Nutritional aspects in patients with cerebral palsy: A multicenter observational study in Spain

Abstract

Introduction: Cerebral palsy (CP) encompasses a group of motor disorders that can result in swallowing difficulties, affecting food intake and contributing to poor nutritional status. The goal of the study was to describe the clinical and nutritional characteristics of Spanish children with CP.

Methods: Multicenter observational study conducted in children aged 4-14 years with a diagnosis of CP. For every patient, we collected data on sociodemographic and clinical characteristics as well as anthropometric measurements, schooling modality, nutrition received at school, nutritional support and gastrointestinal comorbidities.

Results: The sample included a total of 112 patients with a mean age of 9.2 years old. The majority (70.5%) had been classified as Gross Motor Function Classification System (GMFCS) level IV or V. Compared to children classified as GMFCS level I, II or III, the group of children with GMFCS level IV/V had significantly lower mean z scores in body weight, height, weight-to-height ratio, body mass index and upper arm circumference and a significant lower mean arm area. A higher proportion of patients with GMFCS level IV/V attended special education schools compared to patients classified as level I to III (68.4% vs. 12.1%; P < .0001). A higher proportion of children classified as level IV/V compared to children classified as levels I to III presented dysphagia (62.0% vs. 15.2%; P < .0001), constipation (51.9% vs. 27.3%, P = .0218) and gastroesophageal reflux (31.6% vs. 3.0%; P = .0005).

Conclusions: Our study shows that Spanish children with CP, especially those with severe motor impairment, are at risk of malnutrition, present gastrointestinal comorbidities and require nutritional support.

Keywords: Apoyo nutricional; Cerebral palsy; Comorbidities; Comorbilidades; Estado nutricional; GMFCS; Nutritional status; Nutritional support; Parálisis cerebral.