Prevalence and characteristics of pain in children and young adults with cerebral palsy: a systematic review

Abstract

Aim The primary aim of this review is to evaluate the evidence for pain prevalence in children and young adults with cerebral palsy. Secondary aims are to identify pain characteristics and types of pain measurement used in this population. Method Ovid MEDLINE, Embase, CINAHL Plus, and PubMed were searched in October 2016 and updated in November 2017. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Pain outcomes were categorized within a biopsychosocial pain framework, with pain prevalence extracted for all recall periods and measurement types. Results One hundred and six publications from 57 studies met inclusion criteria. Pain prevalence varied widely from 14 per cent to 76 per cent and was higher in females, older age groups, and those classified within Gross Motor Function Classification System level V. Pain was most frequent in the lower limbs, back, and abdomen and associated with reduced quality of life or health status. The influence of pain on psychological functioning, interference, and participation was inconclusive. Interpretation Variation exists in reported pain prevalence because of sampling bias, inconsistent measurement, varying recall periods, and use of different participant age ranges. What this paper adds Pain prevalence varies from 14 per cent to 76 per cent in children and young adults with cerebral palsy. Pain is more prevalent in females, older age groups, and children in Gross Motor Function Classification System level V.

Health‐related quality of life, pain, and fatigue in young adults with cerebral palsy

“…The group is large since most individuals with CP will have a life expectancy similar to the general population . Fatigue, pain, deteriorating mobility, and reduced physical and mental health have been reported as areas of concern . Physical and mental health, frequently expressed as health‐related quality of life (HRQoL), have occasionally been reported in adults with CP.…”

“…Knowledge gaps remain on health specific to young adulthood. Pain, a second important issue, has been reported in 14% to 76% of all individuals with CP . Pain in young adults with CP often remains undiagnosed and untreated .…”

“…Pain, a second important issue, has been reported in 14% to 76% of all individuals with CP . Pain in young adults with CP often remains undiagnosed and untreated . Longitudinal studies in adults with CP have found that pain prevalence increases with age, that it is associated with perceived poor health, and that it interferes with activities of daily living .…”

“…Consequently, analysis is often performed on subgroups; the most common categorization is the Gross Motor Function Classification System – Expanded and Revised (GMFCS‐ER) . Whilst problems with pain seem to be more common in individuals in low‐functioning GMFCS‐ER levels, especially in GMFCS level V, results regarding physical and mental health have not shown clear correlations …”

Pain coping strategies in children with cerebral palsy

“…It is no longer a simple symptom of injury but an illness in itself that can affect the individual's personality and lifestyle, and may be associated with signs of depression and psychosocial disruption. The reported prevalence of pain in individuals with CP varies from 14 per cent to 73 per cent, depending on the evaluation methods used . Some children with CP experience pain from birth, with stays in neonatal intensive care .…”