Keywords
chronic pain,
psycho-emotional state,
physical rehabilitation.
How to Cite
Abstract
Abstract. The current strategy for the treatment of chronic pain in children with paralytic syndromes and neurological lesions, defined by the WHO recommendations in 2012. These recommendations provide a multimodal approach of analgesia for the chronic pain treatment, including the widespread use of non-pharmacological methods and pharmacological therapy.
Aim. Assessing the subjective vision of parents of children with paralytic syndromes regarding the impact of physical rehabilitation on chronic pain and their psycho-emotional state.
Materials and methods. Data from 64 children and their mothers (64 persons) were included in the study. The age of the children ranged from 1 to 6 years, the median age was 3 years and 3 months.
Results. The changed psycho-emotional state of parents of children with paralytic syndromes is determined. If the child has chronic pain, the parents: "Concern about the treatment of the child" is doubled (RR=2.1; p=0.0024), "Hyperopia of the child" - twice (RR=1.9; p=0.0094), "Intolerance to observe the suffering of the child" - one and a half times (RR=1.6; p=0.0017), and increases one and a half times "Sadness and anger when a child cries" (RR=1.5; p=0.0122), "Internal tension" (RR=1.5; p=0.0029), "Insomnia" (RR=1.5; p=0.0215), "Inability of the child to lead a normal image life "(RR=1.5; p=0.0035), "Search for compassion or understanding" (RR=1.5; p=0.0446), "Inner anxiety, feeling of possible trouble" (RR=1.5; p=0.0074). After receiving rehabilitation measures, the psycho-emotional state of the parents of children with paralytic syndromes was determined to decrease: "It is intolerable to observe the child's condition" decreased by 31.3% (p=0.0012); "Feelings of inner anxiety" decreased by 24.5% (p=0.0125); "I fall asleep badly due to the child's condition" decreased by 20.6% (p=0.0109); "Internal tension" decreased by 19.6% (p=0.0269); "Sleepless nights due to the condition of the child" decreased by 18.6% (p=0.0401).
Conclusion.The authors consider that physical rehabilitation in children with paralytic syndromes reduces the incidence of moderate chronic pain and improves the emotional state of parents. So, we think that new approaches to rehabilitation should be applied with daily management of the children with paralytic syndromes’ needs and their families with increased psychological and social support. Perhaps the searching for new approaches that optimize more intensive and effective rehabilitation strategies using the family reserve will provide the potential for adaptability of nerve plasticity and recovery in such a contingent of children and prospects for the future.
References
Hauer, J., & Houtrow, A. J. (2017). Pain Assessment and Treatment in Children With Significant Impairment of the Central Nervous System. Pediatrics, 139(6), e20171002.
Kingsnorth, S., Orava, T., Provvidenza, C., Adler, E., Ami, N., Gresley-Jones, T., … & Fehlings, D. (2015). Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review. Pediatrics, 136(4), e947–e960. doi: 10.1542/peds.2015-0273.
Friedrichsdorf, S. J., Kang, T. I. (2007) The management of pain in children with life-limiting illnesses. Pe-diatr Clin North Am, 54(5), 645‒672.
Hechler, T., Kanstrup, M., Holley, A. L., Simons, L. E., Wicksell, R., Hirschfeld, G., & Zernikow, B. (2015). Systematic Review on Intensive Interdisciplinary Pain Treatment of Children With Chronic Pain. Pediatrics, 136(1), 115–127. doi: 10.1542/peds.2014-3319.
Breau, L. M., McGrath, P. J., Camfield, C. S., & Finley, G. A. (2002). Psychometric properties of the non-communicating children's pain checklist-revised. Pain, 99(1‒2), 349‒357.
Vargus-Adams, J. (2005). Health-Related Quality of Life in Childhood Cerebral Palsy. Archives of Physical Medicine and Rehabilitation, 86(5), 940‒945.
