Document Type

Article

Publication Date

3-9-2020

Identifier

DOI: 10.1016/j.arrct.2020.100049; PMCID: PMC7853392

Abstract

Objective: To characterize musculoskeletal pain intensity, duration, frequency, and interference with activities of daily living in children with cerebral palsy (CP) before and after intrathecal baclofen pump placement.

Design: Prospective cohort study.

Setting: Children's tertiary hospital.

Participants: Participants were children with CP (N=32; 53% male; mean age, 9.9y; age range, 4-17y). The majority of participants had a CP diagnosis of quadriplegia (76%) and relied on wheeled mobility (91%).

Interventions: Assessments were completed pre- and post intrathecal baclofen pump implant.

Main outcome measures: Because of considerable patient heterogeneity, both pain measures (Brief Pain Inventory, Dalhousie Pain Interview) were completed by proxy (parent) report at the time of the procedure and approximately 6 months after intrathecal baclofen (ITB) pump placement.

Results: Prior to implant, 31% of participants were living with constant pain, which reduced to 6% post ITB implant (P <.001). Based on Wilcoxon signed rank tests, pain duration significantly decreased post ITB pump implant (P <.01).

Conclusions: This prospective analysis supports the anecdotal and retrospective evidence that musculoskeletal pain decreases in CP following ITB pump implant. The greatest effect appears to be on the duration of pain experience. Pain did not decrease for all individuals, and it would be worth further investigation to better understand the relation between patient characteristics and pain outcomes.

Journal Title

Arch Rehabil Res Clin Transl

Volume

2

Issue

2

First Page

100049

Last Page

100049

Keywords

BPI, Brief Pain Inventory; CP, cerebral palsy; Cerebral palsy; DPI, Dalhousie Pain Interview; ICF, International Classification of Functioning, Disability and Health; ITB, intrathecal baclofen; MAS, Modified Ashworth Scale; Musculoskeletal pain; Pediatrics; Rehabilitation

Comments

This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.

Publisher's Link: https://www.sciencedirect.com/science/article/pii/S2590109520300148?via%3Dihub

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