title: Investigating the impact of pain, age, Gross Motor Function Classification System, and sex on health-related quality of life in children with cerebral palsy.
abstract: OBJECTIVE
  To explore whether health-related quality of life (HRQOL) can be predicted by pain, age, Gross Motor Function Classification System (GMFCS) level, and sex in children with cerebral palsy (CP) and whether different pain etiologies have varying effects on HRQOL.
  
  
  METHODS
  Children with CP aged 3 to 19 years and their caregivers were consecutively recruited. Caregivers reported their child's pain (Health Utilities Index 3 [HUI3] pain subset) and HRQOL (DISABKIDS questionnaires). Physicians identified pain etiologies. A multiple linear regression model determined whether pain, GMFCS level, sex, and age predicted HRQOL. An ANOVA evaluated the effects of pain etiologies on HRQOL.
  
  
  RESULTS
  Three hundred and forty-four participants were approached and 87% (n=300) participated. Sufficient data were available on 248 (72% of total sample). Sixty-six participants (27%) formed the pain group with HUI3 pain scores of at least 3. The presence of pain and increasing age significantly negatively predicted HRQOL (p<0.001, R(2) =0.141), while GMFCS and sex did not. Musculoskeletal deformity (24%) and hypertonia (18%) were the most frequent pain causes. HRQOL statistically differed depending on the pain etiology (p=0.028) with musculoskeletal deformity showing the lowest mean HRQOL.
  
  
  CONCLUSIONS
  The presence of pain and increasing age negatively predict HRQOL in CP. musculoskeletal deformity has the greatest negative impact on HRQOL.
authors.affiliation: Department of Paediatrics, University of Toronto, Toronto, ON, Canada.|Bloorview Research Institute, Toronto, ON, Canada.
authors.forename: Briar
authors.initials: B
authors.lastname: Findlay
authors.affiliation: Bloorview Research Institute, Toronto, ON, Canada.
authors.forename: Lauren
authors.initials: L
authors.lastname: Switzer
authors.affiliation: Bloorview Research Institute, Toronto, ON, Canada.|Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Unni
authors.initials: U
authors.lastname: Narayanan
authors.affiliation: Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Shiyi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Paediatrics, University of Toronto, Toronto, ON, Canada.|Bloorview Research Institute, Toronto, ON, Canada.
authors.forename: Darcy
authors.initials: D
authors.lastname: Fehlings
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000145:classification*; D009122:Muscle Hypertonia / Q000150:complications; D009139:Musculoskeletal Abnormalities / Q000150:complications; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult