Assessment of Linear Growth of Children With Cerebral Palsy: Use of Alternative Measures to Height or Length

Abstract

SUMMARY Various linear measurements were made of 100 children with cerebral palsy to evaluate the effects of various factors on growth, and to investigate the use of alternative measurements to height or recumbent length. Linear growth was more retarded in children with spastic quadriplegia than in those with less widespread spasticity, and there was a tendency for the older children to be more growth‐retarded. Upper‐arm and lower‐leg lengths provided useful information about linear growth. Growth charts using these alternative measurements have been developed which can be used to assess linear growth of children with cerebral palsy when it is difficult or impossible to measure height or recumbent length because of joint contractures. These charts should improve the assessment of the nutritional status of children with cerebral palsy. RÉSUMÉ Evaluation de la croissance linéaire chez les enfants IMC, à I'aide d'autres mesures que la tattle globale ou la longueur Des mesures linéaires varicés ont été effectuées chez 100 enfants IMC pour apprécier les effets de difféients facteurs de croissance et rechercher une alternative aux mesures de la taille et de la longueur en position couchée. La croissance linéaire était plus retardée en cas de quadriplégie spastique que dans les cas avec spasticité moins diffuse, et il y avait une tendance à un retard plus prononcé chez les enfants les plus âgés. Les longueurs du bras et de la jambes ont fourni des informations utiles sur la croissance linéaire globale. Des tables de croissance utilisant ces mesures alternatives ont été construites et peuvent être utilisées pour évaluer la croissance linéaire globale des enfants IMC lorsqui'il est difficile ou impossible de mesurer la taille ou la longueur en position allongée, du fait de contractures articulaires. Ces tables devraient améliorer la mesure de l'état nutritionnel des enfants IMC. ZUSAMMENFASSUNG Bestimmung des linearen Wachstums bei Kindern mit Cerebralparese durch andere Parameter als Gröβe und Lánge Bei 100 Kindern mit Cerebralparese wurden verschiedene lineare Messungen durchgeführt, um die Anwendbarkeit alternativer Messungen zu Größe und Länge zu überprüfen. Das lineare Wachstum war bei den Kindern mit spastischer Tetraplegie stärker verzögert, als bei denen mit weniger ausgedehnter Spastik, und es fand sich eine Tendenz, daß die älteren Kinder eine stärkere Wachstumsverzögerung haben. Die Oberarm‐und Unterschenkellängen ergaben brauchbare Informationen über das lineare Wachstum. Es wurden Wachstrumskurven mit diesen alternativen Messungen erstellt, die zur Bestimmung des linearen Wachstums bei Kindern mit Cerebralparese verwendet werden können, wenn es wegen Gelenkkontrakturen schwierig oder unmöglich ist, die Größe oder Länge zu messen. Diese Kurven sollten dazu beitragen, den Ernährungszustand von Kindern mit Cerebralparese besser zu beurteilen. RESUMEN Evaluación del crecimiento linear de niños con parálisis cerebral usando otras medidas que no son la talla y el peso Se hicieron diversas mediciones lineares en ...

Bone age and linear skeletal growth of children with cerebral palsy

“…It has been suggested that charts generated from data of individuals without CP could be used for estimating height in children with CP (Spender et al 1989). This study examines the validity of this suggestion by comparing segmental and linear growth (height) of children with CP with that of children without CP.…”

Height prediction from ulna length

“…In the 47 children with spastic quadriplegia, height or recumbent length could be measured in only 17 children, upper arm length in only 43 and lower leg length in only 46. Both upper arm (males r=0.7, females r=0.86) and lower leg (males r=0.67, females r=0.86) were found to be good predictors of height in the 6-to 19-year age group, suggesting that long bone growth remains proportional to height in children with spastic quadriplegia (Spender et al 1989). …”

“…The technique can be taught quickly to clinical staff. Spender et al (1989) compared measurements of upper arm length obtained by using steel and plastic tape measures with those obtained by using an anthropometer: values obtained were on average 1.03cm (SD 0.2cm) and 1.1cm (SD 0.25cm) greater than the anthropometer values respectively, and the intraobserver variability was greater (p=0.002). A similar degree of inaccuracy would be expected when measuring the ulna with a tape measure, and is not recommended.…”

“…The current study has developed different prediction equations that include age, in addition to the anthropometric measurement, leading to greater precision than in the prediction equations developed by Snyder et al (1977). Spender et al (1989) evaluated the prediction equations for height from upper arm and lower leg lengths developed from the data of Snyder et al (1977). Growth in CP was assessed.…”

Nutritional differences in neurologically impaired children

“…Alternative methods of height estimation were developed because these children are unable to stand unassisted and often exhibit severe scoliosis, contractures and involuntary movements (13). BMI calculations, which depend on accurate height, are less accurate when based on estimation.…”