neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2022-3-3-106-113neurojour-70Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКачество жизни пациентов с детским церебральным параличомQuality of life in patients with cerebral palsy: literature reviewhttps://orcid.org/0000-0001-8032-6665НежельскаяАлександра АлександровнаNezhelskayaAleksandra A.

Врач-невролог отделения психоневрологии и психосоматической патологии ФГАУ «НМИЦ здоровья детей», 119991, Москва.

e-mail: anezhelskaya@yandex.ru

Child neurologist, National Medical Research Center of Children’s Health, Moscow, 119991, Russian Federation.

e-mail: anezhelskaya@yandex.ru

anezhelskaya@yandex.ruhttps://orcid.org/0000-0002-7269-9100КуренковА. Л.KurenkovAlexey L.noemail@neicon.ruhttps://orcid.org/0000-0002-9562-3774КузенковаЛ. М.KuzenkovaLyudmila M.noemail@neicon.ruhttps://orcid.org/0000-0001-8506-2064БурсаговаБ. И.BursagovaBella I.noemail@neicon.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииNational Medical Research Center for Children’s Health20221810202233106113Copyright © Нежельская А.А., Куренков А.Л., Кузенкова Л.М., Бурсагова Б.И., 20222022Нежельская А.А., Куренков А.Л., Кузенкова Л.М., Бурсагова Б.И.Nezhelskaya A.A., Kurenkov A.L., Kuzenkova L.M., Bursagova B.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/70

В настоящее время большое внимание уделяется изучению качества жизни (КЖ) больных, страдающих хронической патологией. КЖ тесно связано с осознанием пациентом уверенности и благополучия во многих областях — не только своего физического состояния, но и социальных взаимодействий, эмоциональных переживаний, духовных ценностей и в других сферах. Детский церебральный паралич (ДЦП) является тяжёлым хроническим инвалидизирующим заболеванием с наличием не только двигательных нарушений, но и речевых, когнитивных, психических проблем, приводящих к социальной дезадаптации. Существуют специальные инструменты оценки КЖ, которые включают различные опросники. Некоторые из них, например, опросник «Оценка качества жизни в педиатрии» (Pediatric Quality of Life Inventory — PedsQL) имеет специальный модуль «Церебральный паралич», который охватывает следующие проблемы: повседневная деятельность, перемещение и равновесие, боль, усталость, приём пищи. С 5 лет добавляются блоки «речь и общение», «школьные занятия». Подобные опросники позволяют оценить нарушения КЖ при ДЦП и использовать эти данные при динамическом наблюдении на фоне лечения. В статье представлены наиболее объективные исследования КЖ при ДЦП. Боль у пациентов с ДЦП является серьёзной проблемой и оказывает значимое негативное влияние на КЖ. Показано, что инъекции препаратов ботулинического токсина типа А не только могут приводить к уменьшению боли, но значимо улучшают функционирование пациентов с ДЦП и повышают их КЖ. Не менее важно проводить оценку КЖ родителей и родственников больных детей. Имеются данные, что тяжелые двигательные нарушения при ДЦП оказывают значительное отрицательное влияние на КЖ и развитие депрессии у матерей, осуществляющих уход за ребёнком.

Участие авторов

Участие авторов:Нежельская А.А. — концепция и дизайн, написание текста, редактирование;Куренков А.Л. — концепция и дизайн, написание текста, редактирование;Кузенкова Л.М. — редактирование;Бурсагова Б.И. — написание текста.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 25

Поступила 25.08.2022Принята к печати 12.09.2022Опубликована 30.09.2022

Currently, much attention is paid to the study of the quality of life of patients suffering from chronic pathology. The quality of life is closely related to the patient’s awareness of confidence and well–being in many areas, not only with the perception of their physical condition, but also in many other aspects of life including social interactions, emotional experiences, spiritual values and in other areas. Cerebral palsy is a severe chronic disabling disease with the presence of not only motor disorders, but also speech, cognitive, mental health problems that lead to social maladaptation. There are special tools for quality of life assessment, which include various questionnaires. Some of them, for example, the Pediatric Quality of Life Inventory (PedsQL) has a special module “Cerebral palsy”, the following problems are covered: daily activities, movement and balance, pain, fatigue, eating. From the age of 5 years, the block «speech and communication», «school classes» is added. Such questionnaires allow assessing quality of life disturbances by cerebral palsy and use these data for dynamic observation during the treatment. The article presents the most objective studies of the quality of life with cerebral palsy. Pain in patients with cerebral palsy is a serious problem and has a significant negative impact on the quality of life. It has been shown that injections of botulinum toxin type A can not only lead to pain reduction, but significantly improve the functioning of patients with cerebral palsy and improve their quality of life. It is equally important to assess the quality of life of parents and relatives of sick children. There is evidence that severe motor disorders by cerebral palsy have a significant negative impact on the quality of life and the development of depression by mothers who take care of a child.

