DOS 2020
186 · DOS Abstracts Measuring effects on pain and quality of life after Dysport® injection in children with cerebral palsy Josephine Sandahl Michelsen , Christian Wong Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Background: Studies have shown that 30 – 70 % of children with cerebral palsy (CP) experience chronic pain, which increases with age and is closely in- terrelated to poor quality of life. Despite this, pain is an overlooked and under- treated clinical problem. Botulinum toxin injections have for more than 20 years been used to diminish spasticity in children with CP but the effect on pain has only sparsely been investigated. Purpose / Aim of Study: The aim of this study was to examine the analge- sic effect of a single intramuscular injection of DYSPORT in the most painful muscles of the lower extremities. Materials and Methods: Our interim analysis is based on 14 children with spastic CP, age 5-17, GMFCS I-V. Participants were recruited from outpatient clinics of two regional hospitals. The most painful muscles during a clinical ex- amination were the targets for treatment. The children had to have at least moderate muscle pain (r-FLACC≥4) at inclusion to be enrolled in the study. Pain levels were measured before and 4 weeks after a single injection of botulinum toxin (Dysport). All measurements were performed by a single specially trained rater. The localized pain of the treated muscles was evaluated by r-FLACC. The effect on daily pain was evaluated by the Pediatric Pain Profile (PPP). The effect on clinically relevant problems was evaluated by individual SMART goals using the goal attainment scale. Funding for this research was provided by Ipsen. Findings / Results: A significant pain reduction was observed 4 weeks post- treatment for localized muscle pain (6.71±1.77 vs 3.86±2.63, p:0.001) and the impact on daily activities (Z= -2.496, p:0.013). For PPP, an analgesic but non-significant trend was indicated for pain intensity (z=-1.811, p:0.07) and for pain-related behaviors (27.79±12.82 vs 21.23±14.39, p:0.075). Moreover, a clinically meaningful effect was seen since almost all participants achieved their therapeutic SMART goals (Z= -2.937, p:0.003). Conclusions: Even though Dysport has been utilized for spasticity modulation in children with CP, it also appears to have a significant analgesic effect, when muscle pain is targeted. Moreover, the localized pain reduction seems to have a positive effect on activities of daily living. 165.
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