Pain trajectories and well-being in children and young people with cerebral palsy: A cohort study.
Heather M Shearer, Pierre Côté, Sheilah Hogg-Johnson and 2 others
PMID 35489074WHAT IT FOUND
Children with cerebral palsy fell into five distinct 5-week pain patterns.
Those with high or changing pain reported lower physical and psychological well-being than those with stable low pain. Repeated brief pain checks may help spot children at risk for poor well-being.
Key findings
01Latent class growth modelling identified five distinct short-term pain trajectories in children with CP: no/very mild stable, mild stable, moderate changing, high-to-decreasing, and high stable.
02Children in the high stable pain trajectory had the largest reduction in physical well-being compared to those in the no/very mild stable trajectory, even after adjusting for confounders.
03Children in the moderate changing, high-to-decreasing, and high stable pain trajectories had lower psychological well-being than those in the no/very mild stable trajectory in adjusted models.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only measured pain over 5 weeks, so it is unclear if these trajectories remain stable over longer periods. Some trajectory groups were small, particularly the high stable pain group (n=5), which increases uncertainty around the estimates. Participants who could not complete a sorting task or communicate independently were excluded, potentially under-representing children with severe motor or cognitive impairments (GMFCS IV-V). Socioeconomic status was estimated using postal code, which may not accurately reflect individual household income. The study did not consistently record limb involvement, limiting the ability to generalize findings to specific CP subtypes.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not assume that a child with high pain who shows decreasing pain over 5 weeks is improving in well-being. The study found that even children in the high-to-decreasing pain trajectory had lower psychological well-being compared to those with stable low pain. Short-term pain reduction does not necessarily equate to better well-being outcomes.