Pain in adults with cerebral palsy: A systematic review
Prepared by: AACPDM Digest reviewer/ Manjula Manikandan, PhD
Keywords:
- Cerebral palsy
- Pain
- Prevalence
- Adults
Study type: Systematic review
Summary: Pain is a common but often under-recognized health issue in adults with cerebral palsy (CP). This systematic review aimed to summarize the evidence on the prevalence and incidence of pain in adults with CP, identify associated prognostic factors, review the tools used to assess pain, and evaluate intervention effectiveness.
The study team conducted a comprehensive search of the literature from six databases and included 63 studies. The reported prevalence of pain among adults with CP varied widely, ranging from 24% to 89%. Chronic pain, defined as pain lasting longer than three months, was reported in 75% to 78% of adults with CP. The prevalence of pain was higher in adults with CP compared to those without.
Prognostic factors associated with higher pain prevalence included better communication ability, female sex, and increasing age. The evidence suggested moderate certainty that adults with better communication skills reported more pain, while there was low certainty regarding the association between pain prevalence and Gross Motor Function Classification System levels.
Various pain assessment tools were used across studies, including numerical, verbal, and pictorial rating scales. These tools were found to be valid for assessing pain intensity in adults with CP.
Regarding interventions, the review found very low to low certainty evidence on the effectiveness of both pharmacological and non-pharmacological treatments. Pharmacological and surgical interventions showed no significant effect on pain reduction. However, engaging in an active lifestyle and participating in sports interventions were associated with reduced pain compared to usual care.
The findings highlight the need for high-quality research to develop effective pain management strategies for adults with CP. Clinicians should be aware of the high prevalence of pain in this population and consider incorporating active lifestyle interventions into care plans.