Growth and Health in Children With Moderate-to-Severe Cerebral Palsy

Stevenson, Richard D.; Conaway, Mark R.; Chumlea, William Cameron; Rosenbaum, Peter; Fung, Ellen B.; Henderson, Richard C.; Worley, Gordon; Liptak, Gregory S.; O’Donnell, Maureen; Samson‐Fang, Lisa; Stallings, Virginia A.

doi:10.1542/peds.2006-0298

Cited by 199 publications

(218 citation statements)

References 32 publications

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“…In the present study, the mean age was younger and more homogeneous if compared to the mean age of the subjects included in the studies that investigated the relation between growth discrepancy in the affected side and age (5,16,24) ; even though, we found that the older the age, the higher the percentage of decrease in the circumference of the affected upper-arm. This reinforces the term used by Tizard et al (29) , "undergrowth," since the process of lower growth is related to the difficulty to grow instead of being related to a retrogression.…”

Section: Discussioncontrasting

confidence: 64%

“…tors than children with CP who have more severe growth disorders, as demonstrated by Stevensen et al (24) . Head circumference, which is one of the most important measures during childhood, reflects the intracranial volume of the brain under development.…”

Section: Discussionmentioning

confidence: 89%

“…Growth is an essential aspect of child development, being a marker of health and well-being (24) . Abnormal growth between the two sides of the body in children with hemiplegic CP is used as a model for the study of the influence of non-nutritional factors on growth.…”

Section: Discussionmentioning

confidence: 99%

“…There is controversy on the relation between discrepancy in the growth of the affected side and age (5,16,24) . In the present study, the mean age was younger and more homogeneous if compared to the mean age of the subjects included in the studies that investigated the relation between growth discrepancy in the affected side and age (5,16,24) ; even though, we found that the older the age, the higher the percentage of decrease in the circumference of the affected upper-arm.…”

Section: Discussionmentioning

confidence: 99%

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Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica

Zonta¹,

Agert²,

Muzzolon³

et al. 2009

Rev. paul. pediatr.

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Objective: To analyze the linear growth, the head circumference and the anthropometric differences between involved and non-involved sides of 24 children with hemiplegic cerebral palsy, comparing them to standard values for age.Methods: This cross-sectional study enrolled 24 consecutive children with cerebral palsy clinically classified as spastic hemiplegia. The anthropometric measures included: weight, lenght, head circumference, total upper limb length, hand length, palm width, total lower limb length, foot length, and limb circumference of upper-arm, thigh and calf. The anthropometric differences between both sides were calculated in centimeters and a comparison of the involved and non-involved sides was made. Two different reference values were used to compare the measures of hand and foot length: growth charts and the software ABase ® (a PalmOS-based software). The Spearman's correlation coefficient was estimated for the association between quantitative variables and the Wilcoxon non-parametric test was used for age comparisons between involved and noninvolved sides. Results:The mean values of weight, length and head circumference were within the normal range for age and 21% of the children presented microcephaly. Discrepancy was noted between both sides in all cases, being the largest discrepancy in hand length and width. There was a positive correlation between the discrepancy observed in superior and inferior affected limbs (r=0.48), and discrepancy increases with age (r=0.44). Conclusion: Growth impairment in children with hemiplegic cerebral palsy was observed on the affected limbs and in smaller proportion in head circumference. Key-words:anthropometry; cerebral palsy; hemiplegia; growth; child. RESUMO Objetivo:Analisar o crescimento linear, o perímetro cefálico e as diferenças antropométricas entre o lado envolvido e o não-envolvido de 24 crianças com paralisia cerebral (PC) hemiplégica, comparados à média para a idade.Métodos: Estudo transversal com amostragem consecutiva de crianças com PC, classificadas clinicamente como hemiplegia espástica. As medidas antropométricas incluíram: peso, estatura, perímetro cefálico, comprimento total de membro superior, comprimento da mão, largura da palma da mão, comprimento total do membro inferior, comprimento do pé e a circunferência dos membros (braço, coxa e panturrilha). As diferenças antropométricas entre os dimídios foram calculadas em centímetros e como porcentagem de encurtamento, comparando o lado envolvido com o não-envolvido. Dois referenciais populacionais, tabelas de crescimento e o software ABase ® , desenvolvido para sistema PalmOS, foram comparados na classificação das medidas do comprimento da mão e do pé. A análise estatística utilizou o coeficiente de correlação de Spearman para avaliar a associação entre variáveis quantitativas e o teste não-paramétrico de Wilcoxon para comparar as medidas do lado envolvido e não-envolvido.Rev Paul Pediatr 2009;27(4):416-23. Original ArticleResultados: As médias de peso, estatura e perímetro cefá-lic...

