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Differences in Body Composition According to Gross Motor Function in Children With Cerebral Palsy

Published:April 29, 2017DOI:https://doi.org/10.1016/j.apmr.2017.04.005

      Abstract

      Objective

      To assess differences in body composition according to gross motor function in children with cerebral palsy (CP) compared with healthy controls.

      Design

      Retrospective case-control study.

      Setting

      Tertiary referral center for CP.

      Participants

      Participants (N=146) comprised consecutive patients with CP (n=100; mean age, 11.5±4.2y) who were admitted for orthopedic surgery between May 2014 and March 2016 and typically developing children (TDC, n=46; control group).

      Interventions

      Not applicable.

      Main Outcome Measures

      Bioelectrical impedance analysis (BIA) was used to assess body composition, including body fat, soft lean mass (SLM), fat-free mass (FFM), skeletal muscle mass (SMM), body cell mass (BCM), bone mineral content (BMC), and basal metabolic rate. Body composition measures were compared according to Gross Motor Function Classification System (GMFCS) level, as well as between children with CP and TDC.

      Results

      Children with CP with GMFCS levels IV and V had a lower height, weight, and body mass index than those with GMFCS levels I to III. Children with CP with GMFCS levels IV and V had a significantly lower SLM, SLM index, FFM, FFM index, SMM, SMM index, BCM, BCM index, BMC, and BMC index than those with GMFCS levels I to III and TDC. GMFCS level significantly affected SLM and BMC.

      Conclusions

      Body composition analysis using BIA showed that nonambulatory children with CP had significantly lower FFM, SLM, SMM, BCM, and BMC than ambulatory children with CP and TDC. However, further study is required to allow the use of BIA as a valid nutritional assessment tool in patients with CP.

      Keywords

      List of abbreviations:

      BCM (body cell mass), BIA (bioelectrical impedance analysis), BMC (bone mineral content), BMD (bone mineral density), BMI (body mass index), BMR (basal metabolic rate), CP (cerebral palsy), DXA (dual-energy x-ray absorptiometry), FFM (fat-free mass), GMFCS (Gross Motor Function Classification System), SLM (soft lean mass), SMM (skeletal muscle mass), TDC (typically developing children), VFA (visceral fat area)
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