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. 2020 Jan 11;20(1):15.
doi: 10.1186/s12883-019-1597-7.

Pain in children and adolescents with cerebral palsy - a cross-sectional register study of 3545 individuals

Elsa Eriksson  1 , Gunnar Hägglund  2 , Ann I Alriksson-Schmidt  2
Affiliations

Pain in children and adolescents with cerebral palsy - a cross-sectional register study of 3545 individuals

Elsa Eriksson et al. BMC Neurol. .

Abstract

Background: Pain is a common problem for individuals with cerebral palsy (CP). In Sweden, 95% of children and adolescents with CP are followed in a national follow-up programme (CPUP), which includes data on pain. The purpose of this study was to investigate the prevalence of pain based on age, sex, gross motor function and source of report (self or proxy). Pain intensity, pain site, and how much pain disturbed sleep and daily activities were also studied.

Methods: This was a cross-sectional register study based on all participants in CPUP, 4-18-years of age, with data reported in 2017-2018. Gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Logistic regression was used to analyse prevalence of pain and how much pain had disturbed sleep and daily activities in the last four weeks.

Results: In total, 3545 participants (2065 boys) were included. The overall prevalence of pain was 44%. Older age and female sex were associated with higher risk of pain with odds ratios of 1.07 (95% confidence interval (CI) 1.06-1.09) and 1.28 (CI 1.12-1.47), respectively. Pain was most common in the lower extremities. There was no statistically significant difference in prevalence of pain related to source of report. Pain intensity was higher at older ages and higher GMFCS-levels. Hip/thigh pain and abdominal pain were associated with the most intense pain. Of those who reported pain, pain disturbed sleep for 36% and daily activities for 61%.

Conclusions: Both pain frequency and pain intensity were higher at higher age. Pain intensity increased with increasing GMFCS-level. Two-thirds of all children and adolescents with CP reported that their pain disturbed their daily activities, and one-third reported that pain disturbed their sleep.

Keywords: Cerebral palsy; Children; Pain; Pain intensity; Youths.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pain prevalence related to age and sex. N = 1505
Fig. 2
Fig. 2
Prevalence of pain for the different pain sites in boys and girls. N = 1936
Fig. 3
Fig. 3
Pain prevalence at different pain sites related to GMFCS-level. Each bar represents the percentage of children with pain related to the total number of children in the same GMFCS-level with pain. GMFCS = Gross Motor Function Classification System
Fig. 4
Fig. 4
Highest recorded pain intensity related to age. Only those 1118 who have reported pain and pain intensity are included
Fig. 5
Fig. 5
Distribution of highest pain intensity recorded at any pain site related to GMFCS-level. Only those 1118 who reported pain and pain intensity are included. GMFCS = Gross Motor Function Classification System
See this image and copyright information in PMC

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