Assessment of Nutritional Status and Frequency of Complications Associated to Feeding in Patients With Spastic Quadriplegic Cerebral Palsy

Abstract

Objective: To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP). Methods: This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman’s index. Significance was set at p<0.05. Results: 75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient’s nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status. Conclusions: The results reinforce the need for continued nutritional guidance for the children’s parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.

Dietary Intake, Feeding Pattern, and Nutritional Status of Children with Cerebral Palsy in Rural Bangladesh

“…The high constipation rate, especially among study participants who did not have vegetables or fruits in their diet, also supports the above finding. Similar findings were observed in other studies [20,36]. These practices could be improved through education and demonstration sessions and empowering the caregivers to select/plan a balanced diet for their children when preparing meals or feeding them.…”

Nutritional status of children with severe forms of cerebral palsy undergoing surgical orthopedic treatment for spastic hip dislocation

“…Таким образом, дети с тяжелыми формами ДЦП представляют категорию повышенного риска и требуют особого подхода при проведении хирургического лечения. Оценка нутритивного статуса должна проводиться заблаговременно, а расчет пищевой потребности персонализирован с учетом росто-весовых характеристик, формы церебрального паралича, уровня двигательных расстройств, коморбидного фона [16,17,20].…”

“…Определяли физическое развитие по центильным таблицам для пациентов с ДЦП, учитывающих пол детей, уровень по GMFCS, тип питания. Доли вычисляли по сигмальным отклонениям Z-score, полученным из преобразования центильных значений [2,14,17].…”

Nutritional status of children with neurodevelopmental disorders: A cross-sectional study at the tertiary level hospital in northern Bangladesh

“…Among these children, a complex of nutritional, social, environmental, and biological deprivation leads to malnutrition and afterwards various forms indicators such as stunting (short stature), underweight, muscle wasting, growth retardation, diminished subcutaneous fat, and ill health may occur which in turn increases mortality rate [12]. A positive correlation has been found between the diet received and the patient's nutritional status (0.48; p = 0.01) which shows that individuals with adequate caloric and macronutrients intake had a better nutritional status [13]. Prevalence of children with cerebral palsy is quite noticeable in Bangladesh than rest of the world and they have severely impaired nutritional status [14].…”