Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Whitney, Daniel G.; Gross‐Richmond, Penina; Hurvitz, Edward A.; Peterson, Mark D.

doi:10.1111/cob.12327

Cited by 12 publications

(16 citation statements)

References 66 publications

(300 reference statements)

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“…Furthermore, because of their growth retardation it is difficult to apply the available centile grids enabling assessment of weight and growth rates, and commonly used in evaluating nutritional status of normally developing children [14]. Moreover, the interpretation of body fat using % fat is also affected by low fat-free mass given the interdependency of fat and fat-free mass to estimate % fat [15]. In view of these significant limitations linked with other measurement methods, bioelectrical impedance analysis (BIA) is more and more commonly applied in assessing nutritional status recognised by clinicians monitoring nutritional status of children with CP [12,13].García Íñiguez et al showed that there is a direct correlation between resting energy expenditure, total energy expenditure and fat mass, muscle mass, and total body water in children with CP [16].…”

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confidence: 99%

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

et al. 2020

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The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

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confidence: 99%

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

et al. 2020

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“…Skinfold thickness is well correlated with total body fat in a general paediatric population and also considered appropriate as a single measurement 52,53 . It may not be as accurate in children with CP with more central fat deposits, which is not reflected in reduced peripheral skinfolds 5,50 . Measures of body composition are preferred because of their accuracy and ability to account for compromised growth and altered body composition 29,37 .…”

Section: Discussionmentioning

confidence: 99%

“…52,53 It may not be as accurate in children with CP with more central fat deposits, which is not reflected in reduced peripheral skinfolds. 5,50 Measures of body composition are preferred because of their accuracy and ability to account for compromised growth and altered body composition. 29,37 Further, some studies showed that methods like skinfold and BIA are able to detect both over-and undernutrition.…”

Section: Discussionmentioning

confidence: 99%

“…A recent review concluded that stunted growth and underdeveloped fat-free mass are more pronounced in more severe forms of CP and that abdominal and musculoskeletal fat were favourable compared to subcutaneous fat compared to individuals without CP. 50 This implies that screening tools without physical measurements are possibly more efficient in less affected individuals and that the higher the GMFCS levels the more an assessment of growth and fat mass is required. 10,20,25,31,33,[41][42][43] Traditionally scientific interest has focused on undernutrition rather than overnutrition, which is reflected by the fact that most methods target identification of undernutrition.…”

Section: Discussionmentioning

confidence: 99%

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Nutritional screening of children and adolescents with cerebral palsy: a scoping review

Sørensen

Brekke

Kok

et al. 2021

Develop Med Child Neuro

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Aim To examine nutritional screening methods for children and adolescents with cerebral palsy. Method A scoping review was performed using established methodologies. In June 2020 we searched PubMed, Embase, CINAHL Complete, and the Cochrane Central Register of Controlled Trials to identify articles on tools/methods for nutritional screening of our target groups. Results Thirty studies were included, containing various tools/methods used to identify under‐ and/or overnutrition by weight/height, circumferences, skinfolds, questionnaires, and/or technically advanced or invasive methods. Questionnaires, weight/height, circumferences, and skinfolds were considered feasible based on clinical utility, whereas bioelectrical impedance analysis and blood samples were not. Interpretation We identified two screening tools for undernutrition that include no physical measurements, but did not find any screening tools for overweight and obesity. Most of the studies recommended one or more methods, indicating that determining nutritional status most likely includes a combination of methods, not all of which may be feasible in clinical practice. No nutritional screening tool using anthropometry or body composition was discovered. Heterogenous methods to identify under‐ and/or overnutrition are recommended. Preferable methods for nutritional screening include assessment of body composition. A validated nutritional screening tool for identification of overweight is warranted.

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“…In a non-CP cohort with significant muscle deficits, cystatin c-based eGFR was a better predictor of kidney function than creatinine-based eGFR (34). Although since cystatin c is expressed by adipose tissue (35), more work is needed to identify whether cystatin c or creatinine may be a better biomarker to estimate kidney function in populations with low muscle and high body and regional fat stores, such as CP (3,5,36,37).…”

Section: Discussionmentioning

confidence: 99%

The Association Between Kidney Disease and Mortality Among Adults With Cerebral Palsy—A Cohort Study: It Is Time to Start Talking About Kidney Health

Whitney

Oliverio

2021

Front. Neurol.

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Objective: Recent evidence shows that adults with cerebral palsy (CP) have an increased risk for kidney disease, but nothing is known about how kidney disease integrates with their overall health. To begin understanding the importance of kidney health, the objective was to determine if kidney disease is associated with mortality among adults with CP after accounting for comorbidities common to CP and kidney disease.Methods: Data from 2016 to 2018 from adults ≥18 years with CP were used from a random 20% sample fee-for-service Medicare database. Kidney disease in 2016 was ascertained as chronic kidney disease (CKD) stages 1–4, end stage kidney disease (ESKD), nephritic and nephrotic syndrome, and renal osteodystrophy. A modified version of the Whitney Comorbidity Index (modWCI) was used, which includes 24 comorbidities relevant to CP and kidney disease. Mortality rate ratio (MRR) through the year 2018 was estimated for each kidney disease and Cox regression estimated the hazard ratio (HR) of mortality after adjusting for demographics, co-occurring neurological conditions, and the modWCI.Results: Prevalence of kidney disease was 7.3% among 16,728 adults with CP. MRR was elevated for any kidney disease (MRR = 3.14; 95%CI = 2.76–3.58) and most subtypes (MRR = 2.21–3.56; all p < 0.05). The adjusted HR of mortality remained elevated for any kidney disease (HR = 1.25; 95%CI = 1.09–1.45) and ESKD (HR = 1.38; 95%CI = 1.10–1.74).Discussion: Kidney disease, especially ESKD, is associated with mortality among adults with CP independent of comorbidities that are relevant to CP and kidney disease. Findings suggest that nephrology care should be considered as part of routine clinical care for this population.

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Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Cited by 12 publications

References 66 publications

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

The Relationship between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study

Nutritional screening of children and adolescents with cerebral palsy: a scoping review

The Association Between Kidney Disease and Mortality Among Adults With Cerebral Palsy—A Cohort Study: It Is Time to Start Talking About Kidney Health

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