The Prevalence of Coexisting Motor Proficiency Delay and Chronic Pain in Children Presenting to a Tertiary Pain Service: A Cross-Sectional Observational Study

Abstract

OBJECTIVES: Chronic pain can profoundly impact children's physical, social, and psychological functioning, with negative effects that can persist into adulthood. The prevalence of motor proficiency delay in children with chronic pain is unknown. We aimed to describe the prevalence of motor proficiency delay in a sample of children and estimate potential predictive factors of delayed motor proficiency from routinely collected self-report measures. METHODS: We conducted a cross-sectional study of 94 children and adolescents (6 to 18) with chronic pain who attended a tertiary pain clinic in Australia. We assessed their motor proficiency using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) standardised assessment tool. Participants also completed a suite of routine clinical questionnaires and a self-perception questionnaire. We described the prevalence of motor proficiency delay using descriptive statistics and estimated the extent to which routine demographic and clinical data could explain variation in BOT-2 scores using a multivariable linear model to calculate adjusted R ². RESULTS: Overall, 83% of participants presented with challenges in at least one motor-proficiency subtest (eg, coordination), and 41% had delayed total motor proficiency scores. We found that just 9% of the variance in BOT-2 scores could be explained by the covariates in the multivariable prediction model (adjusted R2 =0.09, 95% CI: 0.01-0.25). DISCUSSION: Most children presenting to a tertiary pain clinic presented with motor proficiency challenges unlikely to be identified through routinely collected self-report measures. Given that the BOT-2 can identify norm-referenced developmental targets, the use of these assessments may enhance clinical formulations and guide developmentally sensitive rehabilitation programs.