A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy

Abstract

Background: Cerebral palsy is the most common cause of physical disability in childhood, occurring in one in 500 children. It is caused by a static brain lesion in the neonatal period leading to a range of activity limitations. Oral motor and swallowing dysfunction, poor nutritional status and poor growth are reported frequently in young children with cerebral palsy and may impact detrimentally on physical and cognitive development, health care utilisation, participation and quality of life in later childhood. The impact of modifiable factors (dietary intake and physical activity) on growth, nutritional status, and body composition (taking into account motor severity) in this population is poorly understood. This study aims to investigate the relationship between a range of factors - linear growth, body composition, oral motor and feeding dysfunction, dietary intake, and time spent sedentary (adjusting for motor severity) - and health outcomes, health care utilisation, participation and quality of life in young children with cerebral palsy (from corrected age of 18 months to 5 years).

Design/methods: This prospective, longitudinal, population-based study aims to recruit a total of 240 young children with cerebral palsy born in Queensland, Australia between 1st September 2006 and 31st December 2009 (80 from each birth year). Data collection will occur at three time points for each child: 17 - 25 months corrected age, 36 +/- 1 months and 60 +/- 1 months. Outcomes to be assessed include linear growth, body weight, body composition, dietary intake, oral motor function and feeding ability, time spent sedentary, participation, medical resource use and quality of life.

Discussion: This protocol describes a study that will provide the first longitudinal description of the relationship between functional attainment and modifiable lifestyle factors (dietary intake and habitual time spent sedentary) and their impact on the growth, body composition and nutritional status of young children with cerebral palsy across all levels of functional ability.

Figure 1

Conceptual model illustrating the hypothesized interactions of the principle factors to be investigated in the prospective, longitudinal study of growth, nutrition and sedentary activity in young children with cerebral palsy.

Figure 2

Flow chart of study timeline & measures from baseline (left), to completion (right). GMFCS = the Gross Motor Function classification System; FMS = Functional Mobility Scale: TBW = Total Body Water; PEDI = The Paediatric Evaluation of Disability Inventory; CAPE = the Children's Assessment of Participation and Enjoyment; CP-QOL-child = the Cerebral Palsy Quality of Life measure (child version); Dx = Confirmed diagnosis.