Anterior pelvic tilt and back pain in adults with cerebral palsy

Abstract Aim To determine the association of anterior pelvic tilt (APT) and other patient risk factors with back pain in adults with cerebral palsy (CP). Method This was a prospective cohort study of adults previously treated at a pediatric specialty center. Inclusion criteria were adults with CP over the age of 24 years, ambulatory Gross Motor Function Classification System (GMFCS) levels I to IV, with at least one instrumented gait analysis during childhood. Kinematic parameters, Patient‐Reported Outcomes Measurement Information System pain interference score, walking activity (StepWatch), and Gait Deviation Index were examined as potential risk factors for back pain. Results There were 118 (42% female) participants who met inclusion criteria: GMFCS level I ( n = 24), II ( n = 64), III ( n = 24), IV ( n = 6); mean age 29 years (SD 4 years), range 24 to 44 years. Prevalence of back pain was 14% ( n = 16). The degree of APT was not significantly different between groups with/without back pain (19.4 [SD 9.0] vs 20.6 [SD 10.1]; p = 0.64). Regression analysis found that neither APT nor secondary factors were significantly related to back pain. Interpretation Despite clinicians' concerns, excessive APT was not significantly associated with back pain in this cohort of adults with CP. The negative consequences of excessive APT related to back pain may not be as significant as previously thought for people with CP.