Contribution

Contribution:Nezhelskaya A.A. — сoncept and design of the study, writing the text, editing;Kurenkov A.L. — сoncept and design of the study, writing the text, editing;Kuzenkova L.M. — editing;Bursagova B.I. — writing the text.All coauthors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments

Acknowledgments. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: August 25, 2022Accepted: September 12, 2022Published: September 30, 2022

качество жизнидетский церебральный параличопросники качества жизниспастичностьбольсиалореяботулинический токсин типа Аthe quality of lifecerebral palsythe questionnaire assessment of quality of lifespasticitypainsialorrheabotulinum toxin type AReferencesWHOQOL: Measuring the quality of life. Available at: https://www.who.int/tools/whoqolWHOQOL: Measuring the quality of life. Available at: https://www.who.int/tools/whoqolКаримуллин Г.А., Левитина Е.В., Змановская В.А. Качество жизни детей с церебральным параличом. Университетская медицина Урала. 2021; 4.Karimullin G.A., Levitina E.V., Zmanovskaya V.A. Quality of life of children with cerebral palsy. Universitetskaya meditsina Urala. 2021; 4. (in Russian)Денисова Р.В. Качество жизни больных ювенильным артритом в условиях лечения химерными моноклональными антителами к ФНО: Автореф. дисс. … канд. мед. наук. М.; 2009.Denisova R.V. The quality of life of patients with juvenile arthritis under treatment with chimeric monoclonal antibodies to TNF: Diss. Moscow; 2009. (in Russian)Винярская И.В. Качество жизни детей как критерий оценки состояния здоровья и эффективности медицинских, технологий (комплексное медико-социальное исследование): Автореф. дисс. … канд. мед. наук. М.; 2008.Vinyarskaya I.V. The quality of life of children as a criterion for assessing the state of health and effectiveness of medical technologies (comprehensive medical and social research): Diss. Moscow; 2008. (in Russian)Кухтина Э.И. Качество жизни детей-инвалидов с детским церебральным параличом: Автореф. дисс. … канд. мед. наук. Уфа; 2006.Kukhtina E.I. Quality of life of disabled children with cerebral palsy: Diss. Ufa; 2006. (in Russian)Bjornson K.F., McLaughlin J.F. The measurement of health-related quality of life (HRQL) in children with cerebral palsy. Eur. J. Neurol. 2001; 8(Suppl. 5): 183-93. https://doi.org/10.1046/j.1468-1331.2001.00051.xBjornson K.F., McLaughlin J.F. The measurement of health-related quality of life (HRQL) in children with cerebral palsy. Eur. J. Neurol. 2001; 8(Suppl. 5): 183–93. https://doi.org/10.1046/j.1468-1331.2001.00051.xVarni J.W., Seid M., Rode C.A. The PedsQL: measurement model for the pediatric quality of life inventory. Med. Care. 1999; 37(2): 126-39. https://doi.org/10.1097/00005650-199902000-00003Varni J.W., Seid M., Rode C.A. The PedsQL: measurement model for the pediatric quality of life inventory. Med. Care. 1999; 37(2): 126–39. https://doi.org/10.1097/00005650-199902000-00003Manificat S., Dazord A., Langue J., Danjou G., Bauche P., Bovet F., et al. Evaluation of the quality of life of infants and very young children: validation of a questionnaire. Multicenter European study. Arch. Pediatr. 2000; 7(6): 605-14. https://doi.org/10.1016/s0929-693x(00)80127-x (in French)Manificat S., Dazord A., Langue J., Danjou G., Bauche P., Bovet F., et al. Evaluation of the quality of life of infants and very young children: validation of a questionnaire. Multicenter European study. Arch. Pediatr. 