Eker, L., & Tüzün, E. H. (2004). An evaluation of quality of life of mothers of children with cerebral palsy. Disabil Rehabil, 26(23), 1354‒1359. doi: 10.1080/09638280400000187.
Novak, I., & Honan, I. (2019). Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review. Aust Occup Ther J., 66(3), 258‒273. doi: 10.1111/1440-1630.12573.
Das, S. P., Ganesh, G. S. (2019). Evidence-based Approach to Physical Therapy in Cerebral Palsy. Indian J Orthop, 53(1), 20‒34. doi: 10.4103/ortho.IJOrtho_241_17.
McKinnon, C. T., Morgan, P. E., Antolovich, G. C., Clancy, C. H., Fahey, M. C., & Harvey, A. R. (2020). Pain in children with dyskinetic and mixed dyskinetic/spastic cerebral palsy. Developmental medicine and child neu-rology, 62(11), 1294–1301. doi: 10.1111/dmcn.14615.
Yarmohammadi, N., Rassafiani, M., Joveini, G., et al. (2018). Validation of Persian Caregivers' Report of Quality of Life questionnaire for adolescents with cerebral palsy. International Journal of Therapy and Rehabilitation, 5, 234‒239.
Kruijsen-Terpstra, A. J., Ketelaar, M., Boeije, H., et al. (2014). Parents' experiences with physical and occupa-tional therapy for their young child with cerebral palsy: a mixed studies review. Child Care Health Dev, 40(6): 787‒796. doi: 10.1111/cch.12097.
Jeglinsky, I., Autti-Rämö, I., & Brogren Carlberg, E. (2012). Professional background and the comprehension of family-centredness of rehabilitation for children with cerebral palsy. Child Care Health Dev., 38(1), 70‒78. doi: 10.1111/j.1365-2214.2011.01211.x.
Lucas, B. R., Elliott, E. J., Coggan, S., Pinto, R. Z., Jirikowic, T., McCoy, S. W., & Latimer, J. (2016). Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis. BMC pediatrics, 16(1), 193. doi: 10.1186/s12887-016-0731-6.
Krigger, K. W. (2016). Cerebral palsy: an overview. Am Fam Physician, 73(1), 91‒100.
Roessler, N., Allen Debeaurepaire, C., Deprez, A., Tanche, L., Pavageau, V., Hamain, A., … & Avez-Couturier, J. (2016). Prise en charge multidisciplinaire des enfants souffrant de douleurs chroniques invalidantes dans un centre de rééducation fonctionnelle pédiatrique français : analyse rétrospective d'une série et perspectives [Multidisci-plinary management of children with disabling chronic pain in a French pediatric rehabilitation center: Current man-agement and perspectives]. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 23(8), 806–814. doi: 10.1016/j.arcped.2016.05.016.
Dietrich, C., Teut, M., Samwel, K. L., Narayanasamy, S., Rathapillil, T., & Thathews, G. (2015). Treating Palliative Care Patients with Pain with the Body Tambura: A Prospective Case Study at St. Joseph's Hospice for Dy-ing destitute in Dindigul South India. Indian journal of palliative care, 21(2), 236–241. doi: 10.4103/0973-1075.156509.
Eccleston, C., Palermo, T. M., Williams, A. C., Lewandowski, A., & Morley, S. (2009). Psychological ther-apies for the management of chronic and recurrent pain in children and adolescents. The Cochrane database of system-atic reviews, (2), CD003968. doi: 10.1002/14651858.CD003968.pub2.
Akyuz, G.; & Kenis, O. (2014). Physical therapy modalities and rehabilitation techniques in the management of neuropathic pain. Am J Phys Med Rehabil, 93(3), 253‒259.
Hauer, J. (2010). Identifying and managing sources of pain and distress in children with neurological impair-ment. Pediatr Ann, 39(4): 198‒205.
