Perry et al. 2010
Australia
Downs & Black score=21
PCT
N=36
NTreatment=19;
NControl=17

Population: Mean age=43.8; Gender: males=28, females=8; Level of injury: tetraplegia=13, paraplegia=20, Severity of injury: complete=13, incomplete=23; Duration of pain (mo)=60.5; Type of pain=mixed.
Treatment: SCI patients with chronic pain were placed in either the multidisciplinary cognitive behavioural pain management program (PMPs) group which involved a pharmacological treatment plan and individual and group based cognitive behavioural therapy for pain; or the usual care group.
Outcome Measures: Pain response self-statement scale; Pain self-efficacy questionnaire; MPI; HADS; SF-12 Mental Component Scale

• At baseline, the PMP group had significantly worse usual pain intensity scores than the usual care group.
• A significant improvement was seen in MPI and SF-12 MCS scores in the PMP group compared to the control group post treatment (p=0.026, 0.015).
• Mean scores of participants in the PMP group moved from moderate to mild disability.
• A trend towards improvement on the usual pain intensity and HADS depression score was seen in the PMP group at 1 month post treatment; however, the HADS depression scores returned to pre-treatment levels at 9 month follow-up.

Norribrink-Budh et al. 2006
Sweden
Downs & Black score=19
PCT
N=38

Population: SCI: Treatment: Mean age = = 53.2 yrs; Gender: males = 9, females = 18; Control: Mean age = 49.9 yrs; Gender: males = 5, females = 6; Severity of injury: AIS A-E.
Treatment: Individuals participated in a 10 wk/2xweek treatment program (20 sessions). 4 elements to the programme: Education sessions, Behavioural therapy, Relaxation techniques, stretching and light exercise; Body awareness training. Each treatment session consisted of 1.5hrs of education, 1.5hrs of Cognitive Behavioural Therapy (CBT), 1hr each of stretching/relaxation and body awareness training.
Outcome Measures: Pain Chart and pain rating was completed, pain intensity and unpleasantness was assessed with the Borg CR10 scale, Quality of sleep (survey), Nottingham Health Profile (Quality of life) was completed, Mood (Hospital Anxiety and Depression) was assessed, Coherence and use of the healthcare system were also assessed.

• From baseline to 12 month evaluation period, the treatment group experienced decrease in:
  • Anxiety and depression.
  • Sleep.
• No change was seen over time in:
  • Pain intensities and unpleasantness.
  • Health-related quality of life.
  • Life satisfaction.
• A significant improvement was noted for the Emotional Reaction subscale only (p<0.01).
• The two groups showed significant differences on the depression and SOC scores.
• A significant decrease in the number of visits between baseline and the 12 month assessment period was noted for the treatment group (from 15 to 5, p<0.03), along with the median number of visits to physicians (from 3 to 1, p<0.03).