2000; 7(6): 605–14. https://doi.org/10.1016/s0929-693x(00)80127-x (in French)Riley A.W., Forrest C.B., Rebok G.W., Starfield B., Green B.F., Robertson J.A., et al. The Child Report Form of the CHIP-Child Edition: reliability and validity. Med. Care. 2004; 42(3): 221-31. https://doi.org/10.1097/01.mlr.0000114910.46921.73Riley A.W., Forrest C.B., Rebok G.W., Starfield B., Green B.F., Robertson J.A., et al. The Child Report Form of the CHIP-Child Edition: reliability and validity. Med. Care. 2004; 42(3): 221–31. https://doi.org/10.1097/01.mlr.0000114910.46921.73Riley A.W., Forrest C.B., Starfield B., Rebok G.W., Robertson J.A., Green B.F. The Parent Report Form of the CHIP-Child Edition: reliability and validity. Med. Care. 2004; 42(3): 210-20. https://doi.org/10.1097/01.mlr.0000114909.33878.caRiley A.W., Forrest C.B., Starfield B., Rebok G.W., Robertson J.A., Green B.F. The Parent Report Form of the CHIP-Child Edition: reliability and validity. Med. Care. 2004; 42(3): 210–20. https://doi.org/10.1097/01.mlr.0000114909.33878.caManificat S., Dazord A., Langue J., Danjou G., Bauche P., Bovet F., et al. Evaluation of the quality of life of infants and very young children: validation of a questionnaire. Multicenter European study. Arch. Pediatr. 2000; 7(6): 605-14. https://doi.org/10.1016/s0929-693x(00)80127-xManificat S., Dazord A., Langue J., Danjou G., Bauche P., Bovet F., et al. Evaluation of the quality of life of infants and very young children: validation of a questionnaire. Multicenter European study. Arch. Pediatr. 2000; 7(6): 605–14. https://doi.org/10.1016/s0929-693x(00)80127-xЧерников В.В. Разработка и оценка эффективности русской версии опросника QUALIN для изучения качества жизни детей раннего возраста. Вопросы современной педиатрии. 2009; 8(1): 14-8.Chernikov V.V. Development and evaluation of the effectiveness of the Russian version of the QUALIN questionnaire for studying the quality of life of young children. Voprosy sovremennoy pediatrii. 2009; 8(1): 14–8. (in Russian)Varni J.W., Burwinkle T.M., Berrin S.J. The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the generic core scales and cerebral palsy module. Dev. Med. Child Neurol. 2006; 48(6): 442-29. https://doi.org/10.1017/s001216220600096xVarni J.W., Burwinkle T.M., Berrin S.J. The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the generic core scales and cerebral palsy module. Dev. Med. Child Neurol. 2006; 48(6): 442–29. https://doi.org/10.1017/s001216220600096xWake M., Salmon L., Reddihough D. Health status of Australian children with mild to severe cerebral palsy: cross-sectional survey using the child health questionnaire. Dev. Med. Child Neurol. 2003; 45(3): 194-9. https://doi.org/10.1017/s0012162203000379Wake M., Salmon L., Reddihough D. Health status of Australian children with mild to severe cerebral palsy: cross-sectional survey using the child health questionnaire. Dev. Med. Child Neurol. 2003; 45(3): 194–9. https://doi.org/10.1017/s0012162203000379McCormick A. Quality of life. In: Panteliadis C.P., ed. Cerebral Palsy: Multidisciplinary Approach. Cham: Springer; 2018: 335-42.McCormick A. Quality of life. In: Panteliadis C.P., ed. Cerebral Palsy: Multidisciplinary Approach. Cham: Springer; 2018: 335–42.Colver A., Rapp M., Eisemann N., Ehlinger V., Thyen U., Dickinson H.O., et al. Self-reported quality of life of adolescents with cerebral palsy: a cross-sectional and longitudinal analysis. Lancet. 2015; 385(9969): 705-16. https://doi.org/10.1016/S0140-6736(14)61229-0Colver A., Rapp M., Eisemann N., Ehlinger V., Thyen U., Dickinson H.O., et al. Self-reported quality of life of adolescents with cerebral palsy: a cross-sectional and longitudinal analysis. Lancet. 2015; 385(9969): 705–16. https://doi.org/10.1016/S0140-6736(14)61229-0Кулишова Т.В., Елисеев В.В., Лобанов Ю.