Article

It is obvious through our exploration of pain associated with DMD, empirical research is needed to address the assessment and treatment of pain in children with all NMD. The initial research aim should be to determine the nature and scope of pain in children with NMD. Information is then needed on the frequency of pain in this population, pain severity, pain quality, pain location, the impact of pain on the daily activities, and quality of life for the child and his family. Pain treatment begins with the elimination of the causes of pain and exacerbating pain factors when ever feasible. Controlled trials of analgesics, therapeutic exercise, modalities, and cognitive behavioral interventions are warranted. Given our current knowledge about pain in children with NMD we offer several basic clinical recommendations. First, all providers need to routinely assess pain in children with NMD, using standardized assessment tools that are valid and reliable for the age and cognitive abilities of the child. Pain is now considered the 5th Vital Sign [14]. Routinely assessing and addressing pain in all children needs to be the standard of care for all healthcare practitioners. With our increasing understanding of pain in the life experiences of children with DMD and the interplay of acute, chronic and recurrent pain through disease progression and management, this is particularly important. Second, a plan of care for pain management and prevention needs to be developed in collaboration with the interprofessional team, with the child and family at its center. Pain treatments must be carefully selected from among the logical options, with thoughtful consideration to the unique characteristics of the child and family and the specific precautions of a given intervention. Third, ongoing evaluation is essential to assess the effectiveness of pain treatments with respect to function and comfort of the child over time. Failure to do so will impact the quality of life of the child and family by dramatically altering meaningful engagement and social participation in life's activities.

Langue : ANGLAIS