Shearer Heather M, Côté Pierre, Hogg-Johnson Sheilah, Mckeever Patricia, Fehlings Darcy L
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Dev Med Child Neurol. 2022 Nov;64(11):1416-1424. doi: 10.1111/dmcn.15252. Epub 2022 Apr 30.
To identify 5-week pain intensity trajectories and their association with physical and psychological well-being in children/young people with cerebral palsy (CP).
A cohort study was conducted with 101 Canadian children/young people with CP, of whom 49 were female, with an overall mean age of 12 years 11 months (SD 3 years 1 month), range of 8 to 18 years, and classified in any Gross Motor Function Classification System level. Self-reported pain intensity (Faces Pain Scale - Revised) was collected weekly for 5 weeks and physical and psychological well-being (KIDSCREEN-27) at baseline and 5 weeks. Statistical analyses included latent class growth and general linear models.
All Gross Motor Function Classification System levels were represented (I = 40.6%; II = 15.8%; III = 20.8%; IV = 13.9%; V = 8.9%). Five pain intensity trajectories were identified. Three trajectories had very low (35.4%), low (32.4%), or high (4.9%) mean stable pain. Two trajectories had moderate changing pain (16.8%) and high pain decreasing to moderate levels (10.5%) respectively. Trajectory participants with stable high pain had the lowest physical well-being (adjusted β = -10.01; 95% confidence interval [CI] = -19.37 to -0.66). Those in the three trajectories with the highest mean baseline pain intensity (>3 out of 10) had the lowest psychological well-being (adjusted β = -8.27, 95% CI = -14.84 to -1.70; β = -6.74, 95% CI = -12.43 to -1.05; β = -5.82, 95% CI = -15.34 to 3.71).
Almost one-third of participants had moderate-to-high pain intensity trajectories. Membership in the higher pain intensity trajectories was associated with lower physical and psychological well-being.
Five distinct 5-week pain intensity trajectories were identified in children/young people with cerebral palsy. Thirty-two per cent of participants had moderate-to-high pain intensity trajectories. Participants in the trajectories with higher pain intensity reported lower physical and psychological well-being.
确定脑瘫患儿/青少年5周的疼痛强度轨迹及其与身心健康的关联。
对101名加拿大脑瘫患儿/青少年进行了一项队列研究，其中49名女性，总体平均年龄为12岁11个月（标准差3岁1个月），年龄范围为8至18岁，且涵盖了所有粗大运动功能分类系统等级。每周收集一次自我报告的疼痛强度（面部疼痛量表修订版），持续5周，并在基线和5周时收集身心健康状况（儿童生活质量量表27项）。统计分析包括潜在类别增长模型和一般线性模型。
所有粗大运动功能分类系统等级均有代表（I级 = 40.6%；II级 = 15.8%；III级 = 20.8%；IV级 = 13.9%；V级 = 8.9%）。确定了五条疼痛强度轨迹。三条轨迹的平均稳定疼痛程度非常低（35.4%）、低（32.4%）或高（4.9%）。两条轨迹分别有中度变化的疼痛（16.8%）和高疼痛程度降至中度水平（10.5%）。稳定高疼痛轨迹的参与者身心健康状况最差（调整后的β = -10.01；95%置信区间[CI] = -19.37至-0.66）。基线疼痛强度平均最高（10分制中>3分）的三条轨迹中的参与者心理健康状况最差（调整后的β = -8.27，95% CI = -14.84至-1.70；β = -6.74，95% CI = -12.43至-1.05；β = -5.82，95% CI = -15.34至3.71）。
近三分之一的参与者有中度至高度疼痛强度轨迹。较高疼痛强度轨迹的参与者身心健康状况较差。
在脑瘫患儿/青少年中确定了五条不同的5周疼痛强度轨迹。32%的参与者有中度至高度疼痛强度轨迹。疼痛强度较高轨迹的参与者身心健康状况较差。
