Document Type : RESEARCH PAPER
Authors
1
1 Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA 2 Harvard Medical School, Boston, MA, USA
2
1 Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA 2 Harvard Medical School, Boston, MA, USA 3 Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, CO, USA
3
Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
10.22038/abjs.2024.76953.3559
Abstract
Objectives: Traumatic orthopedic injuries are a top cause of hospital visits in the U.S. The Toolkit for
Optimal Recovery (TOR) is a brief mind-body intervention that targets catastrophic thinking and pain
anxiety following orthopedic injury. This study examines the baseline presentation of adults with
traumatic orthopedic injuries who were enrolled in our recent multisite feasibility RCT of TOR versus
usual care at four geographically distinct Level 1 trauma centers. We also examine whether patient
presentation varies by site.
Methods: We recruited 181 adults (Mage=44.16, SD=16.5) from four Level I trauma centers located in the northeast
(Site A; N=63), southwest (Site B; N=44), southeast (Site C; N=44), and southeast (Site D; N=30). At baseline,
participants provided information about sociodemographic factors, pain and physical function, and physicians
completed the Abbreviated Injury Scale (AIS). Descriptive statistics were used to characterize the sample, and oneway analysis of variance (ANOVA) and Chi-square tests were used to compare variables between sites.
Results: The majority of the sample (88.4%) sustained a fracture, and the mean AIS score was 2.31 (SD=0.55).
Age, race, sex, gender, occupation, or marital status did not differ across sites (ps>.05). Over half (63%) of the
sample was treated surgically, and 28.7% endorsed taking narcotic pain medications. More participants at Sites B
(75%) and D (96.7%) received surgery than participants at Sites A (41%) and C (61.4%). More participants at Sites
D and B reported narcotic usage than participants at Sites C and A. Participants at Site D demonstrated greater
functional impairment than participants at the other sites.
Conclusion: Although sites were largely comparable, we did find key differences in surgical management, narcotic
use, and functional disability which may have important implications for treatment response. This information will be
used to iterate and refine TOR for a future multisite efficacy trial.
Level of evidence: III
Keywords
Main Subjects
)