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Ruiz Brunner M, Cieri ME, Lucero Brunner RA, Condinanzi AL, Gil C, Cuestas E. Software and equations using segmental measures to estimate height in children and adolescents with cerebral palsy considering the level of gross motor function. Clin Nutr ESPEN 2024; 62:234-240. [PMID: 38848220 DOI: 10.1016/j.clnesp.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND & AIMS In children with Cerebral palsy (CP) bone deformities create a difficulty in the collection of height measures by direct methods. Body segments are an alternative to study for anthropometric evaluation in children with CP. Motor compromise affects growth in these children. To our knowledge, no equations have been developed to estimate height that consider the level of involvement of children with CP. The aim was to develop equations to estimate height using segmental measures for children with cerebral palsy (CP). METHODS This was a cross-sectional study. The sample consisted of children and adolescents with CP of both sexes from 2 to 19 years old from five cities in Argentina. Children whose height and knee-heel height (KH) could be measured were included. Height, KH, and clinical covariables were collected. Linear regression models with height as the dependent variable and KH as predictors adjusted for significant covariates were developed and compared for R2, adjusted R2, and the root mean square of the error. RESULTS 242 children and adolescents (mean age 9 ± 4 years) with a confirmed diagnosis of CP were included. The interaction between height and other variables such KH, sex, GMFCS, and age was analyzed. Two equations were developed to estimate height according to GMFCS level (GMFCS Level I-III: H = 1.5 × KH(cm) + 2.28 × age(years) + 51; GMFCS Level IV-V: H = 2.13 × KH (cm)+ 0.91 × age(years) + 37). The concordance correlation coefficient between estimated and observed height was 0.95 (95%CI [0.94; 0.96]). CONCLUSION Height in children and adolescents with CP can be predicted using KH, GMFCS, and age. The equations and software can estimate height when this cannot be obtained directly.
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Affiliation(s)
- Mercedes Ruiz Brunner
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Maria Elisabeth Cieri
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ruben A Lucero Brunner
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ana Laura Condinanzi
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carla Gil
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Cuestas
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; 2da. Cátedra de Clínica Pediátrica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Ruiz Brunner MDLM, Jahan I, Cuestas E, Cieri ME, Escobar Zuluaga J, Condinanzi AL, Sanchez F, McIntyre S, Smithers-Sheedy H, Muhit M, Badawi N, Díaz R, Diaz A, Carranza J, Durán C, Quintero Valencia CA, Melaragno M, Khandaker G. Latin American Cerebral Palsy Register (LATAM-CPR): study protocol to develop a collaborative register with surveillance of children with cerebral palsy in Latin American countries. BMJ Open 2023; 13:e071315. [PMID: 38070889 PMCID: PMC10729276 DOI: 10.1136/bmjopen-2022-071315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Cerebral palsy (CP) is one of the leading causes of childhood disability globally with a high burden in low-income and middle-income countries (LMICs). Preliminary findings from the global LMIC CP Register (GLM CPR) suggest that the majority of CP in LMICs are due to potentially preventable causes. Such data are lacking in the Latin American region. Generating comparable epidemiological data on CP from this region could enable translational research and services towards early diagnosis and early intervention. We aim to establish a Latin American multicountry network and online data repository of CP called Latin American Cerebral Palsy Register (LATAM-CPR). METHODS AND ANALYSIS The LATAM-CPR will be modelled after the GLM CPR and will support new and emerging Latin American CP registers following a harmonised protocol adapted from the GLM CPR and piloted in Argentina (ie, Argentine Register of Cerebral Palsy). Both population-based and institution-based surveillance mechanisms will be adopted for registration of children with CP aged less than 18 years to the participating CP registers. The data collection form of the LATAM-CPR will include risk factors, clinical profile, rehabilitation, socioeconomical status of children with CP. Descriptive data on the epidemiology of CP from each participating country will be reported, country-specific and regional data will be compared. ETHICS AND DISSEMINATION Individual CP registers have applied ethics approval from respective national human research ethics committees (HREC) and/or institutional review boards prior to the establishment and inclusion into the LATAM-CPR. Ethical approval for LATAM-CPR has already been obtained from the HREC in the two countries that started (Argentina and Mexico). Findings will be disseminated and will be made publicly available through peer-reviewed publications, conference presentations and social media communications.
