979 - Pain in children with cerebral palsy

Objectives: this work is aimed to describe the characteristics of pain in children with cerebral palsy.

Design: A cross-sectional study conducted during the period between November 2021 and
November 2023 including children with CP consulting the outpatient clinic of physical medicine and
rehabilitation(PMR).  We studied demographic information, clinical and functional status (as assessed by the Global Motor Function Classification System (GMFCS) ), pain’s characteristics and management . Pain was assessed by ;The Faces Pain
Scale Revised,(FPS-R), the visual analogue scale (VAS), The Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Pain Scale and The Echelle Douleur Enfant San Salvador (DESS).

Results: We enrolled 45 children , 53%of whom were females. The mean age was 6.72±5.4 years. Thirty-six
of patients had a severe motor impairement with a GMFCS of 4 in 40% of cases
Sixty-five percent of patients experienced pain, most children with pain had orthopedic pain and 48%
had pain of another origin. The main sites of pain were the hips (65%) and knee (18%).Pain was
considered intense in 15% of cases, and the DESS was greater than 20 in 7patients
The prevalence of pain was positively associated with age (P= 0.169)Pain was reported more often in
GMFCS Level V patients.

Conclusions: Despite frequent reports of pain in childhood CP, pain is typically under identified, under measured,
and under treated by clinicians. Difficulties in pain identification and measurement in children with CP
stem from the presence of multiple pain sources, impaired communication, variable cognitive and
physical functioning, and limitations within existing measurement tools.
Little is known regarding the influence of CP on childhood pain experiences, leading to a lack of
targeted pain management strategies in this population.