An internet-delivered cognitive behavioural therapy pain management programme for spinal cord injury pain: A randomized controlled trial

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Title: An internet-delivered cognitive behavioural therapy pain management programme for spinal cord injury pain: A randomized controlled trial
Authors: Burke, DearbhlaLennon, OliveBlake, CatherineFullen, Brona M.
Permanent link: http://hdl.handle.net/10197/11376
Date: Aug-2019
Online since: 2020-05-08T11:16:39Z
Abstract: Background: Chronic pain is common after spinal cord injury (SCI) and dedicated SCI cognitive behavioural therapy pain management programmes (CBT-PMPs) have a growing evidence base to support their uptake clinically. The development of internet-delivered treatment options may overcome barriers to the access and uptake of centre-based programmes. This study examines such an approach on quality of lie (QoL), pain, mood and sleep. Methods: Adults with SCI pain (>3 months) were recruited and randomly assigned to the intervention or control group. The intervention comprised a six module CBT-PMP delivered once weekly. A blinded assessor determined changes in self-reported outcome measures post-intervention and at 3 months. Linear mixed models and effect sizes based on changes between groups were reported. Significance was set p < 0.05. Results: The recruitment rate was 32% (intervention n = 35, control n = 34), and the drop-out rate at 3 months was 26%. On average, participants accessed three (SD 2.1) of six modules. While no difference in QoL was reported, a significant group*time interaction was found for NRS of current pain (χ2 = 8.22, p = 0.016), worst pain (χ2 = 11.20, p = 0.004), and Brief Pain Inventory (interference) (χ2 = 6.924, p = 0.031). Moderate to large effect sizes favouring the intervention were demonstrated at each time point for the pain metrics (Cohen's d: 0.38–0.84). At 3-month follow-up, 48% of the intervention group rated themselves improved or very much improved (p < 0.05). Conclusions: This study demonstrates the potential of an internet-delivered SCI specific CBT-PMP in reporting significant statistical and clinical benefit in pain intensity and interference. Strategies to improve engagement are needed.
metadata.dc.description.othersponsorship: The Irish Society of Chartered Physiotherapists Eastern Branch Research Bursary 2016
Health Informatics Society of Ireland Research Bursary 2016
Type of material: Journal Article
Publisher: Wiley
Journal: European Journal of Pain
Volume: 23
Issue: 7
Start page: 1264
End page: 1282
Copyright (published version): 2019 European Pain Federation
Keywords: Clinical researchSpinal cord injuryClinical trials and supportive activitiesMind and bodyChronic pain conditionsPain researchNeurodegenerativeNeurosciencesHead and spine injuryAdverse effectsPsychological and behaviouralNeurological
DOI: 10.1002/ejp.1402
Language: en
Status of Item: Peer reviewed
Appears in Collections:Public Health, Physiotherapy and Sports Science Research Collection

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