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Disabil Rehabil. 2018 Jun 11:1-8. doi: 10.1080/09638288.2018.1472818. [Epub ahead of print]

Evaluating pain in cerebral palsy: comparing assessment tools using the International Classification of Functioning, Disability and Health.

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a Division of Medical Sciences , University of Victoria , British Columbia , Canada.
b Department of Pediatrics , University of British Columbia , Vancouver , Canada.
c BC Children's Hospital Research Institute , University of British Columbia , Vancouver , Canada.



Pain is prevalent and affects functioning and quality of life of children with cerebral palsy (CP). However, pain in CP is under recognized. The International Classification of Functioning, Disabiity and Health (ICF) guides the selection of comprehensive chronic pain assessment tools. Our objectives were to identify measures addressing pain in children with CP, characterize the content of each measure using the ICF, and identify gaps and overlaps.


Measures were identified from: (1) a systematic review of outcome measures (1998-2012) and (2) a scan of chronic pain measures (2013-2015). Included measures were those published in English, used in children and youth with CP, and contained an item/domain addressing pain. Constructs of the measures were linked to the ICF.


Overall, 31 measures addressing chronic pain in CP were included. Considerable variability was found in the degree to which their content represented the ICF. Most of pain measures address pain intensity and pain location (body functions) as opposed to functional impact of pain (activities and participation).


Functional dimensions are poorly represented in pain measures. Our findings may guide the selection of measures for research and clinical needs for comprehensive chronic pain management in children with CP. Implications for Rehabilitation Chronic pain is prevalent among children with cerebral palsy and significantly interfere with functional activities. To effectively manage chronic pain in children with cerebral palsy, measures capturing functional-based information need to be part of routine chronic pain assessment.


ICF; ICF core sets; Pain; cerebral palsy; child; functioning; measure; participation

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