Downing, J., Jassal, S. S., Mathews, L., Brits, H., & Friedrichsdorf, S. J. (2015). Pediatric pain management in palliative care. Pain management, 5(1), 23–35. doi: 10.2217/pmt.14.45.
Genik, L. M., McMurtry, C. M., Breau, L. M., Lewis, S. P., & Freedman-Kalchman, T. (2018). Pain in Children with Developmental Disabilities: Development and Preliminary Effectiveness of a Pain Training Workshop for Respite Workers. The Clinical journal of pain, 34(5), 428–437. doi: 10.1097/AJP.0000000000000554.
Genik, L. M., Pomerleau, C. A., McMurtry, C. M., & Breau, L. M. (2017). Pain in children with intellectual disabilities: a randomized controlled trial evaluating caregiver knowledge measures. Pain Manag, 7(3), 175‒187. doi: 10.2217/pmt-2016-0049.
Parker, J., & Belew, J. L. (2013). Qualitative evaluation of a pain intensity screen for children with severe neurodevelopmental disabilities. Pain Manag Nurs, 14(4), e115‒e123.
Voepel-Lewis, T., Malviya, S., Tait, A. R., Merkel, S., Foster, R., Krane, E. J., & Davis, P. J. (2008). A comparison of the clinical utility of pain assessment tools for children with cognitive impairment. Anesthesia and an-algesia, 106(1), 72‒78. doi: 10.1213/01.ane.0000287680.21212.d0.
Voepel-Lewis, T., Merkel, S., Tait, A. R., Trzcinka, A., & Malviya, S. (2002). The reliability and validity of the Face, Legs, Activity, Cry, Consolability observational tool as a measure of pain in children with cognitive impair-ment. Anesth Analg, 95(5): p. 1224‒1229. doi: 10.1097/00000539-200211000-00020.
Garg, P., Haynes, N., De Lima, J., & Collins, J. J. (2017). Profile of children with developmental disabilities attending a complex pain clinic of a children's hospital in Australia. J Paediatr Child Health, 53(12), 1186‒1191. doi: 10.1111/jpc.13633.
Massaro, M., Pastore, S., Ventura, A., & Barbi, E. (2013). Pain in cognitively impaired children: a focus for general pediatricians. European journal of pediatrics, 172(1), 9–14. doi: 10.1007/s00431-012-1720-x.
Raina, P., O'Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., … & Wood, E. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115(6), e626–e636. doi: 10.1542/peds.2004-1689.
Guidelines on the management of chronic pain in children. World Health Organization, 2020, p. 39. Re-trieved from https://apps.who.int/iris/bitstream/handle/10665/337644/9789240017894-eng.pdf
McKinnon, C. T., Morgan, P. E., Antolovich, G. C., Clancy, C. H., Fahey, M. C., & Harvey, A. R. (2020). Pain in children with dyskinetic and mixed dyskinetic/spastic cerebral palsy. Developmental medicine and child neu-rology, 62(11), 1294–1301. doi: 10.1111/dmcn.14615.
Yarmohammadi, N., Rassafiani, M., Joveini, G., et al. (2018). Validation of Persian Caregivers' Report of Quality of Life questionnaire for adolescents with cerebral palsy. International Journal of Therapy and Rehabilitation, 5, 234‒239.
"Inter Collegas" is an open access journal: all articles are published in open access without an embargo period, under the terms of the CC BY-NC-SA (Creative Commons Attribution ‒ Noncommercial ‒ Share Alike) license; the content is available to all readers without registration from the moment of its publication. Electronic copies of the archive of journals are placed in the repositories of the KhNMU and V.I. Vernadsky National Library of Ukraine.
Copyright Agreement
1. This Agreement on the transfer of rights to use the work from the Co-authors to the publisher (hereinafter the Agreement) is concluded between all the Co-authors of the work, represented by the Corresponding Author, and Kharkiv National Medical University (hereinafter the University), represented by an authorized representative of the Editorial Board of scientific journals (hereinafter the Editorial Board).
