PDF(Pubmed)
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.
METHODS: 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.
METHODS: 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.
摘要：
背景：疼痛在脑瘫（CP）患者中很常见，并且报告最多的疼痛部位是脚/小腿。我们分析了足部/小腿疼痛的患病率以及与年龄的关系，性别,粗大运动功能，和CP患者的临床发现。
方法：这是一项横断面登记研究，根据瑞典脑瘫随访计划（CPUP）报告的数据。CPUP的所有参与者，四岁或更老,包括在内。采用Pearson卡方检验和logistic回归分析足/小腿疼痛的患病率和程度。
结果：总计，从CPUP数据库中包括5,122个人：58％为男性，66％为18岁以下。总的来说,1,077（21％）报告了足部/小腿疼痛。女性疼痛的比值比（OR）较高（OR1.31，95％置信区间（CI）1.13-1.53），可以走动的个人（粗大运动功能分类系统级别I（OR1.84，CI1.32-2.57）和II（OR2.01，CI1.46-2.79）与级别V相比），并且在踝关节活动范围减小的个体中（背屈1-10度（OR1.43，CI1.13-1.83）和≤0度（OR1.46，CI1.10-1.93），与≥20度相比）。随着年龄的增长，疼痛的OR增加（OR1.02，CI1.01-1.03）以及报告的疼痛强度（p<0.001）。
结论：足部和小腿疼痛似乎是CP患者的一个重要问题，尤其是那些走路的人。就像这个人群的疼痛一样，疼痛强度和频率都随着年龄的增长而增加。在踝关节背屈受限的个体中，足部和小腿疼痛的几率增加。考虑到横截面设计的因果关系无法推断，疼痛是否会导致踝关节活动范围减小或活动范围减小导致疼痛尚不清楚。需要进一步研究因果途径，重要的是预防。
方法：这是一项横断面登记研究，根据瑞典脑瘫随访计划（CPUP）报告的数据。CPUP的所有参与者，四岁或更老,包括在内。采用Pearson卡方检验和logistic回归分析足/小腿疼痛的患病率和程度。
结果：总计，从CPUP数据库中包括5,122个人：58％为男性，66％为18岁以下。总的来说,1,077（21％）报告了足部/小腿疼痛。女性疼痛的比值比（OR）较高（OR1.31，95％置信区间（CI）1.13-1.53），可以走动的个人（粗大运动功能分类系统级别I（OR1.84，CI1.32-2.57）和II（OR2.01，CI1.46-2.79）与级别V相比），并且在踝关节活动范围减小的个体中（背屈1-10度（OR1.43，CI1.13-1.83）和≤0度（OR1.46，CI1.10-1.93），与≥20度相比）。随着年龄的增长，疼痛的OR增加（OR1.02，CI1.01-1.03）以及报告的疼痛强度（p<0.001）。
结论：足部和小腿疼痛似乎是CP患者的一个重要问题，尤其是那些走路的人。就像这个人群的疼痛一样，疼痛强度和频率都随着年龄的增长而增加。在踝关节背屈受限的个体中，足部和小腿疼痛的几率增加。考虑到横截面设计的因果关系无法推断，疼痛是否会导致踝关节活动范围减小或活动范围减小导致疼痛尚不清楚。需要进一步研究因果途径，重要的是预防。
