Sabrina A. Gmuca
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 2013–2026
About
Sabrina A. Gmuca, MD MSCE, is an Assistant Professor of Pediatrics (Rheumatology) at the Children's Hospital of Philadelphia and a senior scholar at the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania School of Medicine. She is a board-certified pediatric rheumatologist with expertise in the treatment and management of pediatric chronic, non-inflammatory musculoskeletal pain, including amplified musculoskeletal pain syndrome (AMPS), juvenile fibromyalgia syndrome, and complex regional pain syndrome (CRPS). Dr. Gmuca serves as the Director of the Center for Amplified Musculoskeletal Pain Syndrome at CHOP and routinely cares for children and young adults with systemic lupus erythematosus, juvenile dermatomyositis, juvenile idiopathic arthritis, and enthesitis. Her research focuses on understanding the etiologic factors involved in the development of chronic non-inflammatory musculoskeletal pain syndromes and advancing interdisciplinary treatment strategies to improve the lives of youth with chronic pain and their families. She has received funding through a K23 award from NIAMS at the NIH and is actively involved in research aimed at promoting better management and understanding of pediatric chronic pain conditions.
Research topics
- Medicine
- Physical therapy
- Internal medicine
- Pediatrics
- Dermatology
Selected publications
Examining Hope in Adolescents with Chronic Musculoskeletal Pain
Children · 2026-03-27
articleOpen accessSenior authorCorrespondingBackground/Objectives: This cross-sectional study aimed to quantify hope levels in adolescents with chronic musculoskeletal pain (CMP) and examine patient-reported outcomes associated with hope. Methods: This was an exploratory, cross-sectional, secondary analysis of baseline data from a prospective, single-center longitudinal study of 60 youth presenting for an initial evaluation at a pediatric subspecialty pain clinic. Subjects were English-speaking 12–17-year-olds with a diagnosis of CMP, primarily female and non-Hispanic White, with diffuse pain, median pain duration of 2 years, and moderate to severe physical dysfunction. Subjects completed surveys measuring hope (Children’s Hope Scale [CHS]) and patient-reported mental, physical, and overall health. Associations between hope scores (total and each subscale) and patient-reported outcomes were evaluated using Spearman rank correlations. Results: The median CHS score was 20.0 (IQR: 16.5–25.0), indicating slight hope. Patient hope was negatively correlated with depression (r = −0.61), anxiety (r = −0.49), psychological distress (r = −0.52), functional disability (r = −0.43), and pain interference (r = −0.37), but not pain intensity. Adolescents’ hope was positively correlated with resilience (r = 0.74) and overall health (r = 0.55; all p < 0.01). Conclusions: Hope is correlated with various patient-reported health measures in youth with CMP. Although causal inferences are not possible due to the cross-sectional nature of this study, the results suggest that hope may be an important coping mechanism in pediatric chronic pain. Future efforts to incorporate existing resilience coaching programs into usual care may improve hope and health-related quality of life in youth with CMP.
Journal of Adolescent Health · 2026-02-13
articleSenior authorJournal of Pediatric and Adolescent Gynecology · 2026-03-11
articlePediatric normative data for the Complete Minnesota Dexterity Test
Journal of Hand Therapy · 2025-04-23 · 1 citations
articleOpen accessSenior authorBACKGROUND: Previous research has established normed and validated assessments to measure manual dexterity in children. However, there currently are no validated brief assessment tools that are specifically designed to measure unilateral and bimanual dexterity in this population. PURPOSE: The main purpose of this study was to develop normative data for the Complete Minnesota Dexterity Test (CMDT) for children and adolescents. Additionally, we assessed the CMDT's test-retest reliability and concurrent validity with the Box and Blocks Test (BBT). STUDY DESIGN: Cross-sectional observational quantitative study. METHODS: Participants were 181 healthy children, aged 7-18 years, with no known physical, cognitive, or emotional conditions which could impact performance. The five subtests of the CMDT were completed for two trials with each hand, and one trial of the BBT was completed with each hand. Age group norms for each CMDT subtest were computed using means and standard deviations. Test-retest reliability was computed using test-retest correlations. Validation of the CMDT was examined using Pearson correlations between the first trial of each CMDT subtest and the BBT score. RESULTS: A total of 98 females and 83 males participated and were divided into eight age groups, with 19-26 participants per group. Normative data were obtained for the placing, turning, displacing, and one-hand and two-hand turning subtests. Reliability measures for all subtests were high, with test-retest correlations ranging from 0.89 to 0.93 (p < 0.0001). There was a high degree of correlation between the CMDT and BBT (r = -0.64 to -0.82, p < 0.0001). CONCLUSIONS: The CMDT's robust construct validity supports its use for the assessment of manual dexterity in children. There were not clinically meaningful improvements on retesting, therefore one trial of each subtest is sufficient.