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica

Zonta¹,

Agert²,

Muzzolon³

et al. 2009

Rev. paul. pediatr.

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“…As crianças com PC que apresentam melhor crescimento utilizaram serviços de saúde por menos dias e perderam menos dias de atividades sociais 2 .…”

Section: Introductionunclassified

Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy

Hegazi¹,

Soliman²,

Hasaneen³

et al. 2012

J Pediatr (Rio J)

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Objective: To assess growth hormone (GH)/insulin like growth factor-1 (IGF-1) axis as a possible non-nutritional factor for growth retardation in children with cerebral palsy (CP). Methods:A case-control study was conducted at a tertiary university hospital. Thirty children with CP (seven children with normal growth [CP-N] and 23 with retarded growth [CP-R]), 30 children with protein energy malnutrition (PEM), and 30 healthy children (REF group) underwent an assessment of growth parameters, serum IGF-1, basal GH, and peak GH after stimulation with insulin.Results: PEM patients had higher basal GH levels than CP-N, CP-R and REF groups (p = 0.026, p < 0.001, and p < 0.001 respectively). After insulin stimulation, CP-N, CP-R, and PEM patients had lower GH levels compared to the REF group (p = 0.04, p = 0.007, and p = 0.036 respectively). IGF-1 levels were lower in CP-R group compared to CP-N and REF groups (p = 0.037 and p < 0.001 respectively), and in PEM group compared to CP-N and REF groups (p < 0.001 and p < 0.001 respectively). Conclusions:CP-R patients failed to demonstrate the same high basal GH response as PEM patients, and responded inadequately to the insulin stimulation test, but they had IGF-1 levels comparable to those of PEM patients. On the other hand, CP-N patients behaved as controls regarding their basal GH and IGF-1 levels, but failed to respond adequately to the insulin stimulation test. The PEM group presented high basal GH and low IGF-1 levels. These findings suggest that nonnutritional factors contribute to growth retardation in CP children. J Pediatr (Rio J). 2012;88(3):267-74:GH, IGF-1, cerebral palsy, children. ResumoObjetivo: Avaliar o eixo hormônio de crescimento (GH)/fator de crescimento semelhante à insulina 1 (IGF-1) como possível fator não nutricional para o retardo de crescimento em crianças com paralisia cerebral (PC). Conclusões:Os pacientes com PC-R não demonstraram a mesma resposta basal elevada do GH apresentada pelos pacientes com DPE, e responderam de forma inadequada ao estímulo com insulina, mas apresentaram níveis de IGF-1 comparáveis aos dos pacientes com DPE. Por outro lado, os pacientes com PC-N tiveram comportamento semelhante ao dos controles com relação aos níveis basais de GH e IGF-1, mas não responderam adequadamente ao estímulo com insulina. O grupo DPE apresentou GH basal elevado e IGF-1 baixo. Esses achados sugerem que fatores não nutricionais contribuem para o retardo de crescimento em crianças com PC. Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy Não foram declarados conflitos de interesse associados à publicação deste artigo.Como citar este artigo: Hegazi MA, Soliman OE, Hasaneen BM, El-Arman M, El-Galel NA, El-Deek BS. Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy. J Pediatr (Rio J). 2012;88(3):267-74.Artigo submetido em 27.11.11, aceito em 14.03.12.http://dx

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Growth and nutrition disorders in children with cerebral palsy

Kuperminc

Stevenson

2008

Dev Disabil Res Revs

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191

138

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Growth and nutrition disorders are common secondary health conditions in children with cerebral palsy (CP). Poor growth and malnutrition in CP merit study because of their impact on health, including psychological and physiological function, healthcare utilization, societal participation, motor function, and survival. Understanding the etiology of poor growth has led to a variety of interventions to improve growth. One of the major causes of poor growth, malnutrition, is the beststudied contributor to poor growth; scientific evidence regarding malnutrition has contributed to improvements in clinical management and, in turn, survival over the last 20 years. Increased recognition and understanding of neurological, endocrinological, and environmental factors have begun to shape care for children with CP, as well. The investigation of these factors relies on advances made in the assessment methods available to address the challenges inherent in measuring growth in children with CP. Descriptive growth charts and norms of body composition provide information that may help clinicians to interpret growth and intervene to improve growth and nutrition in children with CP. Linking growth to measures of health will be necessary to develop growth standards for children with CP in order to optimize health and well-being.

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Growth and Health in Children With Moderate-to-Severe Cerebral Palsy

Abstract: Growth patterns in children with cerebral palsy were associated with their overall health and social participation. The role of these cerebral palsy-specific growth curves in clinical decision-making will require further study.

Cited by 199 publications

References 32 publications

Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica

Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica

Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy

Growth and nutrition disorders in children with cerebral palsy

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