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Affiliation(s)
- Maria de Las Mercedes Ruiz Brunner
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Israt Jahan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Eduardo Cuestas
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Maria Elisabeth Cieri
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Johana Escobar Zuluaga
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Ana Laura Condinanzi
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Federico Sanchez
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Muhit
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Raul Díaz
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Agripina Diaz
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Jorge Carranza
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Claudia Durán
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Carlos Alberto Quintero Valencia
- Departamento de Rehabilitación, Facultad de Medicina de la Universidad de Antioquia, Antoquia, Colombia
- Unidad de Rehabilitación para Niños, Comité de Rehabilitación de Antioquia, Medellín, Colombia
| | - Mariana Melaragno
- Docencia e Investigación, Fundación Teletón Argentina, Buenos Aires, Argentina
| | - Gulam Khandaker
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- Central Queensland Public Health Unit, Central Queensland University, Rockhampton, New South Wales, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Cieri ME, Ruiz Brunner MM, Condinanzi AL, Escobar J, Cuestas E. Nutritional status and dietary intake of children and adolescents with cerebral palsy. Clin Nutr ESPEN 2023; 57:391-398. [PMID: 37739685 DOI: 10.1016/j.clnesp.2023.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/16/2023] [Accepted: 07/15/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE To analyze the association between energy and nutrient intake, nutritional status and motor compromise in children and adolescents aged 2-19 years with cerebral palsy (CP) attending rehabilitation centers in the Province of Cordoba, Argentina. METHODS Cross sectional study. Data from 105 children and adolescents of both sexes aged 2-19 years with CP (67 boys [63.8% 53.84-72.95]) were collected. Motor compromise was assessed with GMFCS. 24 h records were collected and analyzed. The results were compared with the recommended by FAO/UNU/WHO for age and sex. Normal data were presented with mean and SD, while those of non-normal distribution were described as medians with their ranges. The relationship between variables was analyzed using Fisher, t, or Mann-Whitney tests, with a p value < 0.05. RESULTS The mean age was 11 years 6 months (SD 4 years 4 months). Fifteen [14.3% 8.23-22.48] children failed to meet at least 80% of the recommended energy. Children with GMFCS IV-V consume fewer daily calories and carbohydrate calories than their peers (I-III). The median protein intake of children GMFCS IV-V group was significantly lower than that of their peers (47.37 g vs. 71.56 g, p = 0.0057). Those who did not reach 80% of the recommended energy intake had lower intakes of macro and micronutrients. CONCLUSION The greater the motor compromise in children with CP, the greater the compromise in the adequacy of nutrient intake. The intake of macro and micronutrients was different according to whether or not they were able to cover at least 80% of the recommended energy for their age.
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Affiliation(s)
- María Elisabeth Cieri
- Instituto de Investigación en Ciencias de la Salud, Consejo Nacional de Investigación en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, (INICSA-UNC-CONICET) Universidad Nacional de Córdoba, Córdoba, Argentina; Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - María M Ruiz Brunner
- Instituto de Investigación en Ciencias de la Salud, Consejo Nacional de Investigación en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, (INICSA-UNC-CONICET) Universidad Nacional de Córdoba, Córdoba, Argentina; Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ana Laura Condinanzi
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Johana Escobar
- Instituto de Investigación en Ciencias de la Salud, Consejo Nacional de Investigación en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, (INICSA-UNC-CONICET) Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Cuestas
- Instituto de Investigación en Ciencias de la Salud, Consejo Nacional de Investigación en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, (INICSA-UNC-CONICET) Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Cátedra de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Jahan I, Sultana R, Afroz M, Muhit M, Badawi N, Khandaker G. Dietary Intake, Feeding Pattern, and Nutritional Status of Children with Cerebral Palsy in Rural Bangladesh. Nutrients 2023; 15:4209. [PMID: 37836493 PMCID: PMC10574640 DOI: 10.3390/nu15194209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Data on immediate causes of malnutrition among children with Cerebral Palsy (CP) are limited in low- and middle-income countries (LMICs). We aimed to assess the dietary intake pattern, feeding characteristics, and nutritional status of children with CP in Bangladesh; (2) Methods: We conducted a descriptive observational study in Shahjadpur, Bangladesh. Children with CP registered into the Bangladesh CP Register were included. Socio-demographic, clinical, dietary intake, feeding, gastro-intestinal conditions, and anthropometric data were collected. Descriptive and inferential statistics were reported; (3) Results: 75 children (mean (SD) age 3.6 (2.7) years, 42.7% female) and their caregivers participated. Overall, 53.6% and 46.4% of children were underweight and stunted, respectively. Two-thirds children consumed ≤4 out of 8 food groups. Meat, poultry, and fish; dairy products; and sugar consumption was lower among underweight children (43.4%, 48.8%, 25.0%) than others (56.7%, 51.2% 75.0%). Inappropriate feeding position was observed in 39.2% of children. Meal duration was >30 min/meal for 21.7‒28.0% children. Among all, 12.0% had feeding difficulties, 88.0% had ≥1 gastro-intestinal conditions; (4) Conclusions: The study reports preliminary data on the feeding characteristics, dietary intake, and nutritional status of children with CP in rural Bangladesh. The findings are crucial for cost-effective interventions, prevention, and management of malnutrition among children with CP in Bangladesh and other LMICs.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka 1213, Bangladesh; (R.S.); (M.A.); (M.M.); (G.K.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1213, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
| | - Risad Sultana
- CSF Global, Dhaka 1213, Bangladesh; (R.S.); (M.A.); (M.M.); (G.K.)
| | - Mousume Afroz
- CSF Global, Dhaka 1213, Bangladesh; (R.S.); (M.A.); (M.M.); (G.K.)
| | - Mohammad Muhit
- CSF Global, Dhaka 1213, Bangladesh; (R.S.); (M.A.); (M.M.); (G.K.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1213, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Sydney, NSW 2145, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka 1213, Bangladesh; (R.S.); (M.A.); (M.M.); (G.K.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1213, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia
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