Pain, Anxiety, and Cooperativeness in Children with Cerebral Palsy After Rhizotomy: Changes Throughout Rehabilitation

Abstract

Assessed pain, anxiety, physical functioning, and cooperativeness in 32 children with spastic cerebral palsy. This is the first study to assess children throughout rehabilitation following selective posterior rhizotomy. Results of the Observational Scale of Behavioral Distress and observer Likert ratings confirmed the hypothesis that children's pain and anxiety decrease over time. Children's physical functioning and cooperativeness improve over time. No significant correlation was found between pain and changes in physical functioning. Cognitive impairment, parental involvement, and children's pain behaviors explained 77% and 56% of the variance in two forms of cooperativeness. Research and clinical implications are discussed, and special considerations regarding pain assessment and management in this population are addressed.

Impact of the therapist‐child dyad on children's pain and coping during medical procedures

“…When the results of this study are compared to those obtained in an earlier analysis of the data (Miller et al 1997) using the Observational Scale of Behavioral Distress (Elliott et al 1987), much needed evidence of the concurrent validity of the CAMPIS-R is provided. However, measurement limitations in this study should also be considered.…”

“…While all of the children had experience with medical staff and procedures, the frequency and extent of these contacts varied between the children. In addition, child self-reports of pain were not available, as these children were unable to respond validly to one such instrument (Miller et al 1997). Because the child's pain behaviors may not be the same as the child's perception of pain, conclusions regarding the latter cannot be directly addressed.…”

“…Geiduschek et al 1994). However, only one study has addressed the ongoing experiences of pain in these children (Miller et al 1997) by measuring pain, physical functioning, and cooperativeness in children with CP throughout rehabilitation following surgery. The current study extends this work to include children's coping and the impact of the physical therapist on the children's pain and coping.…”

Relación del valor de la clasificación y medición de la función motora gruesa (GMFM66-GMFCS) con episodios de dolor reportados por cuidadores en pacientes con insuficiencia motora de origen central (IMOC)

“…Es conocido que el dolor es una experiencia individual y ha hecho parte del desarrollo cultural en todas las sociedades 3 ; cuenta con grandes componentes emocionales y orgáni-cos 12 , por lo que se convierte hoy día en uno de los principales adversarios en todos los procesos patológicos en cualquier sistema. Genera dudas y nubla el juicio de los pacientes y sus familiares, dejando muchas de sus manifestaciones sujetas a la experiencia individual de cada (diagnosticado por médico fisiatra o neurólo-go pediatra), con las siguientes características:…”

“…En los niños con discapacidad, de entrada hay una dificultad para lograr entablar una comunicación suficientemente buena como para saber si hay dolor y está presente como una barrera al desarrollo de las actividades del paciente 12 .…”