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Experiences of children with CP with physiotherapy

No pain, no gain?!

Physiotherapy plays an important role in the lives of children with cerebral palsy (CP). At the same time, it commonly causes pain in these children. Most children with CP have regular physiotherapy input, and pain during physiotherapy can become an extremely important issue.

Despite this, pain induced by physiotherapy has received little attention and remains understudied. To address this gap, this study used focus group interviews in which 18 children with CP participated discussed physiotherapy induced pain.

To date, there is no clinically significant long-term effect of stretching in children with CP, which questions whether stretching fulfils the intended purpose of improved ROM. There may be more effective alternative methods that integrate flexibility and fitness and there may be also more appropriate methods of managing therapy induced pain. Previous studies have also shown that long lasting and/ or repetitive pain can create a vicious circle of pain, anticipatory anxiety, and emotional distress.

The results show that there is a need for specific training programmes to teach therapists to recognise and measure therapy-induced pain and establish appropriate methods to use with children to alleviate it.

> From: Houx et al., Ann Phys Rehabil Med (2020) 101448 (Epub ahead of print). All rights reserved to Elsevier Masson SAS. Click here for the online summary.

Expert opinion

This study discusses a topic that is rarely addressed, especially in paediatric populations. It provides insight into pain during physiotherapy, pain perception and coping strategies. I personally started to reflect about this topic more while I was reading the paper and must admit that some of the statements of the children did move me emotionally a little bit. So, I felt it is absolutely worth a read.

Unfortunately, the article is very short, and it gives more of a glimpse than a real insight into the topic. On top of that, the methodological part has been kept very brief, which makes it difficult to judge the quality of the methods applied. The results section is structured into subtopics which make reading easier, but again the summary of each topic is very brief and feels somewhat superficial. The discussion appears to be more another summary of the results and the findings were reflected only superficially in the context of current literature.    

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