Growth retardation and undernutrition in children with spastic cerebral palsy

Abstract

Aim: To assess the prevalence of growth retardation and undernutrition in a homogenous group of 30 children with spastic cerebral palsy. Methods: Standard anthropometric assessment and functional assessment of feeding ability. Results: Growth retardation was common and severe: mean length for age standard deviation score (SDS) was −2.1 (SD 1.0) and 60% of the sample were «stunted». Mean weight for height SDS was +0.2 (SD 0.9) and «wasting» was largely confined to those children identified as having feeding problems. Conclusion: Formal assessment of growth and nutritional status is indicated in children with cerebral palsy, even if health and feeding status would otherwise give little cause for concern.

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

“…AXIS scores ranged between 13 and 20 (maximum score). Two studies scored less than 15, whereas five studies received the maximum score . Mean score was 17.2 (SD 1.7).…”

“…Prevalence data of drooling, swallowing, and feeding problems were determined using different types of assessments. Studies used clinical assessments (n=13 studies); 31,33,35,39,41,44,[48][49][50]52,61,62,69 parent or carer questionnaires or interviews (n=7 studies); 29,42,45,46,63,64,68 or a combination of both (n=12). 30,34,36,37,40,43,51,53,56,[65][66][67] Nine studies used data from medical registers or charts, 34,45,54,55,[57][58][59][60]70 of which three added data from either clinical assessments, 47 or parent or carer questionnaires.…”

“…The 42 studies included an estimated total of 23 169 participants. The number of participants per study ranged from 30 to 14 806, with a median participant number of 120 (interquartile range [IQR] 55-186): 30≤n<50 (n=8 studies); 29,[33][34][35][36][37][38]49 n<100 (n=10 studies); 39,[42][43][44]47,48,50,63,64,69 n<200 (n=14 studies); [30][31][32]40,41,46,[51][52][53]61,62,65,67 n<500…”

“…Data from eight studies were included in the meta-analysis on feeding problems, 30,33,38,40,43,45,46,68 resulting in an estimated pooled prevalence of 53.5% (95% CI 40.7-65.9; Table III; Fig. S4, online supporting information).…”

Energy expenditure and physical activity of ambulatory children with cerebral palsy and of typically developing children

“…Poor nutrition and growth are frequently reported, and many children with CP are shorter and lighter than similarly aged typically developing children (2)(3)(4)(5)(6). Conversely, there is some evidence that overweight and obesity may be common, particularly in those with spasticity and who are relatively inactive (7). Prevention and treatment of both undernutrition and obesity in this group requires a thorough understanding of their nutritional needs and most importantly energy requirements; however, there have been few inves-tigations into the energy requirements of children with CP through measurement of total energy expenditure (TEE) (8)(9)(10)(11)(12)(13).…”