Pain is frequent in children with cerebral palsy and negatively affects physical activity and participation

Østergaard, Cecilie Schmidt; Pedersen, Nanna Sofie Astrup; Thomasen, Anne; Mechlenburg, Inger; Nordbye-Nielsen, Kirsten

doi:10.1111/apa.15341

Cited by 19 publications

(25 citation statements)

References 26 publications

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“…However, a limitation of the CPOP registry that we used is that it was not designed to measure pain and that means that pain was not measured, and reported, using a validated tool. 10 Pain was reported as only yes or no by the child or the parents, and there was no grading of the severity of the pain. This limitation may explain why the association between hip contracture and pain was not statistically significant in this study, contrary to the results by Schmidt et al 1 Our study indicated that there seemed to be regional differences in the incidence of hip contractures over time and there may be a number of reasons for this.…”

Section: Discussionmentioning

confidence: 99%

“…This was in contrast with our results, as we did not show a significant association between hip contractures and pain in the lower extremities. However, a limitation of the CPOP registry that we used is that it was not designed to measure pain and that means that pain was not measured, and reported, using a validated tool 10 . Pain was reported as only yes or no by the child or the parents, and there was no grading of the severity of the pain.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, pain is a frequent symptom of CP 10 and three out of four children with CP experience pain 11 . Hip pain, in particular, seems to be frequent, and it has been reported that this most often occurs in children with low gross motor function 11 .…”

Section: Introductionmentioning

confidence: 99%

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Hip contractures were associated with low gross motor function in children with cerebral palsy

et al. 2020

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Aim The aim was to identify the prevalence of hip contractures and their association with gross motor function and pain in the lower extremities among Danish children with cerebral palsy (CP). Methods This cross‐sectional study was based on data collected during regular clinical examinations in 2018–2019 and registered in the National Danish Clinical Quality Database of children with CP. The study population was 688 children (59% boys) aged five to 12 years across all Gross Motor Function Classification System (GMFCS) levels. Any associations between hip contracture and gross motor function and pain were investigated with logistic regression analysis and presented as odds ratios (OR) with 95% confidence intervals (95% CI). Results The prevalence of hip contracture was 22% across all five GMFCS levels, and the incidence varied across the five Danish regions. The odds ratios for hip contracture were significantly higher at GMFCS level IV (OR 1.99, 95% CI 1.10–3.62) and V (OR 5.49, 95% CI 3.33–9.07) compared with level I. Hip contractures were not significantly associated with pain in the lower extremities (OR 1.43, 95% CI 0.95–2.15). Conclusion Hip contractures were frequent and associated with low gross motor function, but not lower extremity pain, in children with CP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hip contractures were associated with low gross motor function in children with cerebral palsy

et al. 2020

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“…More than 50% of children with CP suffer pain from moderate to severe intensity and at multiple body locations [ 1 , 2 ]. Pain negatively affects quality of life [ 2 , 3 ] and participation [ 2 , 4 ]. Furthermore, individuals with CP have altered somatosensory processing and pain sensitivity [ 5 ], requiring the development of specific coping strategies to manage pain [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Social Support in Pain Sensitivity in Children with Cerebral Palsy and Typically Developing Children

Riquelme

Escobio-Prieto

Oliva-Pascual-Vaca

et al. 2021

IJERPH

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Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are highly affected by social and contextual influences for regulating pain sensitivity. Solicitous parental support may enhance pain perception in children with CP. Further research on the topic is warranted in order to attain well-founded conclusions for clinical practice.

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“…There is a growing body of research on pain in CP 1,2 and population‐based studies report the most generalizable estimations of pain prevalence 1 . To date, there are seven population‐based studies representative of the wider CP population 3–9 …”

mentioning

confidence: 99%

Data linkage and pain medication in people with cerebral palsy: a cross‐sectional study

Jalón

Maguire

Perra

et al. 2021

Develop Med Child Neuro

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Aim To explore data linkage and pain medication as a proxy for pain, to assess differences in pain medication between the cerebral palsy (CP) and the general populations, and to identify factors associated with pain medication in CP. Method This cross‐sectional study linked the Northern Ireland CP Register and two administrative health care databases for people resident in Northern Ireland born between 1981 and 2008. Pain medication as a proxy was validated by replicating analyses from the Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE) studies. Logistic regression compared pain medication in the CP and general populations. Multi‐level regression models assessed factors associated with pain medication in the CP cohort. Results The sample size was 701 075, of whom 1430 (0.2%) were people with CP. There were 358 969 males and 340 677 females in the general population, and 810 males and 620 females in the CP population, with an age range of 4 to 31 years in both groups. The validation exercise produced results similar to the SPARCLE studies. More people with CP received pain medication (61% vs 50.9%) and had twice the odds of being prescribed opioid analgesics (odds ratio [OR]=2.81, 95% confidence interval [CI] 2.32–3.40). Among those with CP, the odds of being prescribed pain medication were higher for: females (OR=1.34, 95% CI 1.06–1.70), younger age (OR=1.60, 95% CI 1.02–2.51), Gross Motor Function Classification System level V (OR=2.60, 95% CI 1.52–4.47), seizures (OR=2.55, 95% CI 1.68–3.87), and higher deprivation score (OR=2.06, 95% CI 1.41–3.24). Interpretation Pain medication is an effective proxy for pain. More people with CP were prescribed pain medication than the general population. Pain medication for people with CP is not only dependent on physiological and clinical characteristics, but also environmental factors. Data linkage using pain medication as a proxy for experiencing pain is a valid method. People with cerebral palsy (CP) are more likely to experience pain than the general population. People with CP have over twice the odds of receiving opioids compared to the general population. The odds of being prescribed pain medication were higher for females with CP. Prescription of pain medication among those with CP is not only dependent on clinical characteristics, but also environmental factors.

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Pain is frequent in children with cerebral palsy and negatively affects physical activity and participation

Cited by 19 publications

References 26 publications

Hip contractures were associated with low gross motor function in children with cerebral palsy

Hip contractures were associated with low gross motor function in children with cerebral palsy

Effect of Social Support in Pain Sensitivity in Children with Cerebral Palsy and Typically Developing Children

Data linkage and pain medication in people with cerebral palsy: a cross‐sectional study

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