Department of Clinical Neurosciences for Children, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
University of Oslo, Oslo, Norway.
Dev Med Child Neurol. 2021 May;63(5):601-607. doi: 10.1111/dmcn.14782. Epub 2021 Jan 3.
To investigate the prevalence, characteristics, and risk factors of hip pain in adolescents with cerebral palsy (CP) and compare the findings with those of the same individuals 5 years earlier.
Sixty-seven adolescents (28 females, 39 males; mean age 14y 7mo; SD 1y 5mo; range 12-17y) with bilateral CP, in Gross Motor Function Classification System (GMFCS) levels III to V enrolled in a CP surveillance programme were assessed for hip pain. Their caregivers responded to the questions on the intensity and frequency of hip pain from the Child Health Questionnaire (CHQ) (transformed to CHQ hip pain score; 100 indicates no pain). Interference of hip pain with daily activities and sleep was recorded on numeric rating scales. Hip displacement was measured radiographically by the migration percentage.
Twenty-eight participants had 44 painful hips. Their mean CHQ hip pain score was 40 (SD 21.4; range 10-80). Independent risk factors for hip pain, low CHQ hip pain score, and interference with sleep were severe hip subluxation (migration percentage 50-89%) and GMFCS level V. A migration percentage of 50% to 89% was the only independent risk factor for interference with daily activities. Over 5 years, the number of participants with hip pain increased from 18 to 28, while the mean migration percentage of the most displaced hip was unchanged.
Our CP hip surveillance programme did not protect the participants against increasing prevalence of hip pain during adolescence. We suggest that surveillance programmes for CP should include guidelines on the characteristics and management of hip pain.
Hip pain prevalence increased in adolescents over a 5-year period in a cerebral palsy surveillance programme. Risk factors for hip pain were Gross Motor Function Classification System level V and severe hip subluxation.
调查脑瘫青少年髋关节痛的患病率、特征和危险因素，并将这些发现与 5 年前的同一人群进行比较。
67 名（28 名女性，39 名男性；平均年龄 14 岁 7 个月；标准差 1 岁 5 个月；年龄范围 12-17 岁）双侧脑瘫，粗大运动功能分级系统（GMFCS）III 至 V 级的青少年参加了脑瘫监测计划，对其髋关节痛进行了评估。他们的照顾者根据儿童健康问卷（CHQ）（转换为 CHQ 髋关节痛评分；100 表示无痛）回答髋关节痛的强度和频率问题。髋关节痛对日常活动和睡眠的干扰程度通过数字评分量表记录。髋关节移位通过放射学测量的迁移百分比来测量。
28 名参与者的 44 个髋关节有疼痛。他们的平均 CHQ 髋关节痛评分是 40（标准差 21.4；范围 10-80）。髋关节痛、低 CHQ 髋关节痛评分和睡眠干扰的独立危险因素是严重髋关节半脱位（迁移百分比 50-89%）和 GMFCS 水平 V。迁移百分比为 50%-89%是日常生活活动干扰的唯一独立危险因素。在 5 年期间，患有髋关节痛的参与者人数从 18 人增加到 28 人，而最移位髋关节的平均迁移百分比保持不变。
我们的脑瘫髋关节监测计划并没有保护参与者在青春期髋关节痛的患病率增加。我们建议，脑瘫监测计划应包括髋关节痛的特征和管理指南。
在脑瘫监测计划中，髋关节痛的患病率在 5 年内增加了青少年。髋关节痛的危险因素是粗大运动功能分级系统（GMFCS）V 级和严重髋关节半脱位。
