Body mass index in cerebral palsy patients with various motor severities

Abstract

Objective – To determine the nutritional status of children and adolescents with cerebral palsy (CP) in relation to the degree of functional disability.

Patients and methods – This cross sectional study analyzed the nutritional status of 73 children and adolescents of both sexes suffering from CP, with an average age expressed as a median of 9.6 years (range 2.6 to 19.4). Evaluation of nutritional status in patients with CP was done on the basis of Body Mass Index (BMI). The degree of functional disability was assessed on the basis of the Gross Motor Function Classification System (GMFCS levels I-V). BMI percentiles were expressed by sex and chronological age, based on national standards in 2000 Centers for Disease Control and Prevention Growth Charts for the United States.

Results – Of the total number of participants, 21.9% were underweight (BMI <5th percentile), 11% were overweight (BMI from 85th to 95th percentile) and 9.6% were obese (BMI >95th percentile). Most malnourished participants had a clinical form of quadriplegia, whereas and overweight and obese had diplegia. There is a significant negative correlation between BMI percentile and the degree of functional disability according to the GMFCS (p=0.0001). Immobile participants (GMFCS IV-V) showed a high prevalence of malnutrition (39.4%) compared to the self-mobile participants (GMFCS I-II, 4.3%). Obesity was present in 17.3% selfmoving participants (GMFCS I-II) and in 17.6% mobile participants with mobile device support (GMFCS III), and none of the immobile children were obese.

Conclusion – About 40% of children and adolescents with CP have nutrition problems, where half of them are malnourished and the other half are over-nourished. Immobile children and those with quadriplegia have a higher risk for malnutrition, whereas mobile children and those with diplegia have a higher risk for over-nutritional status.,