Department of Clinical Neurosciences for Children, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
Dev Med Child Neurol. 2012 Sep;54(9):829-35. doi: 10.1111/j.1469-8749.2012.04341.x. Epub 2012 Jul 11.
The aim of the study was to explore the contribution of recurrent musculoskeletal pain and mental health to aspects of participation in children with cerebral palsy (CP).
A total of 105 participants (54 males, 51 females); mean age 14 y (SD 3) were assessed by clinical examination, interview, and parental questionnaires. CP type distribution was as follows: spastic unilateral, 37%; spastic bilateral, 56%; and dyskinetic, 7%. Motor function assessed using the Gross Motor Function Classification System was level I, 33%; level II, 40%; level III, 15%; and level IV/V, 11%. Parents reported child participation using the Assessment of Life Habits, child mental health problems using the Strengths and Difficulties Questionnaire, their own mental health using the General Health Questionnaire, and their socioeconomic status.
Recurrent musculoskeletal pain was associated with reduced accomplishment of daily activities (B=-1.22, p=0.02) and social roles (B=-1.17, p=0.03), and with reduced parental satisfaction with the accomplishment of daily activities (B=-1.14, p=0.03) and social roles (B=-1.48, p<0.01). Increasing levels of child mental health problems was associated with reduced accomplishment of daily activities (B=-0.10, p=0.02) and social roles (B=-0.11, p<0.01), and with reduced parental satisfaction with the accomplishment of social roles (B=-0.21, p<0.01).
Pain and child mental health should be considered in most participation models in CP. Regarding participation as an objective outcome measure is questionable.
本研究旨在探讨复发性肌肉骨骼疼痛和心理健康对脑瘫（CP）患儿参与度各方面的影响。
共评估了 105 名参与者（男 54 名，女 51 名）；平均年龄 14 岁（SD 3），通过临床检查、访谈和家长问卷进行评估。CP 类型分布如下：痉挛性单侧 37%；痉挛性双侧 56%；运动障碍性 7%。使用粗大运动功能分类系统评估运动功能，水平 I 为 33%；水平 II 为 40%；水平 III 为 15%；水平 IV/V 为 11%。父母使用生活习惯评估报告儿童参与度，使用长处和困难问卷报告儿童心理健康问题，使用一般健康问卷报告自身心理健康，使用社会经济地位问卷报告社会经济地位。
复发性肌肉骨骼疼痛与日常活动（B=-1.22，p=0.02）和社会角色（B=-1.17，p=0.03）的完成度降低，以及父母对日常活动（B=-1.14，p=0.03）和社会角色（B=-1.48，p<0.01）完成度的满意度降低有关。儿童心理健康问题水平的增加与日常活动（B=-0.10，p=0.02）和社会角色（B=-0.11，p<0.01）的完成度降低，以及父母对社会角色完成度（B=-0.21，p<0.01）的满意度降低有关。
在 CP 中的大多数参与模型中都应考虑疼痛和儿童心理健康问题。将参与度作为客观的结果测量指标是值得商榷的。