Ф. Качество жизни - критерий эффективности комплексного лечения у больных с детским церебральным параличом в форме спастической диплегии. Дальневосточный медицинский журнал. 2016; (1): 47-9.Kulishova T.V., Eliseev V.V., Lobanov Yu.F. Life quality as the criterion of complex treatment efficacy for patients with cerebral palsy in the form of spastic diplegia. Dal’nevostochnyy meditsinskiy zhurnal. 2016; (1): 47–9. (in Russian)Vinkel M.N., Rackauskaite G., Finnerup N.B. Classification of pain in children with cerebral palsy. Dev. Med. Child. Neurol. 2022; 64(4): 447-52. https://doi.org/10.1111/dmcn.15102Vinkel M.N., Rackauskaite G., Finnerup N.B. Classification of pain in children with cerebral palsy. Dev. Med. Child. Neurol. 2022; 64(4): 447–52. https://doi.org/10.1111/dmcn.15102Penner M., Xie W.Y., Binepal N., Switzer L., Fehlings D. Characteristics of pain in children and youth with cerebral palsy. Pediatrics. 2013; 132(2): e407-13. https://doi.org/10.1542/peds.2013-0224Penner M., Xie W.Y., Binepal N., Switzer L., Fehlings D. Characteristics of pain in children and youth with cerebral palsy. Pediatrics. 2013; 132(2): e407–13. https://doi.org/10.1542/peds.2013-0224Eriksson E., Hägglund G., Alriksson-Schmidt A.I. Pain in children and adolescents with cerebral palsy - a cross-sectional register study of 3545 individuals. BMC Neurol. 2020; 20(1): 15. https://doi.org/10.1186/s12883-019-1597-7Eriksson E., Hägglund G., Alriksson-Schmidt A.I. Pain in children and adolescents with cerebral palsy - a cross-sectional register study of 3545 individuals. BMC Neurol. 2020; 20(1): 15. https://doi.org/10.1186/s12883-019-1597-7Parkinson K.N., Dickinson H.O., Arnaud C., Lyons A., Colver A. Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicenter European study. Arch. Dis. Child. 2013; 98(6): 434-40. https://doi.org/10.1136/archdischild-2012-303482Parkinson K.N., Dickinson H.O., Arnaud C., Lyons A., Colver A. Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicenter European study. Arch. Dis. Child. 2013; 98(6): 434–40. https://doi.org/10.1136/archdischild-2012-303482Alriksson-Schmidt A., Hagglund G. Pain in children and adolescents with cerebral palsy: a population-based registry study. Acta Paediatr. 2016; 105(6): 665-70. https://doi.org/10.1111/apa.13368Alriksson-Schmidt A., Hagglund G. Pain in children and adolescents with cerebral palsy: a population-based registry study. Acta Paediatr. 2016; 105(6): 665–70. https://doi.org/10.1111/apa.13368Комшина К.С., Антипенко Е.А. Оценка особенностей болевого синдрома у взрослых пациентов с детским церебральным параличом. Медицинский альманах. 2020; (1): 73-7.Komshina K.S., Antipenko E.A. Evaluation of the features of pain syndrome in adult patients with cerebral palsy. Meditsinskiy al’manakh. 2020; (1): 73–7. (in Russian)Multani I., Manji J., Hastings-Ison T., Khot A., Graham K. Botulinum toxin in the management of children with cerebral palsy. Paediatr. Drugs. 2019; 21(4): 261-81. https://doi.org/10.1007/s40272-019-00344-8Multani I., Manji J., Hastings-Ison T., Khot A., Graham K. Botulinum toxin in the management of children with cerebral palsy. Paediatr. Drugs. 2019; 21(4): 261–81. https://doi.org/10.1007/s40272-019-00344-8Simpson D.M., Hallett M., Ashman E.J., Comella C.L., Green M.W., Gronseth G.S., et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016; 86(19): 1818-26. https://doi.org/10.1212/WNL.0000000000002560Simpson D.M., Hallett M., Ashman E.J., Comella C.L., Green M.W., Gronseth G.S., et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016; 86(19): 1818–26. https://doi.org/10.1212/WNL.0000000000002560Copeland L., Edwards P., Thorley M., Donaghey S., Gascoigne-Pees L., Kentish M., et al. Botulinum toxin a for nonambulatory children with cerebral palsy: A double blind randomized controlled trial. J. Pediatr. 