Pain characteristics and their association with quality of life and self-concept in children with hemiplegic cerebral palsy identified from a population register.
01 May 2008-The Clinical Journal of Pain (Lippincott Williams & Wilkins)-Vol. 24, Iss: 4, pp 335-342
TL;DR: Quality of life and self-perception in children with hemiplegic cerebral palsy was significantly lower and pain was common, with qualities suggesting a nociceptive origin, and clinicians should assess and actively manage pain in this population.
Abstract: ObjectivesTo describe and characterize the prevalence and quality of pain in a population-based community sample of children with hemiplegic cerebral palsy.MethodsOutcomes were assessed from 2 domains of the World Health Organization International Classification of Functioning, Disability and Health
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27 Apr 2007
TL;DR: The Assessment of Motor and Process Skills (AMPS) is an innovative observational assessment that is used to measure the quality of a person’s performance of domestic or basic activities of daily living (ADL).
Abstract: The Assessment of Motor and Process Skills (AMPS) is an innovative observational assessment that is used to measure the quality of a person’s performance of domestic (instrumental) or basic (personal) activities of daily living (ADL). The quality of the person’s ADL performance is assessed by rating the effort, efficiency, safety, and independence of 16 ADL motor and 20 ADL process skill items. The ADL motor and ADL process skill are analogous to the goal-directed actions defined under the Activities and Participation domains of the International Classification of Functioning, Disability and Health (World Health Organization [WHO], 2001), and are thus the small units of performance that when carried out, one by one, result in the overall task being completed.
477 citations
TL;DR: To summarize evidence on the rates of co-occurring impairments, diseases, and functional limitations with cerebral palsy into succinct clinical messages, a search was conducted of the databases PubMed, Medline, CINAHL, and PsycINFO.
Abstract: OBJECTIVE: To summarize evidence on the rates of co-occurring impairments, diseases, and functional limitations with cerebral palsy into succinct clinical messages. METHODS: A search was conducted of the databases PubMed, Medline, CINAHL, and PsycINFO, and the results were supplemented with hand searches. Two independent reviewers determined whether retrieved abstracts met the following inclusion criteria: human subjects; >90% were children or adults with cerebral palsy; published after 1999; and population-based data. Articles were appraised, analyzing design, participants, level of evidence, rates of impairments, and functional implications. Methodologic quality was rated by using a standardized checklist. RESULTS: A total of 1366 papers were identified in the search; 82 were appraised and 30 were included in the meta-analyses. High-level evidence existed, as rated on the Oxford 2011 Levels of Evidence: 97% of prevalence studies were level 1. The data were of a moderate to high quality grade (with the exception of sleep disorders), allowing plain English clinical messages to be developed. CONCLUSIONS: Among children with cerebral palsy, 3 in 4 were in pain; 1 in 2 had an intellectual disability; 1 in 3 could not walk; 1 in 3 had a hip displacement; 1 in 4 could not talk; 1 in 4 had epilepsy; 1 in 4 had a behavior disorder; 1 in 4 had bladder control problems; 1 in 5 had a sleep disorder; 1 in 5 dribbled; 1 in 10 were blind; 1 in 15 were tube-fed; and 1 in 25 were deaf.
425 citations
01 Jan 2006
TL;DR: The PedsQLTM 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8-18 and 4227 parents of children ages 5-18 as mentioned in this paper.
Abstract: Background: The application of health-related quality of life (HRQOL) as a school population health measure may facilitate risk assessment and resource allocation, the tracking of student health at the school and district level, the identification of health disparities among schoolchildren, and the determination of health outcomes from interventions and policy decisions at the school, district, and county level. Objective:To determine the feasibility, reliability, and validity of the 23-item PedsQLTM 4.0 (Pediatric Quality of Life InventoryTM) Generic Core Scales as a school population health measure for children and adolescents. Design: Survey conducted in 304 classes at 18 elementary schools, 4 middle schools, and 3 high schools within a large metropolitan school district. Methods:The PedsQLTM 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8–18 and 4227 parents of children ages 5–18. Results:The PedsQLTM 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (α = 0.89 child, 0.92, parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQLTM 4.0 was related to indicators of socioeconomic status (SES) at the school and district level. The PedsQLTM School Functioning Scale was significantly correlated with standardized achievement scores based on the Stanford 9. Conclusion: The results demonstrate the feasibility, reliability and validity of the PedsQLTM 4.0 Generic Core Scales as a school population health measure. The implications of measuring HRQOL in schoolchildren at the school, district, and county level for identifying and ameliorating health disparities are discussed.
280 citations
TL;DR: The historical background, classification, and etiology of cerebral palsy (CP), the most common motor disability of childhood, are reviewed.
228 citations
TL;DR: The prevalence, predictors, severity, and impact of recurrent musculoskeletal pain in children and adolescents with cerebral palsy were explored.