Journal of Hand Therapy · 2025-11-20
articleOpen accessSenior authorBACKGROUND: Norms for children aged 6-19 years were developed in 1985 for the Box and Block Test (BBT) and updated in 2013 for 3-10-year-olds. Evidence suggests that past normative data may need to be updated due to changes in children's hand use over the past 40 years. PURPOSE: To compare children's performance on the BBT with existing 1985 normative data. STUDY DESIGN: Secondary analysis of a cross-sectional observational study to validate the Complete Minnesota Dexterity Test (CMDT) using the BBT. METHODS: All were healthy volunteers, aged 7 to 18 years, with no known physical, cognitive, or emotional conditions. Participants completed study procedures in a pediatric hospital. During data collection we noted low performance on the BBT and hypothesized a decline compared to the 1985 norms. Participants completed one trial of the BBT with each hand. We compared our sample to the normative sample using mean number of blocks placed in 60 seconds and standard error of the means using two-tailed, one sample t-tests. RESULTS: Of 816 children screened, 181 were eligible and consented to participate. A total of 98 females and 83 males participated. Each gender-by-age group-by-hand category ranged from 4-21 participants. In each group, means were statistically significantly lower than norms, indicated by nonoverlapping 95% confidence intervals and t-test results. The difference in blocks placed in 60 seconds ranged from 9.1 to 31.3 fewer blocks. DISCUSSION: This study suggests that children's manual dexterity has declined over the past 40 years. Clinicians should consider this when using the BBT to evaluate performance. This study lacked enough subjects to establish new normative data but suggests the 1985 norms need to be updated. CONCLUSIONS: Our findings provide evidence of a decline in manual dexterity among children on the BBT since 1985.
The Journal of Rheumatology · 2025-07-01
articleOpen accessObjectives Young people with juvenile idiopathic arthritis (JIA) often experience pain which has an important impact on their daily life. However, pain is often underestimated by health care providers (HCPs) and is not sufficiently discussed in clinical consultations. Our team developed the JIA Option Map, a web-based patient decision aid, which has demonstrated good usability, and acceptability. In the current study, we evaluated the usability and acceptability of the French version of the JIA Option Map (“Carte d’options en AJI”). Methods We conducted usability and acceptability testing using virtual semi-structured interviews with a total of 3 adolescents 13-18 years old with JIA, 3 young adults 19-30 years old with JIA, as well as 4 parents of youths with JIA. We recruited participants from a pediatric rheumatology clinic and through patient organizations. Participants navigated the web application using the think-aloud method, and answered questions about ease of use, content, format, potential use, and perceived effectiveness. We videotaped interviews and transcribed and analyzed verbatim using simple descriptive content analysis. Results All participants felt that the app was easy to navigate, and the format was user-friendly. All participants felt the content was appropriate and generally easy to understand. They mentioned they would use this app frequently, with the help of recently added reminders. Participants felt the app would help them learn about a range of pain management strategies and help them engage in decision-making with HCPs. Participants liked the wide range of options with a color-coded legend, the evidence-based summaries presenting their probabilities of benefits and harm, the links to online resources and tips to help follow their plan, as well as the dashboard which shows pain over time. Suggestions for improvement included clarifying some of the instructions and icons, adding pain management strategies and links to additional resources and videos and adding instructions to help monitor their pain. Conclusion The French version of the JIA Option Map has good usability and acceptability and has the potential to facilitate decision-making for pain management options among French-speaking young people with JIA and their families and HCPs in the clinic. Changes have been made to improve the content and format of the app. Work is underway to test the effectiveness of the application over time.
