title: Change in pain status in children with cerebral palsy.
abstract: To identify factors associated with a change in pain over time in children with cerebral palsy (CP).
  
  
  
  Pain was assessed at two time-points by physicians and caregiver-rated Health Utilities Index 3 (HUI3) pain scores.
  
  
  
  One hundred and forty-eight children out of 179 approached from outpatient clinics (83% response; 104 males, 44 females mean age 8y 8mo, range 3y-16y) across all Gross Motor Function Classification System (GMFCS) levels were included. Fifty-five percent had changes in caregiver-reported HUI3 pain. A backward stepwise multiple linear regression retained HUI3 pain score at visit 1 and GMFCS level (F[2,144]=23.40, R2=0.35; p<0.001) as variables associated with a change in pain status (HUI3 pain at visit 1: β=0.61, p<0.001; GMFCS level: β=-0.17, p<0.015). The association between HUI3 pain at visit 1 and GMFCS level was significant (β=-0.15, p<0.036). There was an association between pain etiology and pain trajectory (F[3,144]=5.39, p=0.002). Post-hoc testing revealed musculoskeletal pain had the greatest improvements compared with the no pain group (p=0.006).
  
  
  
  Children with CP with more severe initial pain and higher gross motor function have lower pain at follow-up indicating an improvement in pain status over time.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Rhandi
authors.initials: R
authors.lastname: Christensen
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: MacIntosh
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Lauren
authors.initials: L
authors.lastname: Switzer
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.|Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Darcy
authors.initials: D
authors.lastname: Fehlings
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D059408:Pain Management; D010820:Physicians / Q000523:psychology; D055815:Young Adult