
Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis
Author(s) -
Florian Heinen,
Michaela Bonfert,
Petr Kaňovský,
Andreas Schröeder,
Henry G. Chambers,
Edward Dabrowski,
Thorin L. Geister,
Angelika Hanschmann,
Michael Althaus,
Marta Banach,
Deborah GaeblerSpira
Publication year - 2022
Publication title -
journal of pediatric rehabilitation medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.277
H-Index - 23
eISSN - 1875-8894
pISSN - 1874-5393
DOI - 10.3233/prm-220011
Subject(s) - spasticity , cerebral palsy , spastic , physical therapy , medicine , physical medicine and rehabilitation , psychology
PURPOSE: A large prospective database from three Phase 3 studies allowed the study of spasticity-related pain (SRP) in pediatric cerebral palsy (CP). METHODS: Baseline (pretreatment) SRP data occurring during different activities in children/adolescents (aged 2–17 years, ambulant/nonambulant) with uni-/bilateral spastic CP was obtained using the Questionnaire on Pain caused by Spasticity (QPS; six modules specific to spasticity level [lower limb (LL) or upper limb (UL)] and type of respondent [child/adolescent, interviewer, or parent/caregiver]). RESULTS: At baseline, 331 children/adolescents with LL- and 155 with UL-spasticity completed at least one key item of their modules; LL/UL QPS modules of parent/caregivers were at least partially completed (key items) by 841/444 parents/caregivers. SRP with at least one activity at baseline was self-reported in 81.9% /69.7% (LLs/ULs) of children/adolescents with spasticity. Parents/caregivers observed LL/UL SRP behaviors in 85.9% /77.7% of their children, with multiple body regions affected. SRP negatively affected the great majority of the children in various ways. Child/adolescent-reported mean SRP intensity and parent/caregiver-observed mean SRP behavior frequencies were higher for LLs than ULs, and the level of SRP increased with more physically demanding activities. CONCLUSION: These data suggest SRP is more common and intense in pediatric CP than generally thought, emphasizing the need for effective, long-term pain management.