Longitudinal Growth, Diet, and Physical Activity in Young Children With Cerebral Palsy. 2016

Stina Oftedal, and Peter S W Davies, and Roslyn N Boyd, and Richard D Stevenson, and Robert S Ware, and Piyapa Keawutan, and Katherine A Benfer, and Kristie L Bell
Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland Child Health Research Centre, Brisbane, Australia; s.oftedal@uq.edu.au.

To describe the longitudinal relationship between height-for-age z score (HZ), growth velocity z score, energy intake, habitual physical activity (HPA), and sedentary time across Gross Motor Function Classification System (GMFCS) levels I to V in preschoolers with cerebral palsy (CP). Children with CP (n = 175 [109 (62.2%) boys]; mean recruitment age 2 years, 10 months [SD 11 months]; GMFCS I = 83 [47.2%], II = 21 [11.9%], III = 28 [15.9%], IV = 19 [10.8%], V = 25 [14.2%]) were assessed 440 times between the age of 18 months and 5 years. Height/length ratio was measured or estimated via knee height. Population-based standards were used to calculate HZ and growth velocity z-score by age and sex categories. Feeding method (oral or tube) and gestational age at birth (GA) were collected from parents. Three-day ActiGraph and food diary data were used to measure HPA/sedentary time ratio and energy intake, respectively. Oropharyngeal dysphagia was rated with the Dysphagia Disorder Survey (part 2, Pediatric). Analysis was undertaken with mixed-effects regression models. For GMFCS level I, height and growth velocity did not differ from population-level growth standards. Children in levels II to V were significantly shorter, and those in levels III to V grew significantly more slowly than those in level I. There was a significant positive association between HZ and GA at all GMFCS levels. Energy intake, HPA, sedentary time, Dysphagia Disorder Survey score, and feeding method were not significantly associated with either height or growth velocity once GMFCS level was accounted for. Functional status and GA should be considered when assessing the growth of a child with CP. Research into interventions aimed at increasing active movement in GMFCS levels III to V and their efficacy in improving growth and health outcomes is warranted.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D001827 Body Height The distance from the sole to the crown of the head with body standing on a flat surface and fully extended. Body Heights,Height, Body,Heights, Body
D002149 Energy Intake Total number of calories taken in daily whether ingested or by parenteral routes. Caloric Intake,Calorie Intake,Intake, Calorie,Intake, Energy
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002657 Child Development The continuous sequential physiological and psychological maturing of an individual from birth up to but not including ADOLESCENCE. Infant Development,Development, Child,Development, Infant
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding
D005260 Female Females

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