Change in pain status in children with cerebral palsy

Christensen, Rhandi; MacIntosh, Alexander; Switzer, Lauren

doi:10.1111/dmcn.13328

Cited by 24 publications

(44 citation statements)

References 30 publications

(81 reference statements)

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“…Experience of pain may change over time as may intensity . Those who at a younger age have no pain may develop it, and those with more severe initial pain and higher gross motor function have lower pain at follow‐up . Also relevant to prevalence is who is reporting the pain: self‐report or physician observer (54% vs 39% respectively) .…”

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confidence: 99%

“…Ascertaining pain in the non‐verbal population is more problematical as pain has to be inferred from behaviour and relies on parent/carer/observer report. High agreement was reported between physiotherapist and parents in non‐verbal children . Which pain questionnaire to use has varied across studies; a systematic review concluded that tools were often not validated in children with CP, nor was there one tool to meet the needs of all children experiencing chronic pain …”

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confidence: 99%

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Factors associated with pain in adolescents with bilateral cerebral palsy

Fairhurst

Shortland

Chandler

et al. 2018

Develop Med Child Neuro

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Aim We explored factors associated with pain and its severity in a population cohort of young people with bilateral cerebral palsy, comparing parent/carer and young people self‐reports. Method Of 278 survivors (mean age 16y 8mo, SD 1y 4mo, range 13y 8mo–19y 3mo) from the South Thames in the Study of Hips and Physical Experience cohort of 338 young people with bilateral cerebral palsy, 212 parents/carers and 153 young people completed questionnaires on the presence, severity, timing, site, associated factors, impact, and treatment of pain. Results Seventy per cent of parents/carers reported pain within 3 months, 59% the previous week, and 50% the previous day with 56% reporting ‘regularly experienced’. Of young people able to do so, 63% reported pain within 3 months, 50% the previous week, and 42% the previous day, with 48% reporting regular pain. There was strong agreement between the parent/carer and young people, reporting pain severity over the previous 3 months. Pain severity was associated with increased motor impairment and comorbidity, particularly constipation, spasticity, equipment use, and higher emotional score, but not sex, intellectual disability, speech, or maternal education. Multiple sites of musculoskeletal pain were reported in two‐thirds of individuals. Pain was associated with voluntary movement in individuals with less motor impairment and with being moved in those with severe motor impairment. Greater pain severity had a negative effect on both physical and psychological quality of life. Interpretation Increasing awareness of the comorbidities in cerebral palsy may aid effective treatment, reducing pain experienced by young people with cerebral palsy. What this study adds Regular moderate or severe pain is reported in young people with bilateral cerebral palsy (CP) in all Gross Motor Function Classification System levels. Pain is reported more frequently in young people who are non‐ambulant. General ill health is strongly associated with severity of pain after controlling for severity of CP, especially constipation. Pain occurs most often in ambulant young people during voluntary activity and in those who are non‐ambulant when being moved. There is strong agreement between parents/carers and young people about pain presence and severity.

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confidence: 99%

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confidence: 99%

Factors associated with pain in adolescents with bilateral cerebral palsy

Fairhurst

Shortland

Chandler

et al. 2018

Develop Med Child Neuro

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“…correctly highlight, minimal evidence is available on best practices for clinicians to manage pain in individuals with CP. The field also lacks an understanding of pain trajectories over time, although there is some evidence of the existence of chronic pain . Researchers need to continue to build this evidence base and evaluate mechanisms to support chronic pain management.…”

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confidence: 81%

Pain in cerebral palsy: a neglected comorbidity

Fehlings

2017

Develop Med Child Neuro

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“…A year ago, Kjersti Ramstad wrote a commentary on a cross‐sectional study on pain published in DMCN titled ‘Pain hurts worldwide: non‐verbal children with cerebral palsy’ . The present study by Christensen et al is a follow‐up. Indeed, though research on pain in cerebral palsy (CP) has been performed over the last two decades, longitudinal studies are lacking.…”

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confidence: 88%