Pain in children with cerebral palsy: common triggers and expressive behaviors

Hadden, Kellie L.; Baeyer, Carl L. von

doi:10.1016/s0304-3959(02)00123-9

Cited by 137 publications

(123 citation statements)

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“…3 Pain in children and youth with CP is reported in the literature by 14% to 73% of caregivers and in 60% of subjects who can self-report. [4][5][6] Kennes et al 6 reported on quality of life of a communitybased sample of 408 children with CP aged 5 to 10. The pain subset of these data showed that 9.6% had pain that limited their daily activities.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Pain in Children and Youth With Cerebral Palsy

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Pain in children with cerebral palsy is underrecognized and undertreated and negatively affects quality of life. Communication challenges and multiple pain etiologies complicate management. There is a wide range of pain prevalence reported in the literature (14% to 73%). WHAT THIS STUDY ADDS:The impact of pain on activities in children with cerebral palsy across a wide age range and motor abilities is investigated. Physician-identified causes of pain are systematically assessed and reported. Concordance of physician and caregiver identification of pain is evaluated. abstract OBJECTIVES: Pain in children with cerebral palsy (CP) is underrecognized, undertreated, and negatively affects quality of life. Communication challenges and multiple pain etiologies complicate diagnosis and treatment. The primary objectives of this study were to determine the impact of pain on activities and to identify the common physicianidentified causes of pain in children and youth ages 3 to 19 years across all levels of severity of CP. METHODS:The study design was cross-sectional, whereby children/ youth aged 3 to 19 years and their families were consecutively recruited. The primary caregivers were asked to complete a onetime questionnaire, including the Health Utilities Index 3 pain subset, about the presence and characteristics of pain. The treating physician was asked to identify the presence of pain and provide a clinical diagnosis for the pain, if applicable. RESULTS:The response rate was 92%. Of 252 participants, 54.8% reported some pain on the Health Utilities Index 3, with 24.4% of the caregivers reporting that their child experienced pain that affected some level of activities in the preceding 2 weeks. Physicians reported pain in 38.7% and identified hip dislocation/subluxation, dystonia, and constipation as the most frequent causes of pain. CONCLUSIONS:One-quarter of our sample experienced pain that limited activities and participation. Clinicians should be aware that hip subluxation/dislocation and dystonia were the most common causes of pain in children/youth with CP in this study. Potential causes of pain should be identified and addressed early to mitigate the negative impact of pain on quality of life. Pediatrics 2013;132: e407-e413 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

Characteristics of Pain in Children and Youth With Cerebral Palsy

et al. 2013

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“…Parents of children with cerebral palsy (with or without impaired communication) reported that home stretching exercises were the most painful activity of daily living and that passive range-of-motion (ROM) exercises carried out by physiotherapists were also frequently painful. 11,12 Adults with cerebral palsy reported that pain related to stretching and bracing in physiotherapy was one of their most salient negative memories of childhood. 13 Another group working with children with cerebral palsy found that referral to a multidisciplinary pain-treatment team was necessary to enable painful physiotherapy to continue.…”

