Case report

Improvement in montreal cognitive assessment score following three-week pain rehabilitation program

  • Received: 10 June 2019 Accepted: 26 July 2019 Published: 15 August 2019
  • Aim: To demonstrate improvement in cognitive function following a 3-week Intensive Interdisciplinary Pain Rehabilitation Program. Methods: The Montreal Cognitive Assessment (MoCA) was performed at initial evaluation and on dismissal day of the program. Results: The patient had chronic, non-cancer lower back pain for over 15 years for which patient had myriad of treatments. Patient was directed to Intensive Interdisciplinary Pain Rehabilitation Program as a last resort treatment. The patient had moderate cognitive impairment when he joined the program (MoCA score of 17/30) that dramatically improved into the normal cognitive range by the end of the program (MoCA score of 26/30). Conclusions: Improvement in MoCA score was demonstrated after completion of the Intensive Interdisciplinary Pain Rehabilitation Program, which is the first demonstrated case.

    Citation: Joann E. Bolton, Elke Lacayo, Svetlana Kurklinsky, Christopher D. Sletten. Improvement in montreal cognitive assessment score following three-week pain rehabilitation program[J]. AIMS Medical Science, 2019, 6(3): 201-209. doi: 10.3934/medsci.2019.3.201

    Related Papers:

  • Aim: To demonstrate improvement in cognitive function following a 3-week Intensive Interdisciplinary Pain Rehabilitation Program. Methods: The Montreal Cognitive Assessment (MoCA) was performed at initial evaluation and on dismissal day of the program. Results: The patient had chronic, non-cancer lower back pain for over 15 years for which patient had myriad of treatments. Patient was directed to Intensive Interdisciplinary Pain Rehabilitation Program as a last resort treatment. The patient had moderate cognitive impairment when he joined the program (MoCA score of 17/30) that dramatically improved into the normal cognitive range by the end of the program (MoCA score of 26/30). Conclusions: Improvement in MoCA score was demonstrated after completion of the Intensive Interdisciplinary Pain Rehabilitation Program, which is the first demonstrated case.


    加载中


    Conflict of interest



    The authors declare no conflict of interest.

