Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

Abstract

A B S T R A C T ObjectiveTo evaluate the frequency of malnutrition and food consumption of children with cerebral palsy according to the age at the beginning of speech and hearing rehabilitation treatment. MethodsTwo to eleven-year-old children diagnosed with cerebral palsy who had up to three months of speech-language and nutritional rehabilitation were included in two reference centers in Recife, Pernambuco, Brazil. measurement of the children were taken: weight, knee height, arm circumference and triceps skinfold. Weight, estimated height and body mass index were classified into Z-scores according to the World Health Organization curves. Brachial circumference, triceps skinfold and arm circumference were classified according to Frisancho. The 24-hour recall was used to calculate intake of calories, proteins, calcium, iron, vitamin A, and zinc using the NutriWin software. ResultsA total of 68 patients were evaluated. Children older than five had a higher frequency of malnutrition when weight (p=0.02) and arm circumference (p<0.001) were considered, although there was less triceps malnutrition (p=0.002). These also had lower calorie consumption per kg/day, protein/kg/day and calcium than the younger children. ConclusionThe greatest nutritional impairment after the age of five suggests that nutritional and speech therapy interventions could have a greater effect if they were performed before that age.Keywords: Cerebral palsy. Child. Eating behavior. Food consumption. Malnutrition. R E S U M O Objetivo Avaliar frequência da desnutrição e consumo alimentar de crianças com paralisia cerebral de acordo com a idade do início do tratamento de reabilitação fonoaudiológica e nutricional. Métodos Foram incluídas crianças de 2 a 11 anos com diagnóstico de paralisia cerebral e que tinham até três meses de reabilitação fonoaudiológica e nutricional em dois centros de referência em I N T R O D U C T I O NCerebral palsy, the most common cause of physical disability in children, is characterized by permanent disorders of posture and movement [1] and it affects between 2-2.5 per thousand live births worldwide [2]. Cerebral palsy is not progressive, however, due to its motor sequelae and eating difficulties, these children can develop nutritional impairments that prevent early brain development and plasticity [3], leading to impaired health conditions, quality of life and cognitive performance [4].Malnutrition in cerebral palsy is multifactorial. In addition to the nutritional status, other factors such as primary neurological damage, which interferes with muscle constitution, endocrinological factors, immobility and caregiving demands, and overall health conditions may interfere in

Malnutrition is Common in Cerebral Palsy Children in Saudi Arabia – A Cross-Sectional Clinical Observational Study

“…Data Collection: Data were collected in the following distinct stages [8] The procedure for measuring knee-height was completed while the patient was in the supine position.…”

“…Questions were also asked to know feeding problems (yes/no) and appetite status of the children (normal/fair vs. poor) from the parents/caregivers. For this purpose, a questionnaire, based on recommendations from previously published reports [8][9][10][11][12][13] was designed in such a way to identify the most common feeding problems including inability to self-feed, inadequate/absence of tongue lateralization, chewing problem, swallowing problem, cough/choking during feed, drooling, hypertonic tongue, inability to take solid food, constipation, sucking problem, vomiting/regurgitation, non-closure of lips around spoon, Inappropriate wide mouth opening and cry/extensor dystonia during feeding.…”

“…Sex and age normalized z-scores were calculated using WHO Anthro-(2010) and AnthroPlus (2009). Children with extreme z-scores were excluded from the final calculations (8). The weight-for-age z-score was only calculated for children up to 10 years of age and the weight-for-height z-score for those up to 5 years of age [8].…”

“…Children with extreme z-scores were excluded from the final calculations (8). The weight-for-age z-score was only calculated for children up to 10 years of age and the weight-for-height z-score for those up to 5 years of age [8]. Nutritional status of each child was assessed on the basis of z-scores.…”

“…Nutritional status is significantly affected in children with CP [1][2][6][7]. The associated co-morbidities include growth abnormalities, feeding complications, communication disorders, mental obstruction, seizure disorders, and auditory and visual deficiency [8][9]. With the diminished motor and mental capabilities, the patient is unable to eat properly and is very likely to have suboptimal energy intake.…”