Influence of gait analysis on decision-marketing for lower extremity surgery

Relationship between low back ache incidence and psychosciological factors in parents of children with cerebral palsy in developing countries

V SHAH MS A, A N JOHARI MS B, M TIWARI PHD C, M D ALIM BPT A,
R NAMA A, V SHINGADE MS D

  1. 1. Paediatric Orthopaedic & Spine Clinic, Lucknow;
  2. 2. Childrens Orthopedic Centre, Mumbai;
  3. 3. Lecturer in Sociology, Dav College, Kanpur;
  4. 4. Central India Institute of Children, Nagpur, India.

Objective: To investigate low back pain incidence in parents of children with cerebral palsy (CP) and associated psychosocioeconomic factors.

Hypothesis: Low bachache incidence is high in parents in these circumstances. This is an environment where parents have to physically lift and transport their children. The absence of powered wheelchairs and lifts exacerbates the problem.

Design: A prevalence study with matched normative comparison group.

Setting/Participants: One hundred and ten couples with children with CP were assessed for incidence of low backache. All were registered in a facility for such children. Exclusion criterion was children who could walk at least 500m with single support. Parents were given questionnaires to complete and reassessed after 3 months. A matched sample of parents with typically developing children was taken from three schools.

Materials/Methods: Of the 110 couples, all but 10 consented and a further four dropped out, leaving 96 couples.
Parents were requested to maintain a pain diary, submit records of analgesic usage, and state whether or not they consulted any doctor in the interim period. The McGill pain questionnaire was administered to assess pain quality.
The comparison group (37 couples) was similarly assessed.

Results: There was a significant  difference between the two matched groups. The CP group showed a 39% incidence of low backache episodes (more than 2 days/month, more than mild ache was considered significant) while the typically developing group showed a 7% incidence.
There was a sex bias in the CP group having backache with the mother reporting on average 11 days/momth and the father 7 days/month, while in the comparison group it was 2 days/month for mothers and 4 days/month for fathers.
Mothers rarely (7.6% of backache group) consulted physicians, relying on either over-the-counter analgesics, home remedies, or no treatment at all. The fathers on the other hand (25% of backache group) usually consulted doctors at least once.

Conclusion: Patients living in developing countries often have to be lifted physically by parents. With increasing parental age and heavier children this becomes difficult. There is a complex interplay, with homemakers having a higher incidence of backache but men who are wage earners are more likely to get treatment.

 
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