Pain symptoms in patients with severe cerebral palsy: Prevalence among patients with higher degree of locomotor impairment

Clarissa De Albuquerque Botura,Roberto Kenji Nakamura Cuman,Aline Vieira Scarlatelli Lima Bardini,Ana Clara De Albuquerque Botura,Franciele Queiroz Ames,Luiz Eduardo Bersani-Amado

doi:10.4314/tjpr.v16i6.30

Abstract

Purpose: To evaluate the presence of pain in patients diagnosed with severe cerebral palsy (CP) according to the degree of motor function impairment. Methods: A cross-sectional study was conducted on students of the Association of Parents and Friends of Exceptional Children (APAE) diagnosed with cerebral palsy and with severe locomotor disability (GMFCS levels IV and V). The study included students of both genders and of any age. After signing the consent form, a structured questionnaire was administered to parents or caregivers to collect data on the history of the illness and the Paediatric Pain Profile (PPP). A score ≥ 14 out of a possible 60 points suggests the presence of pain. Results: A total of 93 subjects were evaluated. Of the 44 subjects classified with GMFCS level IV, 12 (21.4 %) suffer pain and among the 49 subjects classified with level V, 44 (78.6 %) had pain symptoms (ICDDN ≥ 14, PR = 3.29, 95 % CI 2.01 - 5.38, p < 0.01). Conclusion: The results show that pain is prevalent in individuals with severe CP. Furthermore, it is more prevalent in patients with a higher degree of locomotor impairment (GMFCS – level V). Keywords: Cerebral palsy, Pain measurement, Locomotor disability, Gross motor function classification system (GMFCS)

Highlights

Cerebral palsy (CP) is defined as a permanent disorder of movement and posture due to a nonprogressive brain defect or lesion early in life
This study evaluated the presence of pain in patients with a diagnosis of severe CP according to degree of motor function impairment
Excluded were patients with diagnosis of severe CP, those whose parents or caregivers did could not understand the content of the consent form and unable to respond adequately to the questions asked by the researchers, or those who did not agree to participate in the study

Summary

Introduction

Cerebral palsy (CP) is defined as a permanent disorder of movement and posture due to a nonprogressive brain defect or lesion early in life. Considered as the most common form of physical impairment in the pediatric age group [1], the disorder has a high prevalence, affecting approximately 4 out of 1,000 children born alive in developed countries [2]. There is still no determining factor for the occurrence of CP. The conditions that contribute most to its occurrence are hypoxemia and ischemia due to endogenous or exogenous factors, such as genetic and chromosomal abnormalities, complications during pregnancy or childbirth, infections, parasitoses, among others. Cognitive development is limited and does not accompany chronological age, reflecting a poor quality of life over time [3,4,5,6]

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Conclusion