Foot and lower leg pain in children and adults with cerebral palsy : a population-based register study on 5,122 individuals
Jarlman, Ebba LU
; Hägglund, Gunnar
LU
and Alriksson-Schmidt, Ann I
LU
(2024)
In BMC Musculoskeletal Disorders
25(1).
- Abstract
BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP.
METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg.
RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age.... (More)
BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP.
METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg.
RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001).
CONCLUSIONS: Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.
(Less)
- author
- Jarlman, Ebba
LU
; Hägglund, Gunnar
LU
and Alriksson-Schmidt, Ann I
LU
- organization
- publishing date
- 2024-05-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Cerebral Palsy/epidemiology, Male, Female, Registries, Cross-Sectional Studies, Adult, Adolescent, Child, Young Adult, Sweden/epidemiology, Leg, Child, Preschool, Prevalence, Foot/physiopathology, Middle Aged, Pain/epidemiology, Pain Measurement
- in
- BMC Musculoskeletal Disorders
- volume
- 25
- issue
- 1
- article number
- 391
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:38762469
- scopus:85193526306
- ISSN
- 1471-2474
- DOI
- 10.1186/s12891-024-07486-y
- language
- English
- LU publication?
- yes
- id
- baaee0c7-b999-4ef7-b393-21b2e4c7f14e
- date added to LUP
- 2024-05-28 14:32:20
- date last changed
- 2024-06-26 06:37:03
@article{baaee0c7-b999-4ef7-b393-21b2e4c7f14e,
abstract = {{<p>BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP.</p><p>METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg.</p><p>RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001).</p><p>CONCLUSIONS: Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.</p>}},
author = {{Jarlman, Ebba and Hägglund, Gunnar and Alriksson-Schmidt, Ann I}},
issn = {{1471-2474}},
keywords = {{Humans; Cerebral Palsy/epidemiology; Male; Female; Registries; Cross-Sectional Studies; Adult; Adolescent; Child; Young Adult; Sweden/epidemiology; Leg; Child, Preschool; Prevalence; Foot/physiopathology; Middle Aged; Pain/epidemiology; Pain Measurement}},
language = {{eng}},
month = {{05}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Musculoskeletal Disorders}},
title = {{Foot and lower leg pain in children and adults with cerebral palsy : a population-based register study on 5,122 individuals}},
url = {{http://dx.doi.org/10.1186/s12891-024-07486-y}},
doi = {{10.1186/s12891-024-07486-y}},
volume = {{25}},
year = {{2024}},
}