Parent-reported participation in children with cerebral palsy: the contribution of recurrent musculoskeletal pain and child mental health problems.
OBJECTIVE
The aim of the study was to explore the contribution of recurrent musculoskeletal pain and mental health to aspects of participation in children with cerebral palsy (CP).


METHODS
A total of 105 participants (54 males, 51 females); mean age 14 y (SD 3) were assessed by clinical examination, interview, and parental questionnaires. CP type distribution was as follows: spastic unilateral, 37%; spastic bilateral, 56%; and dyskinetic, 7%. Motor function assessed using the Gross Motor Function Classification System was level I, 33%; level II, 40%; level III, 15%; and level IV/V, 11%. Parents reported child participation using the Assessment of Life Habits, child mental health problems using the Strengths and Difficulties Questionnaire, their own mental health using the General Health Questionnaire, and their socioeconomic status.


RESULTS
Recurrent musculoskeletal pain was associated with reduced accomplishment of daily activities (B=-1.22, p=0.02) and social roles (B=-1.17, p=0.03), and with reduced parental satisfaction with the accomplishment of daily activities (B=-1.14, p=0.03) and social roles (B=-1.48, p<0.01). Increasing levels of child mental health problems was associated with reduced accomplishment of daily activities (B=-0.10, p=0.02) and social roles (B=-0.11, p<0.01), and with reduced parental satisfaction with the accomplishment of social roles (B=-0.21, p<0.01).


CONCLUSIONS
Pain and child mental health should be considered in most participation models in CP. Regarding participation as an objective outcome measure is questionable.
Department of Clinical Neurosciences for Children, Women and Children's Division, Oslo University Hospital, Oslo, Norway. kjersti.ramstad@oslo-universitetssykehus.no
Kjersti
K
Ramstad
Reidun
R
Jahnsen
Ola H
OH
Skjeldal
Trond H
TH
Diseth
D000203:Activities of Daily Living / Q000145:classification* / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D020820:Dyskinesias / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D009460:Neurologic Examination; D015588:Observer Variation; D010290:Parents / Q000523:psychology; D010549:Personal Satisfaction; D010552:Personality Assessment / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012917:Social Adjustment; D011795:Surveys and Questionnaires