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Published on: February 2, 2024
Growth and health in children with moderate-to-severe cerebral palsy
Richard D Stevenson1, Mark Conaway, W Cameron Chumlea
1Department of Pediatrics, School of Medicine, University of Virginia, Kluge Children's Rehabilitation Center and Research Institute, 2270 Ivy Rd, Charlottesville, Virginia 22903, USA. rds8z@virginia.edu
Insights
Children with cerebral palsy (CP) show poor growth. This study found that growth patterns in children with CP are linked to their health status and social participation levels.
Area of Science:
- Pediatric Health
- Growth and Development
- Cerebral Palsy Research
Background:
- Children with cerebral palsy (CP) often experience impaired growth.
- Understanding growth patterns is crucial for managing CP.
- Poor growth can impact overall health and participation in children with CP.
Purpose of the Study:
- To describe growth patterns in a representative sample of children with moderate to severe cerebral palsy.
- To investigate the relationship between observed growth patterns and health status.
- To examine the association between growth patterns and social participation in children with CP.
Main Methods:
- A cross-sectional study involving 273 children with moderate-severe CP (GMFCS levels III-V).
- Collected anthropometric data (weight, knee height, etc.) to create gender-specific growth curves.
- Utilized cluster analysis to identify distinct growth patterns and correlated them with health care use and social participation data.
Main Results:
- Developed gender-specific growth curves for 6 anthropometric measures.
- Identified 3 distinct clusters of children based on growth patterns.
- Children with poorer growth exhibited higher healthcare utilization and missed more social activities.
Conclusions:
- Growth patterns in children with cerebral palsy are significantly associated with their health and social participation.
- These findings highlight the interconnectedness of physical growth, health, and quality of life in pediatric CP.
- Further research is needed to determine the clinical utility of CP-specific growth curves in decision-making.
Background:
Children with cerebral palsy frequently grow poorly. The purpose of this study was to describe observed growth patterns and their relationship to health and social participation in a representative sample of children with moderate-severe cerebral palsy.
Methods:
In a 6-site, multicentered, region-based cross-sectional study, multiple sources were used to identify children with moderate or severe cerebral palsy. There were 273 children enrolled, 58% male, 71% white, with Gross Motor Function Classification System levels III (22%), IV (25%), or V (53%). Anthropometric measures included: weight, knee height, upper arm length, midupper arm muscle area, triceps skinfold, and subscapular skinfold. Intraobserver and interobserver reliability was established. Health care use (days in bed, days in hospital, and visits to doctor or emergency department) and social participation (days missed of school or of usual activities for child and family) over the preceding 4 weeks were measured by questionnaire. Growth curves were developed and z scores calculated for each of the 6 measures. Cluster analysis methodology was then used to create 3 distinct groups of subjects based on average z scores across the 6 measures chosen to provide an overview of growth.
Results:
Gender-specific growth curves with 10th, 25th, 50th, 75th, and 90th percentiles for each of the 6 measurements were created. Cluster analyses identified 3 clusters of subjects based on their average z scores for these measures. The subjects with the best growth had fewest days of health care use and fewest days of social participation missed, and the subjects with the worst growth had the most days of health care use and most days of participation missed.
Conclusions:
Growth patterns in children with cerebral palsy were associated with their overall health and social participation. The role of these cerebral palsy-specific growth curves in clinical decision-making will require further study.
