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Sarmiento CA, Gannotti ME, Gross PH, Thorpe DE, Hurvitz EA, Noritz GH, Horn SD, Msall ME, Chambers HG, Krach LE. Adults with cerebral palsy and chronic pain experience: A cross-sectional analysis of patient-reported outcomes from a novel North American registry. Disabil Health J 2024; 17:101546. [PMID: 37993325 DOI: 10.1016/j.dhjo.2023.101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Chronic pain is common among adults with cerebral palsy (CP) and an area of priority for research and treatment. OBJECTIVE Describe the pain experience and its functional and quality of life impact among adults with CP with chronic pain in the community. METHODS Cross-sectional analysis of adult patient-reported outcomes collected by the Cerebral Palsy Research Network Community Registry. RESULTS Among all participants in the Community Registry, n = 205 reported having chronic pain, and 73 % of those (n = 149) completed the Chronic Pain Survey Bundle (75 % female; mean age 43 years (SD 14 years); 94 % White; 91 % non-Hispanic). Back and weight-bearing joints of lower extremities were most frequently reported as painful. There were no differences in average pain severity scores between varying GMFCS levels (H = 6.25, p = 0.18) and age groups (H = 3.20, p = 0.36). Several nonpharmacologic interventions were most frequently reported as beneficial. Participants with moderate to severe average pain scores (5-10) had higher levels of pain interference (p < 0.01) and depression (p < 0.01), and lower levels of satisfaction with social roles (p < 0.01) and lower extremity function (p < 0.01). Pain interference was significantly positively correlated with depression, and negatively correlated with upper and lower extremity function and satisfaction with social roles. CONCLUSIONS Chronic pain is experienced by adults with CP of varying ages and functional levels and is associated with several adverse quality of life and functional outcomes. Improved understanding of chronic pain in this population will facilitate the development and study of treatment interventions optimizing health, function, participation, and quality of life.
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Affiliation(s)
- Cristina A Sarmiento
- University of Colorado Anschutz, Department of Physical Medicine and Rehabilitation, 13123 East 16th Avenue, Box 285, Aurora, CO, 80045, USA.
| | - Mary E Gannotti
- University of Hartford, Department of Rehabilitation Sciences, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA.
| | - Paul H Gross
- University of Utah Medicine, Department of Population Health Sciences, 95 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT, 84108, USA.
| | - Deborah E Thorpe
- University of North Carolina, Chapel Hill, Department of Allied Health Sciences, Bondurant Hall, CB #7135, Chapel Hill, NC, 27599, USA.
| | - Edward A Hurvitz
- University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, 325 E Eisenhower Parkway Suite 100, Ann Arbor, MI, 48108, USA.
| | - Garey H Noritz
- Nationwide Children's Hospital, Complex Health Care Program, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Susan D Horn
- University of Utah Medicine, Department of Population Health Sciences, 95 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT, 84108, USA.
| | - Michael E Msall
- University of Chicago Kennedy Research Center, 5721 S. Maryland Avenue, Chicago, IL, 60637, USA.
| | - Henry G Chambers
- University of California, San Diego, Department of Orthopedic Surgery, 3030 Children's Way 3rd Floor, San Diego, CA, 92123, USA.
| | - Linda E Krach
- Gillette Children's, Department of Physical Medicine and Rehabilitation, 200 University Avenue East, Mail Code 435-105, St. Paul, MN, 55101, USA.
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Fernandes F, Talih M, Pires C, Navasardyan N, Santos MJ, Lucas R. Pain site persistence and changes from childhood to adolescence: a prospective cohort study. Pediatr Res 2024; 95:1625-1633. [PMID: 38225449 DOI: 10.1038/s41390-024-03021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/22/2023] [Accepted: 12/29/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Pain is a complex experience that interferes with the well-being of youth who experience it. We aimed to assess whether recurrent pain sites in childhood can predict later recurrent pain sites prospectively. METHODS Pain was assessed using the Luebeck Pain Screening Questionnaire at ages 7, 10, and 13 from the Generation XXI cohort. We used multinomial regression to assess the association of recurrent pain sites at ages 7 and 10 with those at age 13. RESULTS We included 3833 participants. Boys with recurrent abdominal/pelvic pain at age 7 were more likely to report headaches (OR 2.81; 95%CI 1.48-5.34), abdominal/pelvic (OR 2.92; 95%CI 1.46-5.84), and musculoskeletal pain (OR 1.55; 95%CI 1.02-2.34) at age 13. Girls with recurrent abdominal/pelvic pain at age 7 were more likely to report both musculoskeletal (OR 1.62; 95%CI 1.10-2.40) and abdominal/pelvic pain (OR 1.74; 95%CI 1.15-2.65). At age 10, all pain sites were associated with pain in the same site at age 13. CONCLUSION Recurrent abdominal/pelvic pain at age 7 may be related to the development of various pains in adolescence. Pain at a given site at age 10 can be associated with pain at that same site at age 13. IMPACT Recurrent abdominal or pelvic pain during childhood was distinctively associated with an increased risk of recurrent pain in other sites during adolescence. Recurrent pain during childhood was associated with pain in the same sites at age 13, and this persistence seemed to emerge between the ages of 7 and 10 for both boys and girls. Studying early pain sites may add to the understanding of the etiology of chronic pain.
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Affiliation(s)
- Francisco Fernandes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.
- Unidade de Saúde Pública - Agrupamento de Centros de Saúde Baixo Mondego, Coimbra, Portugal.
| | - Makram Talih
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Catarina Pires
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
| | - Naré Navasardyan
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
| | - Maria José Santos
- Rheumatology Department, Hospital Garcia de Orta EPE, Almada, Portugal
| | - Raquel Lucas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
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Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med 2024; 20:719-726. [PMID: 38169433 PMCID: PMC11063692 DOI: 10.5664/jcsm.10980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
STUDY OBJECTIVES Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. METHODS We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8-18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self-report pain and sleep disturbance. We collected self-reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric Patient-Reported Outcomes Measurement Information System short form, v1.0-4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. RESULTS A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high-pain group had the greatest sleep disturbance (adjusted β = 5.7; 95% confidence interval, 1.2, 10.2). CONCLUSIONS Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy. CITATION Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med. 2024;20(5):719-726.
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Affiliation(s)
- Heather M. Shearer
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sheilah Hogg-Johnson
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Darcy L. Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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