Pain trajectories in children and adolescents with cerebral palsy: A longitudinal population-based register study

Area of Science:

• Pediatric Neurology
• Pain Medicine
• Rehabilitation Medicine

Background:

• Cerebral palsy (CP) is a group of disorders affecting movement and posture, often accompanied by chronic pain.
• Understanding pain trajectories in children with CP is crucial for effective management and intervention.

Purpose of the Study:

• To investigate the longitudinal patterns of pain occurrence in children with cerebral palsy (CP) from age 1 to 17 years.
• To identify distinct pain trajectories and associated factors in this population.

Main Methods:

• A longitudinal, register-based study utilized data from the Swedish Cerebral Palsy Follow-up Program (2007-2023).
• Included 4887 individuals with CP, with a minimum of three pain assessments and data on Gross Motor Function Classification System (GMFCS) levels.
• Group-based trajectory modeling was employed to analyze pain occurrence over time.

Main Results:

• Four distinct pain trajectories were identified: increasing low occurrence (20.28%), increasing high occurrence (30.30%), decreasing (26.85%), and consistently high occurrence (22.57%).
• Children with higher GMFCS levels (IV-V) were more likely to follow decreasing or consistently high pain trajectories.
• Females were more prone to increasing high and consistently high pain trajectories compared to males.

Conclusions:

• Approximately half of children with CP experience persistent or increasing pain throughout childhood and adolescence.
• Pain management strategies should consider individual trajectories and factors like GMFCS level and sex.
• Further research is needed to explore the underlying mechanisms and optimize interventions for pain in CP.