Affiliations: Department of Pediatrics, University of Virginia,
Charlottesville, VA, USA | James Madison University School of Nursing,
Harrisonburg, VA, USA
Note: [] Address for correspondence: C.M. Houlihan, Kluge Children's
Rehabilitation Center, University of Virginia, 2270 Ivy Road, Charlottesville,
VA 22903, USA. E-mail: ch9g@virginia.edu
Abstract: Objectives: Children with cerebral palsy (CP) experience bodily
pain, leading to functional impairment and decreased quality of life. The
purpose of this study is to characterize subjective descriptors of chronic pain
in children with CP. Methods: One hundred fifty-seven children were
invited to participate in a quantitative pilot survey. Parents were mailed the
Varni-Thompson Pediatric Pain Questionnaire, designed to assess three
dimensions of pain: sensory (physical aspects), affective (emotional response),
and evaluative (the combined intensity of the emotional and physical
responses). Parents assessed their child's pain using non-verbal and verbal
cues. Results: Fifty-two families responded (33% return rate).
Thirty-eight children ages 6–8 years with CP and Gross Motor Function
Classification System (GMFCS) levels I–V were included. Ninety percent of
families reported that their child was experiencing some pain at the time of
the survey. At the time of assessment the children's pain was mild. Their pain,
at its worst, was in the distressing range. The two largest GMFCS groups of
children, levels I and IV, were compared in both severity and intensity of pain
experienced. Increasing intensity of pain was reported in children in the level
IV group compared to children classified as level I. Pain severity in all
dimensions was reported as increasing in Level IV children compared to Level I. Discussion: Children with CP experience frequent pain, which increases
with worsening impairment. Descriptive qualifiers of pain help to elucidate the
etiology of various types of pain which would lead to the development of more
effective approaches to pain management and treatment.
