Article

Several studies have given frequencies of pain in children with
cerebral palsy, but comparing the findings is difficult. We aimed to estimate the
prevalence of pain in non-ambulatory children with cerebral palsy and describe
their characteristics by presence or absence of pain.
METHODS: Data were
extracted from an ongoing longitudinal national cohort following non-ambulatory
children with severe cerebral palsy aged 3 to 10years over 10years. We described
and compared data for the first 240 children at inclusion by presence or absence
of pain. Pain was assessed by a visual analog scale and the Douleur Enfant San
Salvadour scales and by investigator interview. RESULTS: Overall, 65 children
experienced pain, for a prevalence of 27.1% (95% confidence interval 22-33%). All
children experiencing pain had orthopaedic pain and 45.6% had pain from another
origin. The main pain sites were hips (43.4%) and feet (26.9%). Joint
mobilisation was the source of pain for 58.3% of children experiencing pain, and
sitting was identified as painful for 10.3%. Pain was greater with scoliosis
(43.1% vs 24.1% with and without pain; P=0.006) and spasticity treatment (32.3%
vs 17.2%; P=0.020). CONCLUSION: Children with cerebral palsy frequently
experience pain and also early pain, mostly articular and orthopedic. The
assessment of pain should be systematic because of its high prevalence.
Interventions to prevent scoliosis, hip luxation, and foot deformities and to
reduce spasticity, such as the use of analgesics before joint mobilization
exercises, may reduce the prevalence of this pain.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS