Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis

Florian Heinen*, Michaela Bonfert, Petr Kaňovský, A. Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


PURPOSE: A large prospective database from three Phase 3 studies allowed the study of spasticity-related pain (SRP) in pediatric cerebral palsy (CP). METHODS: Baseline (pretreatment) SRP data occurring during different activities in children/adolescents (aged 2-17 years, ambulant/nonambulant) with uni-/bilateral spastic CP was obtained using the Questionnaire on Pain caused by Spasticity (QPS; six modules specific to spasticity level [lower limb (LL) or upper limb (UL)] and type of respondent [child/adolescent, interviewer, or parent/caregiver]). RESULTS: At baseline, 331 children/adolescents with LL- and 155 with UL-spasticity completed at least one key item of their modules; LL/UL QPS modules of parent/caregivers were at least partially completed (key items) by 841/444 parents/caregivers. SRP with at least one activity at baseline was self-reported in 81.9% /69.7% (LLs/ULs) of children/adolescents with spasticity. Parents/caregivers observed LL/UL SRP behaviors in 85.9% /77.7% of their children, with multiple body regions affected. SRP negatively affected the great majority of the children in various ways. Child/adolescent-reported mean SRP intensity and parent/caregiver-observed mean SRP behavior frequencies were higher for LLs than ULs, and the level of SRP increased with more physically demanding activities. CONCLUSION: These data suggest SRP is more common and intense in pediatric CP than generally thought, emphasizing the need for effective, long-term pain management.

Original languageEnglish (US)
Pages (from-to)129-143
Number of pages15
JournalJournal of pediatric rehabilitation medicine
Issue number1
StatePublished - 2022


  • Botulinum toxin
  • all movement disorders
  • all pediatric
  • cerebral palsy
  • muscle spasticity
  • pain

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis'. Together they form a unique fingerprint.

Cite this