Energy expenditure is associated with age, anthropometric indicators and body composition in children with spastic cerebral palsy

Íñiguez, Jorge Abraham García; Garibay, Edgar M Vásquez; Contreras, Andrea A García; Romero‐Velarde, Enrique; Sanromán, Rogelio Troyo; Rocha, Juan Hernández; Rosas, Alejandro Rea; León, Monserrat Rodríguez; Martínez, Elvira Uribe

doi:10.20960/nh.1696

Cited by 12 publications

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“…Moreover, the interpretation of body fat using % fat is also affected by low fat-free mass given the interdependency of fat and fat-free mass to estimate % fat [15]. In view of these significant limitations linked with other measurement methods, bioelectrical impedance analysis (BIA) is more and more commonly applied in assessing nutritional status recognised by clinicians monitoring nutritional status of children with CP [12,13].García Íñiguez et al showed that there is a direct correlation between resting energy expenditure, total energy expenditure and fat mass, muscle mass, and total body water in children with CP [16]. Many studies to date have also shown a relationship between energy demand and muscle tone in children with CP [2,[17][18][19].…”

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confidence: 99%

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The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

et al. 2020

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The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

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confidence: 99%

“…García Íñiguez et al showed that there is a direct correlation between resting energy expenditure, total energy expenditure and fat mass, muscle mass, and total body water in children with CP [16]. Many studies to date have also shown a relationship between energy demand and muscle tone in children with CP [2,[17][18][19].…”

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confidence: 99%

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

et al. 2020

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“…Other authors reported lower resting energy expenditure (between 760 and 876 kcal/day) [ 123 ] and total energy expenditure of 1367 ± 329.17 kcal [ 95 ], both in younger populations. Several publications have suggested that children with bilateral spastic CP have the highest resting energy expenditure and total energy expenditure (due to the hypertonicity of the muscles), whereas children with spastic quadriplegic CP have the lowest [ 26 , 95 , 123 , 124 , 125 , 126 , 127 ]. Studies of Walker and Rieken showed a decline in the total energy expenditure with increasing GMFCS level [ 95 , 128 ].…”

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confidence: 99%

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

et al. 2021

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Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II–III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions.

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“…In addition, cerebral palsy in children is characterized by disordered muscle tone distribution, that is, increased muscle tone (including spasticity) in lower and upper limbs and decreased muscle tone in the head–body axis (central hypotonia), limiting activity of the musculoskeletal system [ 3 , 4 ], which may disturb bone and muscle mass development in children with cerebral palsy. Previous research has shown that both body mass index (BMI) percentile and body composition in children with cerebral palsy are different from those in their healthy peers [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Results of these studies have also shown that, with a higher level of disability defined by Gross Motor Function Classification System (GMFCS) level [ 4 , 5 , 8 , 9 , 10 ], or with the most severe form of cerebral palsy [ 6 , 7 , 11 ], indices based on BMI are lower.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research has shown that both body mass index (BMI) percentile and body composition in children with cerebral palsy are different from those in their healthy peers [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Results of these studies have also shown that, with a higher level of disability defined by Gross Motor Function Classification System (GMFCS) level [ 4 , 5 , 8 , 9 , 10 ], or with the most severe form of cerebral palsy [ 6 , 7 , 11 ], indices based on BMI are lower.…”

Section: Introductionmentioning

confidence: 99%

Body Composition and Spasticity in Children with Unilateral Cerebral Palsy—A Case–Control Study

Szkoda

Szopa²,

Siwiec³

et al. 2022

Children

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The aim of this study was to identify the correlations between segmental body composition and the spasticity level of the affected lower limb in children with unilateral cerebral palsy (spastic hemiplegia). Additionally, an attempt was made to identify the differences in composition between the affected and unaffected lower limbs using segmental body composition analysis. This case–control study included 31 children with spastic hemiplegia aged 8 to 16 years with differing severities of spasticity in the lower limbs. The reference group consisted of a control group which included 31 peers with corresponding age and sex to the tested group. Negative correlations obtained in the statistical analysis showed that higher spasticity level in the iliopsoas muscle is associated with lower limb fat-free mass and lower limb muscle mass. Our results showed that children with spastic hemiplegia have worse parameters of body composition in the affected limb than in the unaffected one. To confirm the importance of these results, further studies are needed in a larger population which includes non-ambulatory children.

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Energy expenditure is associated with age, anthropometric indicators and body composition in children with spastic cerebral palsy

Cited by 12 publications

References 0 publications

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

Body Composition and Spasticity in Children with Unilateral Cerebral Palsy—A Case–Control Study

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