Physical and mental components of health-related quality of life and musculoskeletal pain sites over seven years in adults with spastic cerebral palsy.

Abstract

OBJECTIVE: To analyse the number of musculoskeletal pain sites in adults with spastic cerebral palsy, to correlate these with physical and mental components of health-related quality of life, and to describe changes in pain site prevalence over 7 years and the factors improving or worsening the pain. DESIGN: Seven-year follow-up of a national survey of adults with spastic cerebral palsy (CP). SUBJECTS/PATIENTS: A total of 149 persons: 46% spastic bilateral CP, 54% unilateral CP, 51% females, mean age 40 years. METHODS: Pain sites were recorded and physical and mental component summaries computed using Short Form 36. RESULTS: The median number of pain sites was 3. The mental components showed little, if any correlation (r= -0.08), but the physical components correlated negatively with the number of pain sites (r= -0.36). Back, neck and foot/ankle pain were most common, with an increased prevalence of neck pain. A higher prevalence of hip and foot/ankle pain was found in spastic bilateral CP, and for all pain sites in females. Exertion and physiotherapy were the most important factors for increased and reduced pain, respectively. CONCLUSION: In contrast to the general population, there was hardly any correlation between the number of pain sites and psychological health. Improved pain management, evidence-based physiotherapy and rehabilitation programmes with a life-span perspective are recommended.