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Differences in body composition according to functional ability in preschool-aged children with cerebral palsy
Jacqueline L Walker1, Kristie L Bell2, Richard D Stevenson3
1Children's Nutrition Research Centre, Queensland Children's Medical Research Institute, The University of Queensland, Old Milk Kitchen, Building 916, Cnr Fourth and Back Rds (Southern Annexe of Edith Cavell Building), Herston, QLD 4029, Australia; Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Level 7, Block 6, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Insights
Preschoolers with cerebral palsy (CP) show altered body composition, with lower fat-free mass index and higher body fat percentage in those with greater functional impairment. These differences highlight the need for further investigation into optimal body composition in children with CP.
Area of Science:
- Pediatrics
- Body Composition Analysis
- Cerebral Palsy Research
Background:
- Altered body composition, including fat-free mass and fat mass, is observed in school-aged children with cerebral palsy (CP).
- Differences in body composition are linked to functional ability and typically developing children (TDC).
- The body composition of preschool-aged children with CP remains understudied.
Purpose of the Study:
- To determine fat-free mass index (FFMI) and body fat percentage (BF%) in preschool-aged children with CP.
- To investigate variations in body composition based on functional ability, as assessed by the Gross Motor Function Classification System (GMFCS).
- To compare body composition between children with CP and TDC.
Main Methods:
- A cross-sectional study involving 85 preschool-aged children with CP and 16 TDC.
- Body composition assessed using isotope dilution.
- Children with CP categorized by GMFCS levels (I-V).
- Statistical analyses included ANOVA, ANCOVA, t-tests, and regression.
Main Results:
- No significant overall differences in FFMI or BF% between children with CP and TDC.
- Children with GMFCS levels III-V exhibited significantly lower FFMI compared to GMFCS levels I-II.
- Children with GMFCS levels IV-V had the highest BF% compared to GMFCS levels I-II.
Conclusions:
- Preschool-aged children with CP demonstrate altered body composition.
- A trend of decreasing FFMI and increasing BF% is observed with higher GMFCS levels (I-V).
- Further research is needed to establish optimal body composition parameters and identify contributing factors in this population.
Background & Aims:
Altered body composition is evident in school children with cerebral palsy (CP). Fat free mass and fat mass amounts differ according to functional ability and compared to typically developing children (TDC). The extent to which body composition is altered in preschool-aged children with CP is unknown. We aimed to determine the fat free mass index (FFMI) and body fat percentage (BF%) of preschool-aged children with CP and investigate differences according to functional ability and compared to TDC.
Methods:
Eighty-five children with CP (68% male) of all functional abilities, motor types and distributions and 16 TDC (63% male) aged 1.4-5.1 years participated in this cross-sectional study. Body composition was determined via isotope dilution. Children with CP were classified into groups based on their Gross Motor Function Classification System (GMFCS) level. Statistical analyses were via ANOVA, ANCOVA, post-hoc Tukey HSD tests, independent t-tests and multiple regressions.
Results:
There were no significant differences in FFMI or BF% when comparing all children with CP to TDC. Children classified as GMFCS levels III, IV and V had significantly lower FFMI levels compared to children classified as GMFCS I and II (p < 0.05). Children of GMFCS IV and V had the highest mean (± SD) BF% of all children (24.6% (± 10.7%)), significantly higher than children of GMFCS I and II (18.6% (± 6.8%), p < 0.05).
Conclusions:
Altered body composition is evident in preschool-aged children with CP, with a trend towards lower FFMI levels and greater BF% across functional ability levels from GMFCS I to V. Further research is required to determine optimal body composition parameters and investigate contributing factors.
Clinical Trial Registry:
Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12611000616976.
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