Parental Report of Pain and Associated Limitations in Ambulatory Children With Cerebral Palsy

Tervo RC, Symons F, Stout J, Novacheck T. Parental report of pain and associated limitations in ambulatory children with cerebral palsy. Objective: To document parental reports about pain in children with cerebral palsy (CP). Design: A cross-sectional descriptive study. Setting: Motion analysis laboratory. Participants: Seventy-seven ambulatory children with CP (44 boys, 33 girls; age range, 3-17y) presenting as consecutive assessments. Interventions: Not applicable. Main Outcome Measures: Parents completed (1) a semistructured interview, (2) the Pediatric Outcome Data Collection Instrument (PODCI), (3) the Child Behavior Checklist (CBCL), (4) the Behavior Rating Inventory of Executive Functioning (BRIEF), and (5) Gillette Functional Assessment Questionnaire. Two dichotomous PODCI pain and comfort questions were estimates of pain frequency and impact. Results: Sixty-one percent reported "pain over the last week," and 33% reported "pain interfered with normal activities." Pain did not differ by topographic classification. Girls had more pain. "Pain that interfered with normal activities" was associated with limitations in activities of daily living and physical education. Social problems and attention problems on the CBCL and the initiate scale on the BRIEF were associated with pain that interfered with activity. Conclusions: Pain in children with CP is frequent and associated with behavioral and social consequences. Sex is a risk factor; girls experience more pain. Intervention strategies that successfully support transition into adulthood are needed.