Caregiver-Reported Pain Management Practices for Individuals With Cerebral Palsy

Abstract

Objective To investigate types and intensity of pain experienced by individuals with cerebral palsy (CP) and common pain-relieving approaches used by caregivers. Design The approach was cross-sectional, using standardized interviews. Setting Individuals with CP were recruited from a specialty health care hospital. Participants Eighty-six individuals (N=86; mean age, 17.2 years; male, 58%) with CP and complex communication needs participated. Interventions Not applicable. Main Outcome Measures Pain type, mean pain intensity (MPI) (graded on a scale of 0=no pain to 10=worst possible pain), and mean pain relief (MPR) (graded on a scale of 0=intervention did not help at all to 10=intervention completely relieved pain) were assessed by caregiver report as part of the Dalhousie Pain Interview for each type of pain experienced in the previous 7 days. Results Caregivers reported that 58 participants (67%) had experienced pain in the previous 7 days. MPI was 7.7±1.8 when the pain was worst in the previous 7 days. The 2 most common types of pain included musculoskeletal pain (n=70) and gastrointestinal pain (n=11). The most frequent treatment to relieve musculoskeletal pain was changing positions (n=27, MPI=5.1±2.3, MPR=6.6±2.1), medication (n=25, MPI=7.4±1.6, MPR=5.3±1.9), and massage (n=19, MPI=6.7±1.9, MPR=5.2±1.7). To treat gastrointestinal pain, medication was typically used (n=4, MPI=4.8±1.4, MPR=5.5±1.0), although no treatment was just as common (n=4, MPI=4.5±2.3). Conclusions The results indicate that musculoskeletal pain is prevalent in individuals with CP, and changing physical positions and providing medication are strategies most used by caregivers.

Chronic pain among children with cerebral palsy attending a Ugandan tertiary hospital: a cross-sectional study

“…This may be explained by the fact that older caretakers have much more experience of recognition of pain, and may be giving more support to relieve this chronic pain. In a study done by Abigail M et al in 2021, it showed that caretakers were able to report different types of pain but also used non pharmacologic approaches such as changing positions, massage as well as medication to relieve pain in children with CP [ 17 ].…”

Special issue on pain and intellectual and developmental disabilities

“…We are encouraged by recent work; for example, a pain assessment toolbox and clinical practice points specific to pain in children with physical disabilities were developed and disseminated, 11,12 pain education programs have been developed for caregivers and tested for effectiveness, [13][14][15] and while still severely limited, studies are starting to emerge focused on understanding pain management approaches in this population. [16][17][18][19][20] This special issue features important and diverse research spanning pain prevalence, assessment, and management in children with IDD. We are also pleased to highlight a knowledge mobilization project focused on impacting care and the human experience.…”

“…We are encouraged by recent work; for example, a pain assessment toolbox and clinical practice points specific to pain in children with physical disabilities were developed and disseminated, 11 , 12 pain education programs have been developed for caregivers and tested for effectiveness, 13 , 14 , 15 and while still severely limited, studies are starting to emerge focused on understanding pain management approaches in this population. 16 , 17 , 18 , 19 , 20 …”