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The Prevalence of Coexisting Motor Proficiency Delay and Chronic Pain in Children Presenting to a Tertiary Pain
Rebecca Fechner1,2, Kris Rogers3, Linsay Rogers1
1QIPPPS Queensland Interdisciplinary Paediatric Persistent Pain Service, Children's Health Queensland Hospital and Health Service, South Brisbane.
Insights
Most children with chronic pain show motor proficiency delays, impacting their development. Standardized assessments like the BOT-2 are crucial for identifying these challenges and guiding effective rehabilitation programs.
Area of Science:
- Pediatric chronic pain research
- Developmental pediatrics
- Rehabilitation science
Background:
- Chronic pain significantly affects children's physical, social, and psychological well-being, with potential long-term consequences.
- The prevalence of motor proficiency delay in children experiencing chronic pain remains largely uncharacterized.
Purpose of the Study:
- To determine the prevalence of motor proficiency delay in a cohort of children with chronic pain.
- To identify potential predictors of delayed motor proficiency using routine self-report measures.
Main Methods:
- A cross-sectional study involving 94 children and adolescents (aged 6-18) with chronic pain attending a tertiary pain clinic.
- Motor proficiency was assessed using the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2).
- Routine clinical questionnaires and self-perception tools were administered.
Main Results:
- A high prevalence of motor challenges was observed, with 83% of participants exhibiting difficulties in at least one subtest.
- 41% of children had delayed overall motor proficiency scores.
- Routine demographic and clinical data explained only 9% of the variance in BOT-2 scores.
Conclusions:
- The majority of children in tertiary pain clinics exhibit motor proficiency deficits that are not typically identified through standard self-report measures.
- Utilizing assessments like the BOT-2 can aid in identifying developmental targets and inform tailored, developmentally appropriate rehabilitation strategies.
Objectives:
Chronic pain can profoundly impact children's physical, social, and psychological functioning, with negative effects that can persist into adulthood. The prevalence of motor proficiency delay in children with chronic pain is unknown. We aimed to describe the prevalence of motor proficiency delay in a sample of children and estimate potential predictive factors of delayed motor proficiency from routinely collected self-report measures.
Methods:
We conducted a cross-sectional study of 94 children and adolescents (6 to 18) with chronic pain who attended a tertiary pain clinic in Australia. We assessed their motor proficiency using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) standardised assessment tool. Participants also completed a suite of routine clinical questionnaires and a self-perception questionnaire. We described the prevalence of motor proficiency delay using descriptive statistics and estimated the extent to which routine demographic and clinical data could explain variation in BOT-2 scores using a multivariable linear model to calculate adjusted R ².
Results:
Overall, 83% of participants presented with challenges in at least one motor-proficiency subtest (eg, coordination), and 41% had delayed total motor proficiency scores. We found that just 9% of the variance in BOT-2 scores could be explained by the covariates in the multivariable prediction model (adjusted R2 =0.09, 95% CI: 0.01-0.25).
Discussion:
Most children presenting to a tertiary pain clinic presented with motor proficiency challenges unlikely to be identified through routinely collected self-report measures. Given that the BOT-2 can identify norm-referenced developmental targets, the use of these assessments may enhance clinical formulations and guide developmentally sensitive rehabilitation programs.
