Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia; Kids Rehab, The Children's Hospital at Westmead, Sydney, Australia; Cerebral Palsy Alliance, The University of Sydney, Sydney, Australia.
Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia; Kids Rehab, The Children's Hospital at Westmead, Sydney, Australia.
Arch Phys Med Rehabil. 2020 Feb;101(2):213-219. doi: 10.1016/j.apmr.2019.08.475. Epub 2019 Sep 12.
To determine the prevalence, interference, and management of acute and chronic pain among youth with cerebral palsy (CP) aged 5-18 years attending outpatient rehabilitation services.
A cross-sectional study using the Faces Pain Scale-Revised, Patient Reporting Outcomes Measurement Information System Pediatric Pain Interference Scale, and the Cerebral Palsy Quality of Life questionnaire. Where children were unable to self-report, parent or caregiver proxy was obtained.
Outpatient rehabilitation.
Participants (N=280) with CP aged 5-18 years and their parent or caregiver. Self-report was obtained by 45.7% (n=128) and proxy-report was obtained by 54.3% (n=152) of the cohort.
Not applicable.
Presence or absence of acute pain and chronic pain. Secondary measures were pain intensity, pain interference, pain management, and quality of life.
Acute pain and chronic pain were reported by 67.1% and 31.4% of participants, respectively. Of those reporting acute pain, 42% also experienced chronic pain. Factors that increased the odds of chronic pain were: predominately dyskinesia (odds ratio [OR]=3.52; 95% confidence interval [CI], 1.64-7.55); mixed spasticity-dyskinesia (OR=1.93; 95% CI, 1.07-3.47); bilateral involvement (OR=3.22; 95% CI, 1.844-5.61) and Gross Motor Function Classification System level IV (OR=2.32; 95% CI, 1.02-5.25), and V (OR=3.73; 95% CI, 1.70-8.20). Pain frequently interferes with sleep, attention, ability to have fun, and quality of life. Short-acting pharmacologic analgesics, thermotherapy, hydrotherapy, and massage were commonly used for pain management.
Routine screening for pain is critical for early identification and intervention. Multimodal interventions are needed to address the biopsychosocial model of pain, and should be tailored for all abilities across the CP spectrum.
确定在接受门诊康复服务的 5-18 岁脑瘫（CP）青少年中，急性和慢性疼痛的发生率、干扰程度和管理情况。
使用修订后的面部疼痛量表-修订版、患者报告的结局测量信息系统儿科疼痛干扰量表和脑瘫生活质量问卷进行的横断面研究。对于无法自我报告的儿童，将获得家长或看护者的代理报告。
门诊康复。
5-18 岁 CP 参与者及其家长或看护者（共 280 名）。45.7%（n=128）的参与者进行了自我报告，54.3%（n=152）的参与者进行了代理报告。
不适用。
急性疼痛和慢性疼痛的存在或不存在。次要观察指标为疼痛强度、疼痛干扰、疼痛管理和生活质量。
分别有 67.1%和 31.4%的参与者报告有急性疼痛和慢性疼痛。在报告有急性疼痛的参与者中，有 42%的人也患有慢性疼痛。增加慢性疼痛几率的因素包括：主要为运动障碍（优势比[OR]=3.52；95%置信区间[CI]，1.64-7.55）；痉挛-运动障碍混合（OR=1.93；95%CI，1.07-3.47）；双侧受累（OR=3.22；95%CI，1.844-5.61）和粗大运动功能分级系统（GMFCS）IV 级（OR=2.32；95%CI，1.02-5.25）和 V 级（OR=3.73；95%CI，1.70-8.20）。疼痛经常干扰睡眠、注意力、娱乐能力和生活质量。短期药理镇痛剂、热疗、水疗和按摩常用于疼痛管理。
常规筛查疼痛对于早期识别和干预至关重要。需要采用多模式干预来解决疼痛的生物-心理-社会模型，并且应根据脑瘫谱系内的所有能力进行定制。
