Clinical and maternal factors associated with pain and quality of life in children with cerebral palsy

Background: Cerebral palsy (CP) represents the most common and disabling motor disorder in childhood. It can lead to chronic pain and reduced quality of life (QOL). These challenges can also affect mothers, who are typically the primary caregivers, contributing to physical and psychosocial strain. Objectives: This study explored the associations between motor impairment, chronic pain, and QOL in children with CP, as well as maternal stress and pain intensity, and examined their mediating roles. Method: A cross-sectional study was conducted with 132 mother–child dyads in Tunisia. Children were aged 4 to 12 years. The Gross Motor Function Classification System, the Cerebral Palsy Quality of Life Questionnaire, the Visual Analogue Scale, and the Perceived Stress Scale were used to assess motor impairment, quality of life, and chronic pain intensity in children with CP, as well as maternal pain intensity and stress. Results: Motor impairment was significantly associated with lower child QOL (β = −0.671; SE = 0.657, p  0.001) and higher pain intensity (β = 0.5; SE = 1.213, p  0.001). Maternal stress partially mediated the relationship between motor impairment and child QOL (Sobel test = −4.073; p  0.001). Maternal pain also partially mediated the relationship between motor impairment and child pain (Sobel test = 2.505; p = 0.012). Conclusion: These findings highlight the significant impact of motor impairment on QOL and chronic pain intensity in children with CP. Contribution: This study emphasises the mediating roles of maternal stress and pain intensity, suggesting that interventions should address both the physical symptoms of CP and the psychosocial well-being of children and their mothers.