Affiliations: Department of Orthopedic Surgery, Hvidovre Hospital, Hvidovre, Denmark
Correspondence:
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Corresponding author: Natasja Flyckt, MD, Department of Orthopedic Surgery, Hvidovre Hospital, Hvidovre, Store Kongensgade 63, 2nd floor, 1264 Copenhagen, Denmark. Tel.:+45 31104180; E-mail: [email protected].
Abstract: PURPOSE:To explore the existing literature on non-pharmacological and non-surgical pain management in children and adolescents with cerebral palsy (CP). METHODS:Databases (Cochrane Library, PubMed MEDLINE, Ovid Embase, and PsycINFO) were systematically searched to identify literature on non-pharmacological and non-surgical interventions for relieving pain in children with CP or similar conditions. RESULTS:Thirteen publications met the inclusion criteria. Based on study designs, the overall level of evidence of the included studies was low, justifying the use of a scoping review. Only three were randomized controlled trials. Pain reduction was reported in 8 of the 13 studies from following interventions: physiotherapy/rehabilitation, massage, cranial osteopathy, swimming and aquatics, and assistive devices. These complementary strategies should not omit conventional treatment, and a multidisciplinary approach using multifaceted treatment of pharmacological and non-pharmacological therapy is recommended to increase the pain-relieving effect. CONCLUSION:The results indicate that physiotherapy, massage, swimming exercise, and various assistive devices can have pain-relieving effects. We found limited evidence on the topic of non-pharmacological and non-surgical treatment of pain in children with CP. Due to the lack of power in the included studies, no true evidence-based recommendations can be made from the collected articles; thus, further studies with larger cohorts and more power are needed to substantiate evidence-based treatment of pain in children and adolescents with CP.
