Citation

Ullrich PM, Smith BM, Poggensee L, Evans CT, Stroupe KT, Weaver FM, Burns SP. Arch. Phys. Med. Rehabil. 2013; 94(1): 80-85.

Affiliation

Department of Veterans Affairs, Spinal Cord Injury and Disorders Services, VA Puget Sound Healthcare System, Seattle, Wa; Department of Rehabilitation Medicine, University of Washington, Seattle, Wa.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.07.018

PMID

22864017

Abstract

OBJECTIVE: Tp examine the frequency of PTSD symptoms and pain, and how PTSD symptoms were associated with pain severity ratings and the longitudinal course of pain during inpatient rehabilitation for spinal cord injury (SCI) among veterans of the Operation Enduring Freedom/Operating Iraqi Freedom (OEF/OIF) conflicts. DESIGN: Longitudinal analysis of data gathered from electronic medical records. SETTING: SCI specialty care centers within the Department of Veterans Affairs (VA). PARTICIPANTS: 87 veterans of the OEF/OIF conflicts who received inpatient rehabilitation for SCI/D at VA SCI centers between May 2003 and October 2009. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): PTSD screening at start of rehabilitation and pain numeric rating scale measurements completed throughout rehabilitation. Cut-scores were used to categorize participants into one of four groups based on scores at the start of rehabilitation: Pain and PTSD, Pain Alone, PTSD Alone, Neither Condition. RESULTS: Co-morbid pain and PTSD symptoms were more common than either condition alone, and nearly as common as not having either condition. Participants with pain at start of rehabilitation (Pain and PTSD, Pain Alone groups) showed declines in pain ratings over the course of rehabilitation. In contrast, participants in the PTSD Alone group showed increasing pain over the course of rehabilitation. CONCLUSION(S): Pain and PTSD symptoms may be more likely to manifest as comorbidities than as isolated conditions during inpatient rehabilitation. Assessment routines and care plans should be prepared with comorbidities as a foremost concern. It is advisable to screen for pain and PTSD at multiple time-points during inpatient rehabilitation to detect new or emerging concerns.

Language: en