Division of Women and Children, Department of Clinical Neuroscience, Oslo University Hospital, Olso, Norway.
Dev Med Child Neurol. 2011 Nov;53(11):1013-8. doi: 10.1111/j.1469-8749.2011.04070.x.
The aim of this study was to explore the prevalence, predictors, severity, and impact of recurrent musculoskeletal pain in children and adolescents with cerebral palsy (CP).
One hundred and fifty-three participants (81 males, 72 females) aged 8 to 18 years were assessed by clinical examination, interview, and questionnaires. CP type distribution was 38% unilateral spastic, 55% bilateral spastic, 6% dyskinetic, and 1% ataxic. Gross Motor Function Classification System (GMFCS) levels were as follows: level I, 54; level II, 56; level III, 20; level IV, 8; and level V, 15. Sixty-four children and 89 parents recorded pain on the Child Health Questionnaire, 56 children and 85 parents indicated impact of pain on 0 to 10 numeric rating scales, and 72 children indicated pain intensity on the Faces Pain Scale-Revised.
Ninety-five (62%) children across all GMFCS levels experienced recurrent musculoskeletal pain. Age above 14 years was the only significant predictor (OR 2.90, 95% CI 1.22-7.80, p=0.02, adjusted for sex, CP type, gross motor function and mother's education). Children reported recurrent musculoskeletal pain to be moderate. Parents reported pain to be more severe and with higher impact on sleep than their children did. Children and parents reported similar impact of pain on general activity and walking.
Recurrent musculoskeletal pain is the dominating pain problem in children and adolescents with CP. Monitoring of musculoskeletal pain should be part of the medical follow-up across the whole range of motor impairment.
本研究旨在探讨脑瘫（CP）儿童和青少年反复性肌肉骨骼疼痛的患病率、预测因素、严重程度和影响。
对 153 名 8 至 18 岁的参与者进行临床检查、访谈和问卷调查。CP 类型分布为：38%单侧痉挛型，55%双侧痉挛型，6%手足徐动型，1%共济失调型。粗大运动功能分类系统（GMFCS）水平为：I 级 54 例，II 级 56 例，III 级 20 例，IV 级 8 例，V 级 15 例。64 名儿童和 89 名家长记录了儿童健康问卷中的疼痛情况，56 名儿童和 85 名家长在 0 到 10 的数字评分量表上表示疼痛的影响，72 名儿童表示修订后的面部疼痛量表的疼痛强度。
所有 GMFCS 水平的 95 名（62%）儿童均有反复性肌肉骨骼疼痛。14 岁以上是唯一的显著预测因素（OR 2.90，95%CI 1.22-7.80，p=0.02，调整性别、CP 类型、粗大运动功能和母亲的教育程度后）。儿童报告反复性肌肉骨骼疼痛为中度。父母报告疼痛比孩子更严重，对睡眠的影响也更大。儿童和家长报告疼痛对一般活动和行走的影响相似。
反复性肌肉骨骼疼痛是脑瘫儿童和青少年中主要的疼痛问题。肌肉骨骼疼痛的监测应作为整个运动障碍范围内的医疗随访的一部分。
