Growth and nutritional status in residential center versus home-living children and adolescents with quadriplegic cerebral palsy.
OBJECTIVE
To describe growth and nutrition in nonambulatory youth (<19 years of age) with cerebral palsy (CP) living in residential centers compared with similar youth living at home.


METHODS
A multicenter, cross-sectional, single observational assessment of 75 subjects living in a residential care facility compared with 205 subjects living at home. Primary outcome measures included anthropometric measures of height, weight, triceps, and subscapular skinfolds, and mid-upper-arm muscle area. Z scores were calculated from reference values for healthy children. Age, use of a feeding tube, and Gross Motor Functional Classification System (GMFCS) level were included as important confounders.


RESULTS
Use of a feeding tube was associated with higher skinfold Z scores, and a significantly higher percentage of the residential subjects had a feeding tube. Height, weight, and arm-muscle area Z scores all diverged (negatively) from reference values with age, and the residential subjects were on average older than the home-living subjects. After controlling for age, GMFCS level and use of a feeding tube, residential living was associated with significantly greater weight, height, skinfold thicknesses, and mid-arm muscle area Z scores.


CONCLUSIONS
Poor growth and nutrition in children with CP is a prevalent, important, and complex problem. Although factors intrinsic to the condition of CP likely play a significant role, it is also clear that environmental factors, including the living situation of the child, can have an impact.
Henderson
Richard C
RC
Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina 27599, USA. rchh@med.unc.edu
Grossberg
Richard I
RI
Matuszewski
Jeanine
J
Menon
Nitasha
N
Johnson
Julie
J
Kecskemethy
Heidi H
HH
Vogel
Lois
L
Ravas
Rebecca
R
Wyatt
Megan
M
Bachrach
Steven J
SJ
Stevenson
Richard D
RD
D000293:Adolescent; D000886:Anthropometry; D017028:Caregivers; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006128:Growth; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D011336:Probability; D011782:Quadriplegia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012112:Residential Facilities; D018570:Risk Assessment; D012720:Severity of Illness Index