Prevalence and determinants of hip pain in non-ambulatory cerebral palsy children: a retrospective cohort study.
Silvia Faccioli, Silvia Sassi, Adriano Ferrari and 6 others
PMID 36507793WHAT IT FOUND
Hip pain was reported in 8.9% of children with severe cerebral palsy, rising to 10.9% in those with GMFCS level V.
Key independent predictors were older age, female sex, higher migration percentage, and lumbar scoliosis. Pain often resolved after treatment, suggesting a need for targeted assessment rather than assuming dislocation is the sole cause.
Key findings
01Hip pain or discomfort was reported in 8.9% of the total sample, with higher prevalence in GMFCS level V (6.3%) compared to level IV (2.6%).
02Independent predictors of hip pain identified by multivariate analysis were age, female sex, migration percentage (MP), and lumbar scoliosis.
03Only 39% of patients with hip dislocation complained of hip pain, and many cases of pain were transient, resolving after interventions such as surgery or medication.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Retrospective design with variable follow-up lengths among patients. Pain was recorded as a dichotomous variable without validated pain scales. Medical records prior to 2015 were unavailable, limiting the sample size. Single-center study with a specific population (tertiary referral), which may not represent all children with CP. Causality cannot be established for transient pain resolution due to concurrent treatments.
The easy way to misread this
Do not assume that hip dislocation (high MP) automatically causes pain, as only 39% of patients with dislocations reported pain. Conversely, do not assume that pain is absent in lower MP ranges, as pain was found at all levels. The association between walking/standing devices and lower pain is likely confounded by their suspension during painful episodes.