Abstract: Aim The aim of this study was to explore the prevalence, predictors, severity, and impact of recurrent musculoskeletal pain in children and adolescents with cerebral palsy (CP)
Method One hundred and fifty-three participants (81 males, 72 females) aged 8 to 18 years were assessed by clinical examination, interview, and questionnaires CP type distribution was 38% unilateral spastic, 55% bilateral spastic, 6% dyskinetic, and 1% ataxic Gross Motor Function Classification System (GMFCS) levels were as follows: level I, 54; level II, 56; level III, 20; level IV, 8; and level V, 15 Sixty-four children and 89 parents recorded pain on the Child Health Questionnaire, 56 children and 85 parents indicated impact of pain on 0 to 10 numeric rating scales, and 72 children indicated pain intensity on the Faces Pain Scale-Revised
Results Ninety-five (62%) children across all GMFCS levels experienced recurrent musculoskeletal pain Age above 14 years was the only significant predictor (OR 290, 95% CI 122–780, p=002, adjusted for sex, CP type, gross motor function and mother’s education) Children reported recurrent musculoskeletal pain to be moderate Parents reported pain to be more severe and with higher impact on sleep than their children did Children and parents reported similar impact of pain on general activity and walking
Interpretation Recurrent musculoskeletal pain is the dominating pain problem in children and adolescents with CP Monitoring of musculoskeletal pain should be part of the medical follow-up across the whole range of motor impairment
113 citations
Cites background from "Pain characteristics and their asso..."
...Recognition is important because untreated or undertreated nociceptive pain in childhood may predispose to persisting pain in adulthood through conditioning(2) or through the generation of neuropathic pain, as stimulation of nociceptors may result in changes in the nervous system leading to chronic pain states.(4) The International Association for the Study of Pain defines chronic pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’....
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...Common body regions involved are the limbs, back, and neck.(3,4) Recognition is important because untreated or undertreated nociceptive pain in childhood may predispose to persisting pain in adulthood through conditioning(2) or through the generation of neuropathic pain, as stimulation of nociceptors may result in changes in the nervous system leading to chronic pain states....
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References
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TL;DR: A five‐level classification system analogous to the staging and grading systems used in medicine, which has application for clinical practice, research, teaching, and administration is developed.
Abstract: To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the classification system until consensus among 48 experts (physical therapists, occupational therapists, and developmental pediatricians with expertise in cerebral palsy) was achieved. Interrater reliability (kappa) was 0.55 for children less than 2 years of age and 0.75 for children 2 to 12 years of age. The classification system has application for clinical practice, research, teaching, and administration.
5,582 citations
TL;DR: The relationship between the raters' judgments was significant and the reliability was good, and it is believed these results to be positive enough to encourage further trials of the modified Ashworth scale for grading spasticity.
Abstract: We undertook this investigation to determine the interrater reliability of manual tests of elbow flexor muscle spasticity graded on a modified Ashworth scale. We each independently graded the elbow flexor muscle spasticity of 30 patients with intracranial lesions. We agreed on 86.7% of our ratings. The Kendall's tau correlation between our grades was .847 (p less than .001). Thus, the relationship between the raters' judgments was significant and the reliability was good. Although the results were limited to the elbow flexor muscle group, we believe them to be positive enough to encourage further trials of the modified Ashworth scale for grading spasticity.
4,788 citations
TL;DR: The PedsQL distinguished between healthy children and pediatric patients with acute or chronic health conditions, was related to indicators of morbidity and illness burden, and displayed a factor-derived solution largely consistent with the a priori conceptually-derived scales.
Abstract: Background.The PedsQL (Pediatric Quality of Life Inventory) (Children’s Hospital and Health Center, San Diego, California) is a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales are multidimensional ch
4,155 citations
TL;DR: In this paper, a pictorial scale of perceived competence and social acceptance for young children, a downward extension of the Perceived Competence Scale for Children, is described, and two versions of this instrument, 1 for preschoolers and kindergartners and a second for first and second graders, each tapping four domains: cognitive competence, physical competence, peer acceptance, and maternal acceptance.
Abstract: A new pictorial scale of perceived competence and social acceptance for young children, a downward extension of the Perceived Competence Scale for Children, is described. There are 2 versions of this instrument, 1 for preschoolers and kindergartners and a second for first and second graders, each tapping 4 domains: cognitive competence, physical competence, peer acceptance, and maternal acceptance. Factor analyses reveal a 2-factor solution. The first factor, general competence, is defined by the cognitive and physical competence subscales. The second factor, social acceptance, comprises the peer and maternal acceptance subscales. The psychometric properties were found to be acceptable. Weak correlations between children's and teachers' judgments are discussed in terms of the young child's tendency to confuse the wish to be competent or accepted with reality. It is urged that this instrument not be viewed as a general self-concept scale but be treated as a measure of 2 separate constructs, perceived competence and social acceptance.
1,303 citations
TL;DR: It is indicated that chronic pain is a common complaint in childhood and adolescence, and the high prevalence of severe chronic pain and multiple pain in girls aged 12 years and over calls for follow‐up investigations documenting the various bio‐psycho‐social factors related to this pain.
Abstract: Little is known about the epidemiology of pain in children. We studied the prevalence of pain in Dutch children aged from 0 to 18 years in the open population, and the relationship with age, gender and pain parameters. A random sample of 1300 children aged 0–3 years was taken from the regist
1,041 citations
"Pain characteristics and their asso..." refers methods in this paper
...On a visual analog scale, a cutoff of 50 on a 100-mm scale denotes the category of severe pain.(23) However, the Wong-Baker FACES Pain Rating Scale uses a smiling face to denote ‘‘no pain....
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