Understanding pain mechanisms in children and young people with cerebral palsy: feasibility and acceptability of quantitative sensory testing

Non-nociceptive measures were better tolerated than pinprick-based assessments. Within-session consistency varied across modalities, ranging from poor to excellent. Mean assessment duration was 67 min.

Acceptability was rated highly by participants and guardians.</p> <p>Mechanical QST is safe, acceptable and can be implemented flexibly across the functional diversity of young people with CP who can self-report. A pragmatic battery may support mechanism-based pain and somatosensory assessment in rehabilitation settings to enable individualised management, pending CP-specific normative data and protocol validation.</p> <p></p><p>Chronic pain in cerebral palsy is often driven by more than musculoskeletal factors, so rehabilitation clinicians should consider mechanism-based somatosensory assessment alongside standard pain history when planning individualised management.</p><p>Mechanical QST holds promise as a pain assessment tool: it was safe, well tolerated, and could be flexibly adapted to individual functional and communication needs, rather than requiring a one-size-fits-all protocol.</p><p>Where time or tolerance is limited, clinicians could prioritise pressure pain threshold, dynamic mechanical allodynia and vibration detection threshold as first-line measures at the hand and foot, retaining mechanical pain sensitivity and mechanical pain threshold with reduced repetitions and reserving wind-up ratio for those with sufficient tolerance, still yielding clinically meaningful sensory information without requiring the full battery</p><p>Broader clinical adoption will depend on developing cerebral palsy-specific reference values and simplified protocols; until these exist, results should be interpreted at the individual level rather than against normative benchmarks.</p><p></p> <p>Chronic pain in cerebral palsy is often driven by more than musculoskeletal factors, so rehabilitation clinicians should consider mechanism-based somatosensory assessment alongside standard pain history when planning individualised management.</p> <p>Mechanical QST holds promise as a pain assessment tool: it was safe, well tolerated, and could be flexibly adapted to individual functional and communication needs, rather than requiring a one-size-fits-all protocol.</p> <p>Where time or tolerance is limited, clinicians could prioritise pressure pain threshold, dynamic mechanical allodynia and vibration detection threshold as first-line measures at the hand and foot, retaining mechanical pain sensitivity and mechanical pain threshold with reduced repetitions and reserving wind-up ratio for those with sufficient tolerance, still yielding clinically meaningful sensory information without requiring the full battery</p> <p>Broader clinical adoption will depend on developing cerebral palsy-specific reference values and simplified protocols; until these exist, results should be interpreted at the individual level rather than against normative benchmarks.</p>