2014; 165(1): 140-6. https://doi.org/10.1016/j.jpeds.2014.01.050Copeland L., Edwards P., Thorley M., Donaghey S., Gascoigne-Pees L., Kentish M., et al. Botulinum toxin a for nonambulatory children with cerebral palsy: A double blind randomized controlled trial. J. Pediatr. 2014; 165(1): 140–6. https://doi.org/10.1016/j.jpeds.2014.01.050Barwood S., Baillieu C., Boyd R., Brereton K., Low J., Nattrass G., et al. Analgesic effects of botulinum toxin A: A randomized, placebo-controlled clinical trial. Dev. Med. Child Neurol. 2000; 42(2): 116-21. https://doi.org/10.1017/S0012162200000220Barwood S., Baillieu C., Boyd R., Brereton K., Low J., Nattrass G., et al. Analgesic effects of botulinum toxin A: A randomized, placebo-controlled clinical trial. Dev. Med. Child Neurol. 2000; 42(2): 116–21. https://doi.org/10.1017/S0012162200000220Tilton A., Russman B., Aydin R., Dincer U., Escobar R., Kutlay S., et al. AbobotulinumtoxinA (Dysport®) improves function according to goal attainment in children with dynamic equinus due to cerebral palsy. J. Child Neurol. 2017; 32(5): 482-7. https://doi.org/10.1177/0883073816686910Tilton A., Russman B., Aydin R., Dincer U., Escobar R., Kutlay S., et al. AbobotulinumtoxinA (Dysport®) improves function according to goal attainment in children with dynamic equinus due to cerebral palsy. J. Child Neurol. 2017; 32(5): 482–7. https://doi.org/10.1177/0883073816686910Russo R.N., Crotty M., Miller M.D., Murchland S., Flett P., Haan E. Upper-limb botulinum toxin a injection and occupational therapy in children with hemiplegic cerebral palsy identified from a population register: A single-blind, randomized, controlled trial. Pediatrics. 2007; 119(5): e1149-58. https://doi.org/10.1542/peds.2006-2425Russo R.N., Crotty M., Miller M.D., Murchland S., Flett P., Haan E. Upper-limb botulinum toxin a injection and occupational therapy in children with hemiplegic cerebral palsy identified from a population register: A single-blind, randomized, controlled trial. Pediatrics. 2007; 119(5): e1149–58. https://doi.org/10.1542/peds.2006-2425Lundy C.T., Doherty G.M., Fairhurst C.B. Botulinum toxin type A injections can be an effective treatment for pain in children with hip spasms and cerebral palsy. Dev. Med. Child Neurol. 2009; 51(9): 705-10. https://doi.org/10.1111/j.1469-8749.2009.03315.xLundy C.T., Doherty G.M., Fairhurst C.B. Botulinum toxin type A injections can be an effective treatment for pain in children with hip spasms and cerebral palsy. Dev. Med. Child Neurol. 2009; 51(9): 705–10. https://doi.org/10.1111/j.1469-8749.2009.03315.xVles G.F., de Louw A.J., Speth L.A., van Rhijn L.W., Janssen-Potten Y.J., Hendriksen J.G., et al. Visual analogue scale to score the effects of botulinum toxin a treatment in children with cerebral palsy in daily clinical practice. Eur. J. Paediatr. Neurol. 2008; 12(3): 231-8. https://doi.org/10.1016/j.ejpn.2007.08.002Vles G.F., de Louw A.J., Speth L.A., van Rhijn L.W., Janssen-Potten Y.J., Hendriksen J.G., et al. Visual analogue scale to score the effects of botulinum toxin a treatment in children with cerebral palsy in daily clinical practice. Eur. J. Paediatr. Neurol. 