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Sensory Modulation

An Important Piece of the Disability Puzzle for Adolescents With Persistent Pain

Sinclair, Cate, PhD, Master Art Therapy, B App Sci OT*,†,‡; Meredith, Pamela, PhD, BA(Hons), BSc, BOccThy§; Strong, Jenny, PhD, MOccThy, BOccThy*,∥; Chalkiadis, George A., FANZCA, FFPMANZCA, DA (Lon)†,‡,¶

doi: 10.1097/AJP.0000000000000663
Original Articles

Objectives: Sensory modulation patterns contribute to altered pain perception and disengagement in activities; atypical sensory modulation patterns have been associated with higher pain sensitivity, catastrophizing, and reduced function. Objectives of this study were to ascertain whether: adolescents with persistent pain had atypical sensory modulation patterns, atypical sensory modulation was associated with reduced functioning and higher pain, and pain catastrophizing mediated the relationship between sensory modulation and functional disability.

Methods: Adolescents (N=70, females=63, males=7) attending tertiary level interdisciplinary team assessment for persistent pain completed sensory modulation (Adolescent/Adult Sensory Profile), pain catastrophizing (Bath Adolescent Pain Questionnaire), pain intensity, functional disability (Functional Disability Index), and quality of life (QOL) (Pediatric QOL Scales) questionnaires.

Results: Adolescents with persistent pain had atypical patterns of sensory modulation compared with normative data. Sensory modulation patterns were not associated with pain intensity; however, higher sensitivity was associated with greater disability (r=0.36, P<0.01), and lower registration of sensation was associated with poorer emotional (r=0.31, P<0.01), social (r=0.35, P<0.01), and school-related (r=0.49, P<0.001) QOL. Sensory modulation, pain intensity, and catastrophizing contributed independently to disability; catastrophizing mediated sensory sensitivity and both functional disability and emotional QOL.

Discussion: This study is the first to show that atypical sensory modulation patterns are associated with poorer function for adolescents with persistent pain, suggesting that individualized sensory-informed interventions can potentially facilitate participation in daily activities and improve QOL.

*Department of Health and Rehabilitation Sciences, The University of Queensland

Royal Brisbane and Women’s Hospital, Brisbane

§Central Queensland University, North Rockhampton, Qld

Royal Children’s Hospital

Murdoch Children’s Research Institute

Department of Paediatrics, University of Melbourne, Melbourne, Parkville, Vic., Australia

Initial data presented at the Australian Pain Society Meeting, 2017, Adelaide.

C.S. was supported by an Australian Government Research Training Program Scholarship from The University of Queensland, Brisbane, Queensland, Australia. The authors declare no conflict of interest.

Reprints: Cate Sinclair, PhD, Master Art Therapy, B App Sci OT, Anaesthesia and Pain Management Department, Royal Children’s Hospital, 50 Flemington Road, Parkville, Vic. 3052, Australia (e-mail:

Received January 14, 2018

Received in revised form September 18, 2018

Accepted September 19, 2018

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