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Vol. 89. Núm. 3.
Páginas 307-314 (Maio - Junho 2013)
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Vol. 89. Núm. 3.
Páginas 307-314 (Maio - Junho 2013)
ARTIGO ORIGINAL
DOI: 10.1016/j.jpedp.2012.11.010
Open Access
Anthropometric assessment of patients with cerebral palsy: Which curves are more appropriate?
Avaliação antropométrica dos pacientes com paralisia cerebral: quais as curvas mais adequadas?
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4209
Liubiana A. Araújoa,
Autor para correspondência
, Luciana R. Silvab
a Doutora em Neuropediatria, Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil. Fellow, Harvard Medical School, Boston, MA, EUA
b Doutora. Pós-doutora. Chefe, Serviço de Gastroenterologia e Hepatologia Pediátrica, Complexo do Hospital Universitário Professor Edgard Santos (HUPES), Centro Pediátrico Professor Hosannah de Oliveira (CPPHO), UFBA, Salvador, BA, Brasil
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Informação do artigo
Abstract
Objective

To describe the nutritional assessment of children with cerebral palsy, verifying the correlation of growth curves specific for cerebral palsy with general curves, in addition to assessing the presence of digestive manifestations associated with nutritional problems.

Methods

This was a cross-sectional study of 187 individuals with cerebral palsy, evaluating anthropometric data in curves commonly used in pediatrics and specific curves for cerebral palsy, in addition to the description of presence of dysphagia, constipation, and respiratory infections.

Results

58% of patients were males, with a mean age of 5.6±3.5 years. Anthropometric data of weight below the 10th percentile occurred in 10% of the sample considering the cerebral palsy scale, versus 51% when considering the reference from the Centers for Disease Control and Prevention (p < 0.01; Kappa 0.19). The weight of most individuals with dysphagia, recurrent respiratory infections, and constipation was below the 50th percentile, with respective percentages of 67%, 75%, and 72%.

Conclusion

The references commonly used in pediatrics tend to overestimate malnutrition in individuals with cerebral palsy, and their correlation with specific references for cerebral palsy is low. Digestive manifestations were mainly found in those individuals whose anthropometric measurements were below the 50th percentile.

Keywords:
Cerebral palsy
malnutrition
swallowing disorders
intestinal constipation
respiratory infections
Resumo
Objetivo

Descrever a avaliação nutricional de crianças com paralisia cerebral, verifi- cando a concordância de curvas de crescimento específicas para paralisia cerebral com curvas gerais, além de avaliar a presença das manifestações digestórias associadas a agravos nutricionais.

Métodos

Corte transversal de 187 indivíduos com paralisia cerebral, avaliando-se dados antopométricos em curvas habitualmente utilizadas em pediatria e em curvas especí- ficas para paralisia cerebral, além da descrição da presença de disfagia, constipação intestinal e infecções respiratórias de repetição.

Resultados

Dos indivíduos, 58% eram masculinos; média de idade de 5,6 anos ± 3,5 anos. Dados antopométricos de peso abaixo do percentil 10 ocorreu em 10% da amostra, consi- derando a escala para paralisia cerebral, contra 51% na referência do Center of Disease Control (p < 0,01; Kappa 0,19). A maioria dos indivíduos comprometidos com disfagia, infecções respiratórias de repetição e constipação intestinal encontrava-se abaixo do percentil 50, com porcentagens respectivas de 67%, 75% e 72%.

Conclusão

As referências habitualmente utilizadas em pediatria tendem a superestimar a desnutrição em indivíduos com paralisia cerebral, e sua concordância com referências específicas para paralisia cerebral é baixa. As manifestações digestórias foram encon- tradas principalmente naqueles indivíduos cujas medidas antropométricas encontram-se abaixo do percentil 50.

