Growth in children with Cerebral Palsy

✍ Scribed by Cronk, Christine E. ;Stallings, Virginia A.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 216 KB
• Volume: 3
• Category: Article
• ISSN: 1080-4013
• DOI: 10.1002/(sici)1098-2779(1997)3:2<129::aid-mrdd4>3.0.co;2-m

✦ Synopsis

Cerebral palsy (CP) is an often severe disability associated with abnormal growth, body composition, physical activity, and food intake as well as malnutrition. Children with severe CP have linear growth that is often reduced to less than 3rd centile with progressively delayed growth with age. Milder CP is characterized by somewhat reduced growth (near 25th to 50th centiles). A primary contributor to growth retardation is malnutrition associated with poor feeding skills and oromotor dysfunction. Disease severity and the complex of other associated abnormalities (e.g., abnormal stress on bones, endocrine abnormalities) also appear to contribute to poor growth. Body composition in children with CP is also abnormal. As expected, fat free mass is reduced due to poor linear growth, muscle mass depletion, and disuse atrophy. Fat mass is also reduced, at least in part secondary to malnutrition. Dietary intake in most children is less than normal for age, although sometimes appropriate for body size. Resting energy expenditure is decreased in the most severely affected children, particularly among those who are most severely malnourished. Total energy expenditure is also reduced due to lack of physical activity and malnutrition. Reported dietary intake appears to be a poor indicator of actual energy needs when compared with information from total energy expenditure. Clinical evaluation of growth, body composition, and nutritional status should be performed using a specialized measurement to replace body height. In addition, fat mass should be assessed using skinfold thicknesses to detect malnutrition. When possible, measurements of energy expenditure should be used to estimate dietary requirements.