Laetitia Houx1, Christelle Pons2, Hélène Saudreau3, Amandine Dubois4, Mathilde Creusat3, Philippe Le Moine5, Olivier Rémy-Néris6, Juliette Ropars7, Jean-Yves LeReste8, Sylvain Brochard9. 1. Physical and medical rehabilitation department, CHRU de Brest, France; Paediatric physical and medical rehabilitation department, Fondation ILDYS, Brest, France; Laboratory of medical information processing, Inserm U1101, Brest, France. Electronic address: laetitia.houx@chu-brest.fr. 2. Paediatric physical and medical rehabilitation department, Fondation ILDYS, Brest, France; Laboratory of medical information processing, Inserm U1101, Brest, France. 3. Paediatric physical and medical rehabilitation department, Centre de Kerpape, Ploemeur, France. 4. Department of psychology, university of Western Brittany Brest, France; CRPCC, EA 1285, Rennes 2, Rennes, France. 5. Centre for the evaluation and treatment of pain, CHRU Brest, Brest, France. 6. Physical and medical rehabilitation department, CHRU de Brest, France; Laboratory of medical information processing, Inserm U1101, Brest, France. 7. Laboratory of medical information processing, Inserm U1101, Brest, France; Department of pediatry, CHRU de Brest, Brest, France; University of Western Brittany, Brest, France. 8. Department de generale médecine, university of Western Brittany ERCR SPURBO, Brest, France. 9. Physical and medical rehabilitation department, CHRU de Brest, France; Paediatric physical and medical rehabilitation department, Fondation ILDYS, Brest, France; Laboratory of medical information processing, Inserm U1101, Brest, France.
Abstract
OBJECTIVES: Recent studies have shown that physiotherapy can induce pain in children and young adults with cerebral palsy (CP). There is a lack of knowledge of children's pain experiences during therapy sessions and the specific causes of pain. The main objective of this study was to better understand the experience of children and young adults with CP during physiotherapy sessions and to analyse the coping strategies used by children and therapists. METHODS: Qualitative study with focus groups. Eighteen children/young adults with CP who experienced pain during physiotherapy were interviewed, using focus groups as a source of data collection in a phenomenological perspective. Data collection and analysis were consecutive to ensure that the data saturation point was reached. The transcripts were coded manually using thematic analysis. First, interesting features of the verbatim were coded, then codes were collated into potential themes and then the themes were checked to ensure they worked in relation to the coded extracts. Multiple coding was performed by 3 different researchers, and results were merged at each step. RESULTS: This study confirmed that among the 18 children interviewed (mean [SD] age 13.17 [4.02] years, 10 girls), physiotherapy, particularly stretching, induced pain. Participants reported that the experience of pain led to a dislike of physiotherapy, although some believed that the pain was necessary to show that the treatment was effective. The use of distraction techniques and the relationship with the physiotherapist were key elements associated with the perception and experience of pain. CONCLUSIONS: This study confirmed that patients with CP experience pain during physiotherapy. Stretching seems to be the main source of pain. Beliefs and practices regarding the concept of pain show that physiotherapists need training in this field.
OBJECTIVES: Recent studies have shown that physiotherapy can induce pain in children and young adults with cerebral palsy (CP). There is a lack of knowledge of children's pain experiences during therapy sessions and the specific causes of pain. The main objective of this study was to better understand the experience of children and young adults with CP during physiotherapy sessions and to analyse the coping strategies used by children and therapists. METHODS: Qualitative study with focus groups. Eighteen children/young adults with CP who experienced pain during physiotherapy were interviewed, using focus groups as a source of data collection in a phenomenological perspective. Data collection and analysis were consecutive to ensure that the data saturation point was reached. The transcripts were coded manually using thematic analysis. First, interesting features of the verbatim were coded, then codes were collated into potential themes and then the themes were checked to ensure they worked in relation to the coded extracts. Multiple coding was performed by 3 different researchers, and results were merged at each step. RESULTS: This study confirmed that among the 18 children interviewed (mean [SD] age 13.17 [4.02] years, 10 girls), physiotherapy, particularly stretching, induced pain. Participants reported that the experience of pain led to a dislike of physiotherapy, although some believed that the pain was necessary to show that the treatment was effective. The use of distraction techniques and the relationship with the physiotherapist were key elements associated with the perception and experience of pain. CONCLUSIONS: This study confirmed that patients with CP experience pain during physiotherapy. Stretching seems to be the main source of pain. Beliefs and practices regarding the concept of pain show that physiotherapists need training in this field.