Abstract
Sixty-seven percent of children with cerebral palsy (CCP) experience pain. Pain is closely interrelated to diminished quality of life. Despite this, pain is an overlooked and undertreated clinical problem. The objective of this study was to examine the analgesic effect of a single lower extremity intramuscular injection of Abobotulinum toxin A/Dysport in CCP. Twenty-five CCP with at least moderate pain (r-FLACC ≥ 4) during passive range of motion were included. Localized pain and pain in everyday living were measured by r-FLACC and the Paediatric Pain Profile (PPP), respectively. Functional improvements were evaluated by the goal attainment scale (SMART GAS). Quality of life was evaluated by either the CPCHILD or the CP-QOL. The subjects were evaluated at baseline before injection, then after 4, 12, and 28 weeks. Twenty-two subjects had a significant mean and maximum localized pain reduction (p < 0.001) at four weeks post-treatment in 96% (21/22). The reduction was maintained at 12 (19/19) and 28 weeks (12/15). Daily pain evaluated by the PPP was significantly reduced and functional SMART GAS goals were significantly achieved from 4 to 28 weeks. Quality of life improved significantly at four weeks (CPCHILD). Significant functional gains and localized and daily pain reduction were seen from 4 to 28 weeks.
Highlights
Publisher’s Note: MDPI stays neutralCerebral palsy (CP) is the most common inborn neurological disease in children with a prevalence of 2.4 per 1000 live births [1]
Pain can be as disabling as the movement disorder in itself [7,8], and self-reported pain is the primary determinator for diminished quality of life [9]
Children with CP in our general service area were screened for eligibility
Summary
Publisher’s Note: MDPI stays neutralCerebral palsy (CP) is the most common inborn neurological disease in children with a prevalence of 2.4 per 1000 live births [1]. The prevalence of pain is reported by caregivers as high as 67% [4,5], and the incidence increases with age and severity of the disease [6]. Pain can be as disabling as the movement disorder in itself [7,8], and self-reported pain is the primary determinator for diminished quality of life [9]. Despite the high prevalence of pain in CP, it is unrecognized and undertreated; diagnostic strategies and treatment are inadequate, and the consequences are detrimental since chronic pain is associated with decreased physical functioning and with disturbances in sleep, increased fatigue, and depression [4,5,10].
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