Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis.
Florian Heinen, Michaela Bonfert, Petr Kaňovský and 8 others
PMID 35342060WHAT IT FOUND
Spasticity-related pain is common in children with cerebral palsy, affecting over 80% of those with lower limb spasticity and nearly 70% with upper limb spasticity.
Pain intensity increases with physical demand, being highest during exercises and hard tasks rather than at rest.
Key findings
0181.9% of children with lower limb spasticity and 69.7% with upper limb spasticity self-reported spasticity-related pain in at least one activity at baseline.
02Parents/caregivers observed spasticity-related pain in at least one activity in 85.9% of children with lower limb spasticity and 77.7% with upper limb spasticity.
03Pain was reported less frequently at rest (26.5% lower limb, 23.0% upper limb) but more frequently during exercises (70.9% lower limb, 64.7% upper limb) and hard tasks.
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 population was drawn from clinical trials, so they met specific inclusion criteria (e.g., Ashworth Scale ≥2) and may not represent all children with CP. Children who were too young or had severe disabilities were unable to self-report, so data relies more heavily on parent/caregiver observation for these groups. The study is a pooled analysis of baseline data from trials designed to test incobotulinumtoxinA, not primarily to investigate pain epidemiology, though pain was a pre-specified secondary outcome. Concomitant therapies (physiotherapy, OT) were allowed but not standardized, which may influence pain perception.
Declared interests
The study was supported by Merz Pharmaceuticals GmbH, the manufacturer of incobotulinumtoxinA. Authors declared affiliations with the sponsor or received funding from it.
The easy way to misread this
Do not assume that low pain scores at rest mean a child is pain-free. Pain intensity and prevalence increase significantly with physical demand, so children may experience substantial pain during therapy exercises or daily activities even if they appear comfortable at rest.