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.

Keywords: CP, cerebral palsy; Cerebral palsy; Developmental disabilities; ITB, intrathecal baclofen; MPI, mean pain intensity; MPR, mean pain relief; Pain management; Rehabilitation.

Fig 1

MPR scores associated with all pain treatment approaches reported. MPR scores range from 0 meaning “no pain” to 10 meaning “worst pain possible.” Data points are color coded by pain type, and each data point represents an individual response. Mean and SD are represented by the bar and whiskers.

Fig 2

MPR scores associated with different pain medications used to relieve pain. MPR scores range from 0 meaning “intervention did not help” to 10 meaning “intervention completely relieved pain.” Data points are color coded by pain type, and each data point represents an individual response. Mean and SD are represented by the bar and whiskers.