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Change in pain status in children with cerebral palsy
Author(s) -
Christensen Rhandi,
MacIntosh Alexander,
Switzer Lauren,
Fehlings Darcy
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13328
Subject(s) - gross motor function classification system , cerebral palsy , physical therapy , medicine , psychology
Aim To identify factors associated with a change in pain over time in children with cerebral palsy ( CP ). Method Pain was assessed at two time‐points by physicians and caregiver‐rated Health Utilities Index 3 ( HUI 3) pain scores. Results One hundred and forty‐eight children out of 179 approached from outpatient clinics (83% response; 104 males, 44 females mean age 8y 8mo, range 3y–16y) across all Gross Motor Function Classification System ( GMFCS ) levels were included. Fifty‐five percent had changes in caregiver‐reported HUI 3 pain. A backward stepwise multiple linear regression retained HUI 3 pain score at visit 1 and GMFCS level ( F [2,144] =23.40, R 2 =0.35; p <0.001) as variables associated with a change in pain status ( HUI 3 pain at visit 1: β =0.61, p <0.001; GMFCS level: β =−0.17, p <0.015). The association between HUI 3 pain at visit 1 and GMFCS level was significant ( β =−0.15, p <0.036). There was an association between pain etiology and pain trajectory ( F [3,144] =5.39, p =0.002). Post‐hoc testing revealed musculoskeletal pain had the greatest improvements compared with the no pain group ( p =0.006). Interpretation Children with CP with more severe initial pain and higher gross motor function have lower pain at follow‐up indicating an improvement in pain status over time.