Expressed Beliefs about the Cause of Pain in a Pediatric Population: A Qualitative Study.

(1) Background: The aims of this study are to explore what beliefs children and adolescents manifest about the cause of the pain they describe, to compare whether there are differences between beliefs by age and the persistence of pain, and to relate the explanations of the cause of pain with current scientific evidence. (2) Methods: a cross-sectional qualitative study was used. The primary endpoint of the study was obtaining explanations of the cause of pain recorded by means of an open-ended question. The participants were school-age children attending a charted school in the province of Barcelona. (3) Results: The children and adolescents proposed a diverse range of explanations for the cause of pain that they reported in their responses. The most frequent explanation for the cause of pain were pathologies and injuries (45.95%), ergonomic issues (22.60%) and psychological issues (15.95%). (4) Conclusions: There is a lot of variety in the explanations that young people give about the cause of their pain in schoolchildren aged between 10 and 16 years old. There exists a high prevalence of explanations non-associated with tissue damage (ENAD) concerning the causes of pain described. It is necessary that future health prevention programs dedicated to early ages consider which beliefs about the cause of pain are the most frequent in the pediatric population.

Ankle Joint Dorsiflexion Reference Values in Non-Injured Youth Federated Basketball Players: A Cross-Sectional Study.

(1) Background: The aim of the present study was to establish ankle joint dorsiflexion reference values among youth federated basketball players. (2) Methods: Cross-sectional study. The participants were basketball players who belonged to youth basketball developmental teams (female and male) from under-12 (U12) to under-17 (U17) categories. Ankle joint dorsiflexion range of motion was evaluated with the weight-bearing lunge test through the Leg Motion system. The distance achieved was recorded in centimeters. (3) Results: 693 basketball players who met the eligibility criteria and volunteered to participate were included in the study. The mean (SD) of ankle joint dorsiflexion was 10.68 (2.44) cm and the reference values were: excessive hypomobility < 6.09 (0.54) cm; hypomobility 6.09 (0.88) cm-8.43 (0.77) cm; normal 8.44 (0.77)-13.11 (0.79) cm; hypermobility 13.11 (0.74)-15.44 (0.86) cm; and excessive hypermobility >15.44 (0.86) cm. (4) Conclusions: This study provides ankle joint dorsiflexion reference values in youth basketball players from 12 to under 17 years old.

Detection of Neuromuscular Deficits in Movement Pattern among Uninjured Federated Youth Basketball Players: A Cross-Sectional Study.

(1) Background: The aim of the present study was to evaluate and to detect neuromuscular deficiencies in static and dynamic tests among federated youth basketball players. (2) Methods: Cross-sectional study with 778 basketball players. Specific tests and trials were conducted to evaluate members of teams from several clubs in male and female from under 12 (U12) to under 17 (U17) categories. The evaluations consisted of static physical measurements and dynamic measurements. (3) Results: 575 players were included in this study. A total of 95% of participants are unable to keep their ankle stable in monopodial loading; 86% present dynamic lower extremity valgus with statistically significant differences between categories (p = 0.004); 94% are unable to keep the pelvis stable when performing a single-leg squat; 93% are unable to keep their trunk stable when performing the same movement. During landing, 96% present dynamic lower extremity valgus. The thighs of 92% do not reach parallel (peak of jump). (4) Conclusions: The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. Deficits in jumping/landing technique are also very frequent in all the items analyzed (jumping, landing and plyometrics). The performed tests, which mostly showed a poor performance by the sample, can be indicative of injury probability.

Development of the Conceptualization of Pain Questionnaire: A Measure to Study How Children Conceptualize Pain.

(1) Background: Research has shown that thoughts about pain are important for the management of chronic pain in children. In order to monitor changes in thoughts about pain over time and evaluate the efficacy of treatments, we need valid and reliable measures. The aims of this study were to develop a questionnaire to assess a child's concept of pain and to evaluate its psychometric properties; (2) Methods: This is a cross-sectional, two-phase, mixed-method study. A total of 324 individuals aged 8 to 17 years old responded to the newly created questionnaire. The Conceptualization of Pain Questionnaire (COPAQ) was calibrated using the Rasch model. The chi-square test was used for the fit statistics. Underfit and overfit of the model were determined and a descriptive analysis of infit and outfit was conducted to identify who responded erratically. Internal consistency was measured using the Person Separation Index (PSI); (3) Results: Fit to the Rasch model was good. Suitable targeting indicated which items were simple to answer; Person Fit identified 9.56% children who responded erratically; PSI = 0.814; (4) Conclusions: The findings suggest that COPAQ is a measure of a child's concept of pain that is easy to administer and respond to. It has a good fit and a good internal consistency.

