Risk factors associated with low back pain in mothers of children with cerebral palsy

Abstract

Introduction: Despite the important contribution of multifaceted risk factors on low back pain (LBP), only few studies have attempted to examine the impact of functional level and environmental factors on LBP in mothers of children with disabilities. Moreover, there has been no previous study investigating the risk factors associated with LBP in mothers of children with cerebral palsy. Hence, the present study was to investigate the risk factors associated with LBP in mothers of children with cerebral palsy. Patients and methods: A sample of 94 mothers of children attending three pediatric physical medicine and rehabilitation clinics at three major medical centers and local community rehabilitation centers for their rehabilitation services were recruited for this study. They were divided into two groups: group 1 (mothers of children with the Functional Independent Measure for Children [WeeFIM] score ≥ 5); and group 2 (mothers of children with WeeFIM score < 5). The independent variables included demographic characteristics of mothers and children, and functional independence levels in children with cerebral palsy as determined by the WeeFIM measurement. The dependent variables entailed level of pain and disability, which were determined by the Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI), respectively. Multiple regression analysis, one-way analysis of variance (ANOVA), independent t-test, and frequency analysis statistics were performed at P < 0.05. Results: The most important risk factors associated with LBP in the care-giving mothers were type of housing, weight, and locomotion of the children in this order (P < 0.05). The regression equation for locomotion measure was significant (R2 = 0.22; F [3, 94] = 7.43; P = 0.002). The regression equation for weight measure was significant (R2 = 0.22; F [3, 94] = 7.43; P = 0.0 06). The regression equation for the type of housing measure was significant (R2 = 0.22; F [3, 94] = 7.43; p = 0.025). ANOVA revealed that mothers living in multi-unit villas complained of significantly greater pain when compared to the other types of housing (P = 0.037). Independent t-test showed that the group of children who required physical assistance from their mothers for transfer (P = 0.000), locomotion (P = 0.005) and overall WeeFIM score (P = 0.029) showed greater pain in NRS when compared with the controls who did not require physical assistance. Pearson correlation showed that LBP pain in NRS was correlated with the children's transfer (r = −0.23; P < 0.05), locomotion (r = −0.24; P < 0.01), and weight (r = 0.27; P < 0.01) variables, respectively. Frequency analysis of the home environmental factors showed that mothers' care and independence of children in the home were affected by access to the bathroom, entrance, kitchen, and corridors. Adaptive devices that influenced children's independence were in self-care, sphincter control, and locomotion, followed by transfer.