JMIR Research Protocols · 2025-07-22
articleOpen access1st authorCorrespondingBACKGROUND: Levels of self-perceived psychological resilience are low to moderate among youth with chronic musculoskeletal pain (CMP). Furthermore, resilience has been associated with symptom severity in CMP. Resilience coaching programs may therefore be of benefit in the nonpharmacologic management of adolescent CMP and may serve as an adjunctive way to access mental health services in an approachable and affordable way. OBJECTIVE: The main goal of the study is to assess the feasibility, acceptability, and preliminary efficacy of the resilience coaching program called Promoting Resilience in Stress Management (PRISM) and to obtain the data needed to plan a larger trial. METHODS: The Resilience Coaching for Adolescents with Chronic Musculoskeletal Pain pilot study is an investigator initiated, 2-arm, randomized controlled trial (RCT) of PRISM in the interdisciplinary management of CMP among adolescents. The study will compare usual care versus PRISM+usual care among adolescents newly diagnosed with CMP in the outpatient setting. One caregiver per patient will also be enrolled. The control group will receive usual care with no specific intervention. The treatment arm will receive PRISM, which is a remotely delivered, 1-on-1resilience coaching program, consisting of 4 required skill-based sessions and an optional final session. Sessions will be delivered every 1-2 weeks, lasting about 3 months in total. The primary outcome is the Functional Disability Inventory (FDI) score at 3 months postrandomization. The secondary objectives are to evaluate potential patient- and caregiver-level moderators of PRISM and identify facilitators of and barriers to engagement in PRISM. The estimated sample size is 65 patient-caregiver dyads per group, for a total of 130 dyads. RESULTS: The trial is currently open. Initial Institutional Review Board approval was obtained on April 4, 2023, and protocol version 4 was amended on January 14, 2025. Recruitment began on May 8, 2023, and recruitment is anticipated to be completed on August 1, 2025. CONCLUSIONS: Resilience coaching has demonstrated excellent feasibility, acceptability, and efficacy in teenagers with chronic illness; however, evidence to support its use in adolescent CMP is lacking. Resilience coaching has the potential to improve patient outcomes in this population. This pilot RCT will demonstrate acceptability, feasibility, and preliminary efficacy and reveal critical barriers to and facilitators of engagement. This will inform a larger multisite trial to evaluate the definitive efficacy of the intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05834725; https://clinicaltrials.gov/study/NCT05834725. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/73385.
A Qualitative Exploration of Adherence to Methotrexate in Juvenile Idiopathic Arthritis
The Journal of Pediatrics · 2025-08-29 · 1 citations
articleOpen accessSenior authorChildren · 2025-10-09
articleOpen accessObjectives: Chronic pain corresponds to hypersensitivity to painful stimuli; however, its relation to acute pain sensitivity in children is poorly understood. We explored this relationship by comparing acute and chronic pain measures, along with related factors, in children with chronic pain syndromes versus controls, before and after therapeutic intervention. Methods: This prospective controlled cohort study involved 57 children with chronic pain undergoing intensive interdisciplinary pain treatment in a hospital-based pain rehabilitation program and 50 controls. Participants, aged 7–18, were tested using a cold pressor task (CPT) at admission, discharge, and first follow-up visit. Data on sleep, anxiety, psychological distress, functional impairment, and pain were collected. Results: Significant differences were found between control and treatment groups in average pain threshold (p < 0.001), pain tolerance (p = 0.035), sleep visual analog scale (VAS) (p < 0.001), functional disability inventory (p < 0.001), patient reported outcomes information system anxiety assessment tool (p < 0.001), general anxiety disorder 7-item scale (p < 0.001), pain VAS (p < 0.001) and total brief symptom inventory (BSI) (p < 0.001) scores at admission with children with chronic pain scoring worse on all measures save the pain VAS during the CPT. After treatment and at follow-up, function and mental health measures improved but not acute pain threshold. Conclusions: At treatment completion, function and mental health significantly improved but acute pain threshold and sleep quality were unchanged. These findings suggest that while chronic pain treatment improves overall function and mental health, acute pain thresholds may not be a suitable indicator for evaluating the efficacy of interventions.
Have Kids’ Manual Dexterity Skills Change in the Past 40 Years?
American Journal of Occupational Therapy · 2025-07-30
articleSenior authorAbstract Date Presented 04/05/2025 While completing a validation study on the Complete Minnesota Dexterity Test for pediatrics, we discovered that children’s performance on the Box and Block Test has changed in the past 40 years, suggesting a decline in manual dexterity. Primary Author and Speaker: Tami Konieczny Contributing Authors: Nellie Butler, Ashley Binkowski, Lynne Allen-Taylor, Sabrina Gmuca
Recent grants
Frequent coauthors
- 37 shared
David D. Sherry
University of Pennsylvania
- 34 shared
Pamela F. Weiss
Children's Hospital of Philadelphia
- 24 shared
Jeffrey S. Gerber
Children's Hospital of Philadelphia
- 17 shared
Rui Xiao
Nanchang University
- 14 shared
Maitry Sonagra
Children's Hospital of Philadelphia
- 13 shared
Jon M. Burnham
Children's Hospital of Philadelphia
- 12 shared
Joyce C. Chang
Children's Hospital of Philadelphia
- 11 shared
Jami F. Young
Philadelphia University
Education
- 2018
Master of Science in Clinical Epidemiology, Perelman School of Medicine
University of Pennsylvania
- 2017
Fellow Physician, Pediatric Rheumatology
Children's Hospital of Philadelphia
- 2014
Pediatric Residency, Pediatrics
New York University Langone Medical Center
- 2011
MD
State University of New York Downstate Medical Center
- 2007
Bachelor of Sciences
University of Rochester
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