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Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study.
PLoS One. 2017; 12(4):e0175028.Plos

Abstract

OBJECTIVE

We investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care.

METHODS

Pain Visual-Analogue-Scale (range 1-5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3.85± 1.39; p = 0.036) even though pain anticipated prior to procedures was similar (~3).

FINDINGS

Children who underwent the first procedure with clown-care reported lower pain even after they crossed-over to the following procedure which was standard (p = 0.048). Carryover effect was more prominent in injection-naïve children (p = 0.019) and during multiple procedures (p = 0.009). Prior pain experience correlated with pain in subsequent procedures only when first experience was standard-care (p = 0.001).

CONCLUSIONS

Clown-care alleviated pain sensation during Botulinum-toxin injections and initial clown-care experience reduced pain during subsequent injections even though clowns were not present.

TRIAL REGISTRATION

clinicaltrials.gov ID # NCT01377883.

Authors+Show Affiliations

Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.Biostatistical Consulting (L.D), BioStats, Modien, Israel.School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28414728

Citation

Ben-Pazi, Hilla, et al. "Clown-care Reduces Pain in Children With Cerebral Palsy Undergoing Recurrent Botulinum Toxin Injections- a Quasi-randomized Controlled Crossover Study." PloS One, vol. 12, no. 4, 2017, pp. e0175028.
Ben-Pazi H, Cohen A, Kroyzer N, et al. Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study. PLoS One. 2017;12(4):e0175028.
Ben-Pazi, H., Cohen, A., Kroyzer, N., Lotem-Ophir, R., Shvili, Y., Winter, G., Deutsch, L., & Pollak, Y. (2017). Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study. PloS One, 12(4), e0175028. https://doi.org/10.1371/journal.pone.0175028
Ben-Pazi H, et al. Clown-care Reduces Pain in Children With Cerebral Palsy Undergoing Recurrent Botulinum Toxin Injections- a Quasi-randomized Controlled Crossover Study. PLoS One. 2017;12(4):e0175028. PubMed PMID: 28414728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study. AU - Ben-Pazi,Hilla, AU - Cohen,Avraham, AU - Kroyzer,Naama, AU - Lotem-Ophir,Renana, AU - Shvili,Yaakov, AU - Winter,Gidon, AU - Deutsch,Lisa, AU - Pollak,Yehuda, Y1 - 2017/04/17/ PY - 2016/07/02/received PY - 2017/03/19/accepted PY - 2017/4/18/entrez PY - 2017/4/18/pubmed PY - 2017/5/10/medline SP - e0175028 EP - e0175028 JF - PloS one JO - PLoS One VL - 12 IS - 4 N2 - OBJECTIVE: We investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care. METHODS: Pain Visual-Analogue-Scale (range 1-5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3.85± 1.39; p = 0.036) even though pain anticipated prior to procedures was similar (~3). FINDINGS: Children who underwent the first procedure with clown-care reported lower pain even after they crossed-over to the following procedure which was standard (p = 0.048). Carryover effect was more prominent in injection-naïve children (p = 0.019) and during multiple procedures (p = 0.009). Prior pain experience correlated with pain in subsequent procedures only when first experience was standard-care (p = 0.001). CONCLUSIONS: Clown-care alleviated pain sensation during Botulinum-toxin injections and initial clown-care experience reduced pain during subsequent injections even though clowns were not present. TRIAL REGISTRATION: clinicaltrials.gov ID # NCT01377883. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28414728/Clown_care_reduces_pain_in_children_with_cerebral_palsy_undergoing_recurrent_botulinum_toxin_injections__A_quasi_randomized_controlled_crossover_study_ L2 - https://dx.plos.org/10.1371/journal.pone.0175028 DB - PRIME DP - Unbound Medicine ER -