Effect of a Nutritional Support System (Diet and Supplements) for Improving Gross Motor Function in Cerebral Palsy: An Exploratory Randomized Controlled Clinical Trial

Abstract

Background: Most patients with cerebral palsy (CP) do not respond to physical therapy due to deterioration in their nutritional status, secondary to gastrointestinal disorders and the catabolic state of the disease itself. However, basic treatments only contemplate the energy requirements and do not consider supplementation with glutamine, zinc, selenium, colecalciferol, spirulina, omega 3 or even vegetal proteins. Objective: In this study, we determined the effect of using a nutritional support system (NSS): diet and supplements, on the gross motor function in children with CP with spastic diparesic and Gross Motor Function Classification System III (GMFCS III). Methods: An exploratory study was performed. Thirty patients (from 4 to 12 years old) were randomly assigned to: (1) dietary surveillance (FG), (2) deworming and WHO diet (CG), or (3) deworming and the NSS (IG). Gross motor function was evaluated using the gross motor function measure (GMFM) scale. Results: The IG-treated group presented a significant improvement in standing and walking parameters analyzed in the GMFM compared with FG and CG groups. Fifty percent of the IG-treated patients managed to walk, while in the other groups, no patients were able to walk. Conclusions: The NSS used in the present work improves gross motor function and promotes walking in patients with CP.

Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review

“…Four studies presented some concerns only in one domain (bias in selection of the reported results) [7,12,21,23]; two presented some concerns in two domains [22,28]; and four presented some concerns in three domains [11,20,26,29]. In the five studies with high-risk domains, three presented high risk in only one domain [19,25,27], and two studies presented high risk of bias for two domains [10] (Fig 2B).…”

“…Three studies evaluated other outcomes, comprising gross motor function, iron deficiency anemia and feeding skills. Aiming to improve gross motor function, Leal-Martinez et al (2020) [27] compared a nutritional support system with the diet recommended by the World Health Organization (WHO) and an observational group of patients between 4 and 12 years old. The…”

“…The allocation was dependent on the baseline serum concentrations of vitamin D that were arranged in increasing order, and every other child was assigned to receive the supplement. In turn, Leal-Martinez et al (2020) [27] performed adequate randomization, but baseline results of the motor function scale showed an important difference between groups. Although differences were not statistically significant, the lack of significance may be merely due to the small sample size.…”

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

“…With the extreme shortage of trained professionals including dietitians, in addition to the limited availability and accessibility to institutionalized intervention programs in LMICs [ 13 ], it is likely that not all the interventions found effective in HIC settings may be applicable in LMIC settings. In absence of optimal management, these children are at high risk of malnutrition, which can in turn impact their functional outcomes, quality of life, and survival [ 14 , 15 , 16 ].…”

Food Bioactives: Impact on Brain and Cardiometabolic Health—Findings from In Vitro to Human Studies

“…The study by Leal-Martinez et al (2020) is an exploratory randomized controlled clinical trial investigating the effects of a nutritional support system for improving motor function in children living with cerebral palsy (CP) in Mexico [ 5 ]. CP is one of the most common disabilities in childhood and changes to gross motor function is one of the main characteristics associated with this disease that can contribute to malnutrition in patients with CP.…”