index, Treatment Outcome, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
