Department of Physiotherapy, Monash University, Frankston, Victoria, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Dev Med Child Neurol. 2019 Mar;61(3):305-314. doi: 10.1111/dmcn.14111. Epub 2018 Dec 3.
The primary aim of this review is to evaluate the evidence for pain prevalence in children and young adults with cerebral palsy. Secondary aims are to identify pain characteristics and types of pain measurement used in this population.
Ovid MEDLINE, Embase, CINAHL Plus, and PubMed were searched in October 2016 and updated in November 2017. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pain outcomes were categorized within a biopsychosocial pain framework, with pain prevalence extracted for all recall periods and measurement types.
One hundred and six publications from 57 studies met inclusion criteria. Pain prevalence varied widely from 14 per cent to 76 per cent and was higher in females, older age groups, and those classified within Gross Motor Function Classification System level V. Pain was most frequent in the lower limbs, back, and abdomen and associated with reduced quality of life or health status. The influence of pain on psychological functioning, interference, and participation was inconclusive.
Variation exists in reported pain prevalence because of sampling bias, inconsistent measurement, varying recall periods, and use of different participant age ranges.
Pain prevalence varies from 14 per cent to 76 per cent in children and young adults with cerebral palsy. Pain is more prevalent in females, older age groups, and children in Gross Motor Function Classification System level V.
本综述的主要目的是评估脑瘫儿童和青少年疼痛发生率的证据。次要目的是确定该人群中疼痛的特征和疼痛测量类型。
我们于 2016 年 10 月在 Ovid MEDLINE、Embase、CINAHL Plus 和 PubMed 进行检索，并于 2017 年 11 月进行更新。两名作者根据系统评价和荟萃分析的首选项目（PRISMA）指南独立筛选研究。根据生物-心理-社会疼痛框架对疼痛结果进行分类，提取所有回忆期和测量类型的疼痛发生率。
从 57 项研究中共有 106 篇文献符合纳入标准。疼痛发生率差异很大，范围从 14%到 76%，女性、年龄较大的组和被分类为粗大运动功能分级系统（GMFCS）V 级的患者发生率较高。疼痛最常见于下肢、背部和腹部，与生活质量或健康状况下降有关。疼痛对心理功能、干扰和参与的影响尚无定论。
由于抽样偏差、测量不一致、回忆期不同以及使用不同的参与者年龄范围，报告的疼痛发生率存在差异。
脑瘫儿童和青少年的疼痛发生率从 14%到 76%不等。女性、年龄较大的组和 GMFCS 级别为 V 的儿童疼痛发生率更高。
