title: Differences in body composition according to functional ability in preschool-aged children with cerebral palsy.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12611000616976.
authors.affiliation: Children'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. Electronic address: jacki.walker@hotmail.com.
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Walker
authors.affiliation: Children'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; Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, QLD, Australia; Department of Paediatric Rehabilitation, Royal Children's Hospital, Brisbane, QLD, Australia. Electronic address: k.bell@uq.edu.au.
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Bell
authors.affiliation: Department of Pediatrics, Division of Developmental Pediatrics, Kluge Children's Rehabilitation Center and Research Institute, University of Virginia, 2270 Ivy Road, Charlottesville, VA 22903, USA. Electronic address: RDS8Z@hscmail.mcc.virginia.edu.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stevenson
authors.affiliation: 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; Speech Pathology Department, Level 4, Coles Health Services Building, Royal Children's Hospital, Herston, QLD 4029, Australia; Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, QLD, Australia. Electronic address: k.weir1@uq.edu.au.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Weir
authors.affiliation: 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. Electronic address: r.boyd@uq.edu.au.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.affiliation: Children'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. Electronic address: ps.davies@uq.edu.au.
authors.forename: Peter S W
authors.initials: PS
authors.lastname: Davies
mesh_terms: D000203:Activities of Daily Living; D001315:Australia; D001823:Body Composition / Q000502:physiology*; D002547:Cerebral Palsy / Q000503:physiopathology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000502:physiology; D012720:Severity of Illness Index
keywords: Body composition; Cerebral palsy; Children; Functional ability