Palavras chave:
Paralisia cerebral
Desnutrição
Transtornos de deglutição
Constipação intestinal
Infecções respiratórias
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Referências
[1]
E.A. Calis, R. Veugelers, J.J. Sheppard, D. Tibboel, H.M. Evenhuis, C. Penning.
Dysphagia in children with severe generalized cerebral palsy and intellectual disability.
Dev Med Child Neurol., 50 (2008), pp. 625-630
[2]
K.L. Bell, R.N. Boyd, S.M. Tweedy, K.A. Weir, R.D. Stevenson, P.S. Davies.
A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy.
BMC Public Health., 10 (2010), pp. 179
[3]
H.Y. Tomoum, N.B. Badawy, N.E. Hassan, K.M. Alian.
Anthropometry and body composition analysis in children with cerebral palsy.
Clin Nutr., 29 (2010), pp. 477-481
[4]
A.L. Caram, A.M. Morcillo, E.A. Costa-Pinto.
Nutritional status of children with cerebral palsy in a Brazilian tertiary-care teaching hospital.
Dev Med Child Neurol., 50 (2008), pp. 956
[5]
J. Brooks, S. Day, R. Shavelle, D. Strauss.
Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts.
Pediatrics., 128 (2011), pp. 299-307
[6]
S.M. Day, D.J. Strauss, P.J. Vachon, L. Rosenbloom, R.M. Shavelle, Y.W. Wu.
Growth patterns in a population of children and adolescents with cerebral palsy.
Dev Med Child Neurol., 49 (2007), pp. 167-171
[7]
M.N. Kuperminc, R.D. Stevenson.
Growth and nutrition disorders in children with cerebral palsy.
Dev Disabil Res Rev., 14 (2008), pp. 137-146
[8]
R.D. Stevenson.
Use of segmental measures to estimate stature in children with cerebral palsy.
Arch Pediatr Adolesc Med., 149 (1995), pp. 658-662
[9]
R.J. Kuczmarski, C.L. Ogden, S.S. Guo, L.M. Grummer-Strawn, K.M. Flegal, Z. Mei, et al.
2000 CDC Growth Charts for the United States: methods and development.
Vital Health Stat 11, (2002), pp. 1-190
[10]
R. Veugelers, E.A. Calis, C. Penning, A. Verhagen, R. Bernsen, J. Bouquet, et al.
A population-based nested case control study on recurrent pneumonias in children with severe generalized cerebral palsy: ethical considerations of the design and representativeness of the study sample.
BMC Pediatr., 5 (2005), pp. 25
[11]
K.A. Weir, S. McMahon, S. Taylor, A.B. Chang.
Oropharyngeal aspiration and silent aspiration in children.
Chest., 140 (2011), pp. 589-597
[12]
R. Vega-Sanchez, M. de la Luz Gomez-Aguilar, K. Haua, G. Rozada.
Weight-based nutritional diagnosis of Mexican children and adolescents with neuromotor disabilities.
BMC Res Notes., 5 (2012), pp. 218
[13]
L.A. Araújo, L.R. Silva, F.A. Mendes.
Controle neuronal e manifestações digestórias na paralisia cerebral.
J Pediatr (Rio J)., 88 (2012), pp. 455-464
[14]
M.L. Shim, T. Moshang Jr., W.L. Oppenheim, P. Cohen.
Is treatment with growth hormone effective in children with cerebral palsy?.
Dev Med Child Neurol., 46 (2004), pp. 569-571
[15]
V. Marchand, K.J. Motil.
NASPGHAN Committee on Nutrition. Nutrition support for neurologically impaired children: a clinical report of the North American Society for Pediatric Gastroenterology.
Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr., 43 (2006), pp. 123-135
[16]
K.E. Troughton, A.E. Hill.
Relation between objectively measured feeding competence and nutrition in children with cerebral palsy.
Dev Med Child Neurol., 43 (2001), pp. 187-190
[17]
J.C. Vélez, A.L. Fitzpatrick, C.I. Barbosa, M. Díaz, M. Urzua, A.H. Andrade.
Nutritional status and obesity in children and young adults with disabilities in Punta Arenas, Patagonia.
Chile. Int J Rehabil Res., 31 (2008), pp. 305-313
[18]
Z. Mei, C.L. Ogden, K.M. Flegal, L.M. Grummer-Strawn.
Comparison of the prevalence of shortness, underweight, and overweight among US children aged 0 to 59 months by using the CDC 2000 and the WHO 2006 growth charts.
J Pediatr., 153 (2008), pp. 622-628
[19]
J. Krick, P. Murphy-Miller, S. Zeger, E. Wright.
Pattern of growth in children with cerebral palsy.
J Am Diet Assoc., 96 (1996), pp. 680-685
[20]
D. Oeffinger, M. Conaway, R. Stevenson, J. Hall, R. Shapiro, C. Tylkowski.
Tibial length growth curves for ambulatory children and adolescents with cerebral palsy.
Dev Med Child Neurol., 52 (2010), pp. e195-e201
[21]
O.G. Macedo, J.G. Carazzato, S. Meirelles Ede, A. Paula, C.A. Santos, N.R. Bolliger, et al.
Comparative study of skin folding of dominant and nondominant hemibodies in spastic hemiplegic cerebral palsy.
Clinics (Sao Paulo)., 63 (2008), pp. 601-606
[22]
M.N. Kuperminc, M.J. Gurka, J.A. Bennis, M.G. Busby, R.I. Grossberg, R.C. Henderson, et al.
Anthropometric measures: poor predictors of body fat in children with moderate to severe cerebral palsy.
Dev Med Child Neurol., 52 (2010), pp. 824-830
[23]
R. Rieken, E.A. Calis, D. Tibboel, H.M. Evenhuis, C. Penning.
Validation of skinfold measurements and bioelectrical impedance analysis in children with severe cerebral palsy: a review.
Clin Nutr., 29 (2010), pp. 217-221
[24]
P.B. Sullivan, B. Lambert, M. Rose, M. Ford-Adams, A. Johnson, P. Griffiths.
Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study.
Dev Med Child Neurol., 42 (2000), pp. 674-680
[25]
A.J. Costa, G.A. Silva, P.A. Gouveia, E.M. Pereira Filho.
Prevalência de refluxo gastroesofágico patológico em lactentes regurgitadores.
J Pediatr (Rio J)., 80 (2004), pp. 291-295
[26]
B. Rogers.
Feeding method and health outcomes of children with cerebral palsy.
J Pediatr., 145 (2004), pp. S28-S32
[27]
S.M. Day.
Do we know what the prevalence of cerebral palsy is?.
Dev Med Child Neurol., 53 (2011), pp. 876-877
[28]
E. Pollitt.
Developmental sequel from early nutritional deficiencies: conclusive and probability judgements.
J Nutr., 130 (2000), pp. S350-S353
[29]
L.P. Miranda, R. Resegue, A.C. De Melo Figueiras.
A criança e o adolescente com problemas do desenvolvimento no ambulatório de pediatria.
J Pediatr (Rio J)., 79 (2003), pp. S33-S42

Como citar este artigo: Araújo LA, Silva LR. Anthropometric assessment of patients with cerebral palsy: which curves are more appropriate?. J Pediatr (Rio J). 2013;89:307–14.

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