2008; 12(3): 231–8. https://doi.org/10.1016/j.ejpn.2007.08.002Rivard P.F., Nugent A.C., Symons F.J. Parent-proxy ratings of pain before and after botulinum toxin type A treatment for children with spasticity and cerebral palsy. Clin. J. Pain. 2009; 25(5): 413-7. https://doi.org/10.1097/AJP.0b013e31819a6d07Rivard P.F., Nugent A.C., Symons F.J. Parent-proxy ratings of pain before and after botulinum toxin type A treatment for children with spasticity and cerebral palsy. Clin. J. Pain. 2009; 25(5): 413–7. https://doi.org/10.1097/AJP.0b013e31819a6d07Kingsnorth S., Orava T., Provvidenza C., Adler E., Ami N., Gresley-Jones T., et al. Chronic pain assessment tools for cerebral palsy: A systematic review. Pediatrics. 2015; 136(4): e947-60. https://doi.org/10.1542/peds.2015-0273Kingsnorth S., Orava T., Provvidenza C., Adler E., Ami N., Gresley-Jones T., et al. Chronic pain assessment tools for cerebral palsy: A systematic review. Pediatrics. 2015; 136(4): e947–60. https://doi.org/10.1542/peds.2015-0273Jog M., Wein T., Bhogal M., Dhani S., Miller R., Ismail F., et al. Real-World, long-germ Quality of life following therapeutic OnabotulinumtoxinA treatment. Can. J. Neurol. Sci. 2016; 43(5): 687-96. https://doi.org/10.1017/cjn.2016.262Jog M., Wein T., Bhogal M., Dhani S., Miller R., Ismail F., et al. Real-World, long-germ Quality of life following therapeutic Onabo­tulinumtoxinA treatment. Can. J. Neurol. Sci. 2016; 43(5): 687–96. https://doi.org/10.1017/cjn.2016.262Wong С., Westphall I., Michelsen J.S. Measuring effects on pain and quality of life after AbobotulinumtoxinA injections in children with cerebral palsy. Toxins (Basel). 2022; 14(1): 43. https://doi.org/10.3390/toxins14010043Wong С., Westphall I., Michelsen J.S. Measuring effects on pain and quality of life after AbobotulinumtoxinA injections in children with cerebral palsy. Toxins (Basel). 2022; 14(1): 43. https://doi.org/10.3390/toxins14010043Boyer E.R., Novaczyk Z.B., Novacheck T.F., Symons F.J., Burkitt C.C. Presence and predictors of pain after orthopedic surgery and associated orthopedic outcomes in children with cerebral palsy. Paediatr. Neonatal. Pain. 2021; 4(1): 44-52. https://doi.org/10.1002/pne2.12067Boyer E.R., Novaczyk Z.B., Novacheck T.F., Symons F.J., Burkitt C.C. Presence and predictors of pain after orthopedic surgery and associated orthopedic outcomes in children with cerebral palsy. Paediatr. Neonatal. Pain. 2021; 4(1): 44–52. https://doi.org/10.1002/pne2.12067Guinet A.L., Khouri N., Desailly E. Rehabilitation after single-event multilevel surgery for children and young adults with cerebral palsy: A systematic review. Am. J. Phys. Med. Rehabil. 2022; 101(4): 389-99. https://doi.org/10.1097/PHM.0000000000001864Guinet A.L., Khouri N., Desailly E. Rehabilitation after single-event multilevel surgery for children and young adults with cerebral palsy: A systematic review. Am. J. Phys. Med. Rehabil. 2022; 101(4): 389–99. https://doi.org/10.1097/PHM.0000000000001864Riva A., Amadori E., Vari M.S., Spalice A., Belcastro V., Viri M., et al. Impact and management of drooling in children with neurological disorders: an Italian Delphi consensus. Ital. J. Pediatr. 2022; 48(1): 118. https://doi.org/10.1186/s13052-022-01312-8Riva A., Amadori E., Vari M.S., Spalice A., Belcastro V., Viri M., et al. Impact and management of drooling in children with neurological disorders: an Italian Delphi consensus. Ital. J. Pediatr. 2022; 48(1): 118. https://doi.org/10.1186/s13052-022-01312-8Sonune S.P., Gaur A.K., Shenoy A. Prevalence of depression and quality of life in primary caregiver of children with cerebral palsy. J. Family Med. Prim. Care. 2021; 10(11): 4205-11. https://doi.org/10.4103/jfmpc.jfmpc.70.21Sonune S.P., Gaur A.K., Shenoy A. Prevalence of depression and quality of life in primary caregiver of children with cerebral palsy. J. Family Med. Prim. Care. 2021; 10(11): 4205–11. https://doi.org/10.4103/jfmpc.jfmpc.70.21

The authors declare that there are no conflicts of interest present.