Analysis of dynamic elbow flexion deformity in children with hemiplegic cerebral palsy.

BACKGROUND: Cerebral palsy affects 1 per 1.000 children, and in 83% of the cases upper extremity is involved. Dynamic elbow flexion deformity is a movement disorder observed in individuals with hemiparesis secondary to cerebral palsy. We sought to determine whether children with hemiplegic cerebral palsy exhibit dynamic elbow flexion deformity during daily activities and its influence to reaching function. METHODS: Sixteen children with upper limb hemiparesis and cerebral palsy (age 11y 7mo (SD 3y 2mo); 11 boys, 5 girls; Gross Motor Function Classification System level I or II) were included in this observational descriptive study. Manual Ability Classification System, Children's Hand-use Experience Questionnaire and Shriners Hospital for Children Upper Extremity Evaluation were used to evaluate affected upper extremity function. Spasticity was assessed with Modified Ashworth scale. Involuntary elbow flexion was recorded in eight daily activities. Elbow motion during reach function was measured. FINDINGS: Fifteen out of 16 individuals showed dynamic elbow flexion deformity. There was a significative increase of involved median elbow flexion in all the activities studied, except for "high speed stairs climbing" evaluation. Children's Hand-use Experience Questionnaire showed that children were independent in most of the daily activities (21 out of 29). Correlation between dynamic elbow flexion deformity and Shriners Hospital for Children Upper Extremity Evaluation was observed only in sitting-standing activity (Spearman's ρ 0.549, P = 0.028). INTERPRETATION: Dynamic elbow flexion deformity is very common in hemiplegic cerebral palsy and occurs proportionally to the degree of the effort demanded by the activities. Despite of presenting this movement disorder, it does not affect in children participation in daily activities.

Comparison of pain neurophysiology knowledge among health sciences students: a cross-sectional study.

BACKGROUND: A key tool for use in approaching chronic pain treatment is educating patients to reconceptualize pain. Thus, health professionals are fundamental to the transmission of pain information to patients. Because their understanding of pain is acquired during the educational process, the aim of this study was to compare the knowledge about pain neurophysiology in first and final-year students from three different health science programs at a single University to determine their gain in knowledge using a well-known questionnaire designed to evaluate the understanding of pain. METHODS: The Neurophysiology of Pain Questionnaire (19 closed-ended questions) was administered to students in their first and final years of study in Medicine, Physiotherapy, or Nutrition. The percentage of correct responses was determined and comparisons of the results were analyzed between the programs as well as between the first and final years of study within each program. For all tests, p-values were two-sided, and results with p-values below 0.05 were considered statistically significant. RESULTS: The participation rate was greater than 51% (n = 285). The mean percentage of correct responses, reported as mean (SD), among the first year students was 42.14 (12.23), without significant statistical differences detected between the programs. The mean percentages of correct responses for students in their final year were as follows: Medicine, 54.38 (13.87); Physiotherapy, 68.92 (16.22); Nutrition, 42.34 (10.11). We found statistically significant differences among all three programs and between the first and final years in Medicine and Physiotherapy. A question-by-question analysis showed that the percentage of correct responses for questions related to the biopsychosocial aspects of pain was higher for students in Physiotherapy than those in Medicine. CONCLUSIONS: Students in their final years of Medicine and Physiotherapy programs know more about the neurophysiology of pain than students in their first years of these programs, however there are some questions where first years students have better results. Physiotherapy students have greater knowledge of neurophysiology of pain than Medicine students, especially the biopsychosocial aspects. Even so, their understanding may not be sufficient and does not guarantee an approach to chronic pain that will help patients reconceptualize their pain.