Section: Procedural Pain In Physiotherapymentioning

confidence: 99%

Procedural Pain Management for Children Receiving Physiotherapy

Baeyer

Tupper²

2010

Physiotherapy Canada

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Purpose: This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children. Summary of key points: Physiotherapists are generally well trained in assessing and managing pain as a symptom of injury or disease, but there is a need to improve the identification and management of pain produced by physiotherapy procedures such as stretching and splinting. In contrast to physiotherapy, other health care disciplines, such as dentistry, nursing, paediatrics, emergency medicine, and paediatric psychology, produce extensive literature on painful procedures. Procedural pain in children is particularly important because it can lead to later fear and avoidance of necessary medical care. Recommendations: We emphasize the need for physiotherapists to recognize procedural pain and fear in the course of treatment using verbal, nonverbal, and contextual cues. We present many methods that physiotherapists can use to prevent or relieve procedural pain and fear in paediatric patients and provide an example of a simple, integrated plan for prevention and relief of distress induced by painful procedures.Key Words: child, pain, painful procedures, paediatric, physiotherapy von Baeyer CL, Tupper SM. Procedural pain management for children receiving physiotherapy. Physiother Can. 2010;62:327-337 RÉ SUMÉObjectif : Cet article propose un survol de la documentation relative à la pré vention et au soulagement de la douleur et de l'anxié té qui surviennent pendant des interventions de physiothé rapie, et propose des avenues en ce sens aux physiothé rapeutes qui traitent des enfants. Ré sumé des principaux points : Les physiothé rapeutes sont gé né ralement bien formé s pour l'é valuation et la gestion de la douleur en tant que symptô me d'une blessure ou d'une maladie, mais des amé liorations sont né cessaires pour l'identification et la gestion de la douleur qui ré sultent des procé dures de physiothé rapie, comme les é tirements ou les contractions. Contrairement à la physiothé rapie, d'autres disciplines de la santé , notamment la dentisterie, les soins infirmiers, la pé diatrie, la mé decine d'urgence et la psychologie pé diatrique ont inspiré une abondante documentation sur les procé dures douloureuses. Les douleurs procé durales chez les enfants sont particuliè rement importantes, parce qu'elles peuvent les amener à avoir peur des soins mé dicaux né cessaires ou à les é viter. Recommandations : Nous insistons sur la né cessité pour les physiothé rapeutes de savoir reconnaître la douleur procé durale et la peur qui surviennent en cours de traitement à l'aide d'indices verbaux ou non verbaux et contextuels. Nous pré sentons plusieurs mé thodes que les physiothé rapeutes peuvent utiliser pour pré venir ou soulager la douleur procé durale et la peur chez les patients pé diatriques et donnons aussi un exemple de plan inté gré simple pour la pré vention et le soulagement de l'anxié té causé e par les procé dur...

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“…9 The vast heterogeneity of the CP condition, as well as multiple potential sources of pain and varied communicative abilities hampers accurate assessment; this often leaves pain unrecognized and untreated. 9,11,12 Unrecognized pain can have negative implications on health and quality of life, with the possibility that childhood pain will persist and progress into adulthood. 1,9,11,[13][14][15][16][17][18][19][20] Chronic pain can significantly interfere with participation in daily living activities, both as a result of limited mobility resulting from the source of pain and fear-driven avoidance of specific activities.…”

mentioning

confidence: 99%

“…9,11,12 Unrecognized pain can have negative implications on health and quality of life, with the possibility that childhood pain will persist and progress into adulthood. 1,9,11,[13][14][15][16][17][18][19][20] Chronic pain can significantly interfere with participation in daily living activities, both as a result of limited mobility resulting from the source of pain and fear-driven avoidance of specific activities. 8,15,16,[21][22][23][24] Childhood chronic pain has been associated with disturbances in sleep, increased fatigue, depression, and decreased physical functioning.…”

mentioning

confidence: 99%

“…8,15,16,[21][22][23][24] Childhood chronic pain has been associated with disturbances in sleep, increased fatigue, depression, and decreased physical functioning. 11 Unmanaged pain leads to social, functional, and behavioral consequences, increased stress on the family, and unnecessary prolonged suffering by the child. 25 To effectively manage chronic pain in children with CP, the source, site, and ways in which participation in daily living activities is limited must first be accurately identified.…”

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confidence: 99%

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Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review

et al. 2015

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BACKGROUND AND OBJECTIVE: Chronic pain in children with cerebral palsy (CP) is underrecognized, leading to detriments in their physical, social, and mental well-being. Our objective was to identify, describe, and critique pediatric chronic pain assessment tools and make recommendations for clinical use for children with CP. Secondly, develop an evidenceinformed toolbox to support clinicians in the assessment of chronic pain in children with disabilities.

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Pain in children with cerebral palsy: common triggers and expressive behaviors

Cited by 137 publications

References 10 publications

Characteristics of Pain in Children and Youth With Cerebral Palsy

Characteristics of Pain in Children and Youth With Cerebral Palsy

Procedural Pain Management for Children Receiving Physiotherapy

Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review

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