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

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.