Body Functions of Individuals with Poly-trauma and Chronic Pain
American Journal of Physical Medicine and Rehabilitation
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Disclosures: Armando S. Miciano, Jr., MD: No financial relationships or conflicts of interest. Objective : 1) Quantify body function (BF) change(s) in individuals with poly-trauma and chronic pain (PtP); and, 2) Determine inter-relationships between BF and other WHO-ICF disablement components: activity limitation (AL) and participation restrictions (PR) in PtP. Design: Retrospective cross-sectional study Setting : PMR clinic. Participants : 25 subjects (age range 22 – 84) found to have poly-trauma (defined as >/=2 injuries to multiple body parts/organ systems) and chronic pain (defined as >6 months). Interventions: n/a. Main Outcome Measures: PROMIS-29v2.0-Anxiety (AN), Depression (DE), Fatigue (FA) and Sleep Disturbance (SL) sub-scales assessed BF. PROMIS-29v2.0-physical-function (PF) described AL; and, PROMIS-29v2.0-satisfaction-with-social-role (SSR) and Pain Interference (PInt) quantified PR. Results: Mean (SD) BF T-scores were: AN 62.66(11.2); DE 59.74(10.5); FA 60.20(9.3); SL 65.35(8.9); F 36.85(7.96); SSR 37.66(7.67); and, PInt 64.05(7.81). Compared to males, females had significantly higher DE and AN scores, not correlated with other variables for females. For males, AN significantly correlated with DE, FA, and SL; and, DE correlated with SL. PF negatively correlated with SL (r=-0.44;p=0.03) and positively correlated with SSR (r=0.51;p=0.009). PInt was positively associated with FA (r=0.664;p=0.00) and negatively correlated with SSR (r=-0.54;p=0.005). Conclusions: PtP individuals tend to have moderate levels of AN, DE, FA, and SD, while having severe AL and severe PR. Their sleep disturbances had a statistically significant association with activity limitations, while their fatigue had a positive association with participation restrictions. The study supports the role of patient reported outcomes (PRO) in quantifying body function changes (i.e. fatigue, sleep disturbance, anxiety/depression) and thereby also addressing home and community reintegration efforts. Further research should be on inter-relationships of WHO-ICF components in other musculoskeletal syndromes, such as fall injuries. Level of Evidence: Level II
Body functions; Chronic pain; Poly-trauma; Activity limitation; Participation restrictions
Medicine and Health Sciences | Rehabilitation and Therapy
Miciano, A. S.,
Cross, C. L.
Body Functions of Individuals with Poly-trauma and Chronic Pain.
American Journal of Physical Medicine and Rehabilitation, 12