2. This Agreement is an accession agreement within the meaning of clause 1 of Article 634 of the Civil Code of Ukraine: that is, a contract, "the terms of which are established by one of the parties in forms or other standard forms, which can be concluded only by joining the other party to the proposed contract as a whole. The other party cannot offer its terms of the contract." The party that established the terms of this contract is the University.
3. If there is more than one author, the authors choose the Corresponding Author, who communicates with the Editorial Board on his own behalf and on behalf of all Co-authors regarding the publication of a written work of a scientific nature (article or review, hereinafter referred to as the Work).
4. The contract begins from the moment of submission of the manuscript of the Work by the Corresponding Author to the Editorial Board, which confirms the following:
4.1. all Co-authors of the Work are familiar with and agree with its content, at all stages of reviewing and editing the manuscript and the existence of the published Work;
4.2. all Co-authors of the Work are familiar with and agree to the terms of this Agreement.
5. The published Work is in electronic form in public access on the websites of the University and any websites and electronic databases in which the Work is posted by the University and is available to readers under the terms of the "Creative Commons" license (Attribution NonCommercial Sharealike 4.0 International)" or more free licenses "Creative Commons 4.0".
6. The Corresponding Author transfers, and the University receives, the non-exclusive property right to use the Work by placing the latter on the University's websites for the entire term of copyright. The University participates in the creation of the final version of the Work by reviewing and editing the manuscript of the article or review provided to the Editorial Board by the Corresponding Author, translating the Work into any languages. For the participation of the University in the finalization of the Work, the Co-authors agree to pay the invoice issued to them by the University, if such payment is provided by the University. The size and procedure of such payment are not the subject of this contract.
7. The University has the right to reproduce the Work or its parts in electronic and printed forms, to make copies, permanent archival storage of the Work, distribution of the Work on the Internet, repositories, scientometric databases, commercial networks, including for monetary compensation from third parties.
8. The co-authors guarantee that the manuscript of the Work does not use works whose copyright belongs to third parties.
9. The authors of the Work guarantee that at the time of submission of the manuscript of the Work to the Editorial Board, the property rights to the Work belong only to them, neither in whole nor in part have they been transferred to anyone (not alienated), they are not the subject of a lien, litigation or claims by third parties.
10. The Work may not be posted on the University's website if it violates a person's right to the privacy of his personal and family life, harms public order and health.
11. The work may be withdrawn by the Editorial Board from the University websites, libraries and electronic databases where it was placed by the Editorial Board, in cases of detection of violations of the ethics of the authors and researchers, without any compensation for the losses of the Co-authors. At the time of submission of the manuscript to the Editorial Board and all stages of its editing and review, the manuscript must not have already been published or submitted to other editorial offices.
12. The right transferred under this Agreement extends to the territory of Ukraine and foreign countries.
13. The rights of Co-authors include the requirement to indicate their names on all copies of the Work or during any public use or public mention of the Work; the requirement to preserve the integrity of the Work; legal opposition to any distortion or other encroachment on the Work, which may harm the honor and reputation of the Co-authors.
14. Co-authors have the right to control their personal non-property rights by familiarizing themselves with the text (content) and form of the Work before its publication on the University's website, when transferring it to a printing company for reproduction or when using the Work in other ways.
15. The Co-authors, in addition to the property rights not transferred under this Agreement and taking into account the non-exclusive nature of the rights transferred under this Agreement, retain the property rights to finalize the Work and to use certain parts of the Work in other works created by the Co-authors.
16. The Co-authors are obliged to notify the Editorial Board of all errors in the Work, discovered by them independently after the publication of the Work, and to take all measures to eliminate such errors as soon as possible.
17. The University undertakes to indicate the names of the Co-authors on all copies of the Work during any public use of the Work. The list of Co-authors may be shortened according to the rules for the formation of bibliographic descriptions determined by the University or third parties.
18. The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.
19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.
20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.
21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects.