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

• Published in: BMC neurology Vol. 20; no. 1; p. 15
• Main Authors: Eriksson, Elsa, Hägglund, Gunnar, Alriksson-Schmidt, Ann I
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11-01-2020; BioMed Central; BMC
• Subjects: Abdomen; Adolescent; Adolescents; Age; Boys; Care and treatment; Cerebral palsied children; Cerebral palsy; Cerebral Palsy - complications; Child; Child health; Child, Preschool; Childhood mental disorders; Children; Children & youth; Clinical Medicine; Complications and side effects; Cross-Sectional Studies; Demographic aspects; Female; Girls; Health aspects; Humans; Klinisk medicin; Logistic Models; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Neurologi; Neurology; Pain; Pain - epidemiology; Pain - etiology; Pain intensity; Paralysis; Pediatric pain; Prevalence; Proxy; Quality of life; Registries; Risk factors; Sleep; Social aspects; Statistical analysis; Sweden - epidemiology; Teenagers; Variables; Youths; Sweden; Cerebral palsy; Youths; Pain; Children; Pain intensity
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-019-1597-7

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.
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.
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%.
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.