    [1] Steglitz J, Buscemi J, Ferguson MJ (2012) The future of pain research, education, and treatment: A summary of the IOM report "Relieving pain in America: A blueprint for transforming prevention, care, education, and research". Transl Behav Med 2: 6–8. doi: 10.1007/s13142-012-0110-2
    [2] Latina R, De Marinis MG, Giordano F, et al. (2019) Epidemiology of chronic pain in the Latium region, Italy: A cross-sectional study on the clinical characteristics of patients attending pain clinics. Pain Manag Nurs 20: 373–281. doi: 10.1016/j.pmn.2019.01.005
    [3] Guy GP, Zhang K, Bohm MK, et al. (2017) Vital signs: Changes in opioid prescribing in the United States, 2006–2015. MMWR Morb Mortal Wkly Rep 66: 697–704. doi: 10.15585/mmwr.mm6626a4
    [4] Lee M, Silverman SM, Hansen H, et al. (2011) A comprehensive review of opioid-induced hyperalgesia. Pain Physician 14: 145–161.
    [5] Chu LF, Angst MS, Clark D (2008) Opioid-induced hyperalgesia in humans: Molecular mechanisms and clinical considerations. Clin J Pain 24: 479–496. doi: 10.1097/AJP.0b013e31816b2f43
    [6] Volkow ND, McLellan TA (2011) Curtailing diversion and abuse of opioid analgesics without jeopardizing pain treatment. JAMA 305: 1346–1347. doi: 10.1001/jama.2011.369
    [7] Von Korff M, Kolodny A, Deyo RA, et al. (2011) Long-term opioid therapy reconsidered. Ann Intern Med 155: 325–328. doi: 10.7326/0003-4819-155-5-201109060-00011
    [8] Sullivan MD, Von Korff M, Banta-Green C, et al. (2010) Problems and concerns of patients receiving chronic opioid therapy for chronic non-cancer pain. Pain 149: 345–353. doi: 10.1016/j.pain.2010.02.037
    [9] CDC (2017) Wide-ranging online data for epidemiologic research. Atlanta, GA: CDC, National Center for Health Statistics.
    [10] Dowell D, Haegerich TM, Chou R (2016) CDC guideline for prescribing opioids for chronic pain-United States, 2016. MMWR Recommendations and reports: Morbidity and mortality weekly report Recommendations and reports 65: 1–49.
    [11] Vivolo-Kantor AM, Seth PR, Gladden M, et al. (2018) Vital signs: Trends in emergency department visits for suspected opioid overdoses-United States, July 2016–September 2017. MMWR Morb Mortal Wkly Rep 67: 279–285. doi: 10.15585/mmwr.mm6709e1
    [12] Goodman CW, Brett AS (2017) Gabapentin and pregabalin for pain-is increased prescribing a cause for concern? New Engl J Med 377: 411–414. doi: 10.1056/NEJMp1704633
    [13] Stanos S (2012) Focused review of interdisciplinary pain rehabilitation programs for chronic pain management. Curr Pain Headache R 16: 147–152. doi: 10.1007/s11916-012-0252-4
    [14] Schatman ME (2015) The American chronic pain crisis and the media: about time to get it right? J Pain Res 8: 885–887.
    [15] Gatchel RJ, McGeary DD, McGeary CA, et al. (2014) Interdisciplinary chronic pain management: past, present, and future. Am Psychol 69: 119–130. doi: 10.1037/a0035514
    [16] Ferreira KS, Oliver GZ, Thomaz DC, et al. (2016) Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use. Arq Neuro-psiquiat 74: 361–366. doi: 10.1590/0004-282X20160071
    [17] Sjogren P, Christrup LL, Petersen MA, et al. (2005) Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre. Eur J Pain 9: 453–462. doi: 10.1016/j.ejpain.2004.10.005
    [18] Nadar MS, Jasem Z, Manee FS (2016) The Cognitive Functions in Adults with Chronic Pain: A Comparative Study. Pain Res Manag 2016: 5719380.
    [19] Moore DJ, Keogh E, Eccleston C (2012) The interruptive effect of pain on attention. Q J Exp Psychol 65: 565–586. doi: 10.1080/17470218.2011.626865
    [20] Marco CA, Mann D, Rasp J, et al. (2018) Effects of opioid medications on cognitive skills among Emergency Department patients. Am J Emerg Med 36: 1009–1013. doi: 10.1016/j.ajem.2017.11.017
    [21] Copersino ML, Schretlen DJ, Fitzmaurice GM, et al. (2012) Effects of cognitive impairment on substance abuse treatment attendance: predictive validation of a brief cognitive screening measure. Am J Drug Alcoh Abuse 38: 246–250. doi: 10.3109/00952990.2012.670866
    [22] Snyder D (1992) Pain: Clinical manual for nursing practice. Cancer Nurs 15: 211–212.
    [23] Farrar JT, Young JP, LaMoreaux L, et al. (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94: 149–158. doi: 10.1016/S0304-3959(01)00349-9
    [24] Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30: 473–483.
    [25] Ware JE, Snow KK, Kosinski M, et al. (1993) SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA The Health Institute, New England Medical Center.
    [26] McHorney CA, Ware JE, Raczek AE (1993) The MOS 36-Item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31: 247–263.
    [27] Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas 1: 385–401. doi: 10.1177/014662167700100306
    [28] Sullivan MJL, Thorn B, Haythornthwaite JA, et al. (2001) Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 17: 52–64. doi: 10.1097/00002508-200103000-00008
    [29] Sullivan MJL, Bishop SR, Pivik J (1995) The pain catastrophizing scale: Development and validation. Psychol Assessment 4: 524–553.
    [30] Sullivan MJL (2009) The pain catastrophizing scale-user manual. Available from: https://sullivan-painresearch.mcgill.ca/pdf/pcs/PCSManual_English.pdf
    [31] Carswell A, McColl MA, Baptiste S, et al. (2004) The Canadian occupational performance measure: A research and clinical literature review. Can J Occup Ther 71: 210–222. doi: 10.1177/000841740407100406
    [32] McColl MA, Law M, Baptiste S, et al. (2005) Targeted applications of the Canadian occupational performance measure. Can J Occup Ther 72: 298–300. doi: 10.1177/000841740507200506
    [33] Larsen AE, Carlsson G (2012) Utility of the Canadian occupational performance measure as an admission and outcome measure in interdisciplinary community-based geriatric rehabilitation. Scand J Occup Ther 19: 204–213. doi: 10.3109/11038128.2011.574151
    [34] McColl MA, Paterson M, Davies D, et al. (2000) Validity and community utility of the Canadian occupational performance measure. Can J Occup Ther 67: 22–30. doi: 10.1177/000841740006700105
    [35] Cooper KH (1968) A means of assessing maximal oxygen intake. Correlation between field and treadmill testing. JAMA 203: 201–204.
    [36] Enright PL, McBurnie MA, Bittner V, et al. (2003) The 6-min walk test-A quick measure of functional status in elderly adults. Chest 123: 387–398. doi: 10.1378/chest.123.2.387
    [37] Sletten CD, Kurklinsky S, Chinburapa V, et al. (2015) Economic analysis of a comprehensive pain rehabilitation program: a collaboration between Florida Blue and Mayo Clinic Florida. Pain Med 16: 898–904. doi: 10.1111/pme.12679
    [38] Kurklinsky S, Perez RB, Lacayo ER, et al. (2016) The efficacy of interdisciplinary rehabilitation for improving function in people with chronic pain. Pain Res Treat 2016: 7217684.
    [39] Perera S, Mody SH, Woodman RC, et al. (2006) Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 54: 743–749. doi: 10.1111/j.1532-5415.2006.00701.x
    [40] Angst F, Aeschlimann A, Stucki G (2001) Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower extremities. Arthritis Rheum 45: 384–391. doi: 10.1002/1529-0131(200108)45:4<384::AID-ART352>3.0.CO;2-0
    [41] Walters SJ, Munro JF, Brazier JE (2001) Using the SF-36 with older adults: A cross-sectional community-based survey. Age Ageing 30: 337–343. doi: 10.1093/ageing/30.4.337
    [42] Townsend CO, Kerkvliet JL, Bruce BK, et al. (2008) A longitudinal study of the efficacy of a comprehensive pain rehabilitation program with opioid withdrawal: comparison of treatment outcomes based on opioid use status at admission. Pain 140: 177–189. doi: 10.1016/j.pain.2008.08.005
    [43] Darchuk KM, Townsend CO, Rome JD, et al. (2010) Longitudinal treatment outcomes for geriatric patients with chronic non-cancer pain at an interdisciplinary pain rehabilitation program. Pain Med 11: 1352–1364. doi: 10.1111/j.1526-4637.2010.00937.x
  • Reader Comments
  • © 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(3121) PDF downloads(564) Cited by(0)

Article outline

Figures and Tables

Tables(2)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog