Keywords
Pain
Stretching
How to Cite
Abstract
Introduction: Pain is defined as disturbed sensation that causes suffering or distress. Repeated and prolonged experience to pain can alter future responses to painful stimuli. Pain is common in children with cerebral palsy which may be unrecognized and not managed on time. children with cerebral palsy have difficulty in communicating their own pain experience. Pain related to stretching is one of the most salient negative memories in childhood, as pain has negative impact on health outcomes.
Objective: To assess the pain during stretching session of hamstring muscle among children with cerebral palsy.
Methodology: A cross-sectional study design was carried out among 35 children with cerebral palsy aged 3 to 18 years using purposive sampling technique. Children were assessed for pain during stretching of hamstring muscles in both passive stretching and positioning stretching using Non-Communicating Children’s Pain Checklist-Post-operative Version scale at Bhaktapur Community Rehabilitation Center, Patan Community Rehabilitation Center and Special Education and Rehabilitation Center. Data collection was done from April to July 2018. Data analysis was done using SPSS Inc. SPSS Statistics for Windows Version 16.0. Chicago, IL: SPSS Inc.; 2007. Frequency and percentage were used to interpret descriptive findings and Chi-square test was used to find out the association.
Results: In passive stretching 5.71% children experienced mild pain and 94.29% experienced moderate/severe pain. In positional stretching 17.14% experienced mild pain and 82.86% experienced moderate/severe pain.
Conclusion: Children with cerebral palsy experienced more pain in positional stretching than passive stretching ,there was no association between pain and severity level of cerebral palsy.
References
Swiggum M, Hamilton M., Gleeson P, Roddey T, Mitchel K. Pain assessment and management in children with neurologic impairment: a survey of pediatric physical therapists. Pediatric Physical Therapy. 2010; 22(3): p. 330-335.[PubMed | Full Text | DOI]
Koch K. Paediatric pain management in general practice. South African Family Practice. 2012; 54(4):292-295. [Full Text | DOI]
Hadden KL, C.L. Von B. Global and specific behavioral measures of pain in children with cerebral palsy. The Clinical journal of pain. 2005; 21(2):140-146. [PubMed | Full Text | DOI]
Breau LM, Burkit C. Assessing pain in children with intellectual disabilities. Pain Research and Management. 2009;14(2):116-120. [PubMed | Full Text | DOI]
Breau LM, Camfield CS, McGrath PJ, Finley GA. Risk factors for pain in children with severe cognitive impairments. Developmental Medicine & Child Neurology. 2004; 46(6): 364-371.[ PubMed | Full Text | DOI]
Hadden KL, LeFort S, OʼBrien M, Coyte PC, Guerriere DN. A comparison of observers' and self-report pain ratings for children with cerebral palsy. Journal of Developmental & Behavioral Pediatrics. 2015 Jan ;36(1):14-23.[PubMed | Full Text | DOI]
Lauren Schwartz JME, Mark P. Jensen. Pain in Persons With Cerebral Palsy.Arch Phys Med Rehabil. 1999; 80:1243-6. [PubMed | Full Text | DOI]
Parkinson KN, Drewett RF, Jones AR, Dale A, Pearce MS, Wright CM, et.al. Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study. Arch Dis Child. 2013; 98(6): 434-440.[ PubMed | Full Text | DOI]
Wiart L, Darrah J, Kembhavi G . Stretching with children with cerebral palsy: what do we know and where are we going? Pediatric Physical Therapy. 2008;20(2): p. 173-178. [PubMed | Full Text | DOI]
Von Baeyer CL, Tupper SM. Procedural pain management for children receiving physiotherapy. Physiotherapy Canada. 2010;62(4): 327-337. [ PubMed | Full Text | DOI]
Voepel-Lewis T, Malviya S, Tait AR, Merkel S, Foster R, Krane EJ, et.al. A. comparison of the clinical utility of pain assessment tools for children with cognitive impairment. Anesthesia & Analgesia. 2008;106(1): 72- 78 [PubMed | Full Text | DOI]
Kellie Hadden, Carl L von Baeyer. Pain in children with cerebral palsy : common triggers and expressive behaviours, Journal of pain. October 2002; 99(1- 2):281-8 [ PubMed | Full Text | DOI]
López-Bedoya J, Vernetta-Santana M, Lizaur-Girón P, MartínezPatiño MJ, Ariza-Vargas L. effectiveness and pain perception with holdrelax stretching technique and electrostimulation. revista Internacional de Medicina y Ciencias de la Actividad Física y el Deporte vol; 20(80): 623-640 [ Full Text | DOI]
Pin T, Dyke P, Chan M. The effectiveness of passive stretching in children with cerebral palsy. Developmental Medicine & Child Neurology. 2006;48(10):855-862. [ PubMed | Full Text | DOI]
Penner M, et al., Characteristics of pain in children and youth with cerebral palsy. Pediatrics, 2013. 132(2):e407-e413.[ PubMed | Full Text | DOI]
Krigger, K.W., Cerebral palsy: an overview. Am Fam Physician. 2006;73(1): p. 91-100.[ PubMed | Full Text]
Banskota, B., et al., A Snapshot of 1001 Children Presenting with Cerebral Palsy to a Children’s Disability Hospital. Journal of Nepal Health Research Council. 2013 Aug;132(2):e407-13 [ PubMed | Full Text | DOI]
Oskoui M., Xie WY., Binepal N., Switzer L., Fehlings D. An update on the prevalence of cerebral palsy: a systematic review and meta‐analysis. Developmental Medicine & Child Neurology. 2013;55(6): 509-519. .[ PubMed | Full Text | DOI]
Kirby, R.S., Wingate MS., Van Naarden Braun K., Doernberg NS., Arneson CL., Benedict RE et al., Prevalence and functioning of children with cerebral palsy in four areas of the United States in 2006: a report from the Autism and Developmental Disabilities Monitoring Network. Research in developmental disabilities. 2011; 32(2): 462-469. [ PubMed | Full Text | DOI]
Schellack, N. and M. Matimela, Paediatric pain management. South African Family Practice. 2016;58(3):42-47. [FullText ]
Breau LM., Camfield CS., McGrath PJ., Finley GA. The incidence of pain in children with severe cognitive impairments. Archives of pediatrics & adolescent medicine. 2003;157(12):1219-1226. [ PubMed | Full Text | DOI]
Fillingim R.B., King CD, Ribeiro-Dasilva MC, RahimWilliams B, Riley JL III. Sex, gender, and pain: a review of recent clinical and experimental findings. The journal of pain. 2009;10(5):447-485. [ PubMed | Full Text | DOI]
Theis N., Korff T., Kairon H., Mohagheghi AA. Does acute passive stretching increase muscle length in children with cerebral palsy? Clinical biomechanics. 2013;28(9):1061-1067. [PubMed | Full Text | DOI]
Breau, L.M., McGrath PJ., Camfield CS., Finley GA . Psychometric properties of the non-communicating children's pain checklist-revised. Pain. 2002; 99(1): 349-357 [PubMed | Full Text | DOI]
Zabalia, M., Breau LM., Wood C., Lévêque C., Hennequin M., Villeneuve E.,et al., Validation of the French version of the non-communicating children's pain checklist-postoperative version. Canadian journal of anaesthesia. 2011;58(11):1016-1023. [PubMed | Full Text | DOI]