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The Impact of Nutrition on Growth and Development in Children with Cerebral Palsy

Year 2021, Volume: 2 Issue: 2, 37 - 50, 30.08.2021

Abstract

Objective: Cerebral palsy (CP) is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement and motor skills. The aim of this study is to determine the effect of nutritional status on growth and development of children with Cerebral Palsy between the ages of 4-16 applied to a special education and rehabilitation center. Method: The study was carried out by face-to-face questionnaire prepared by the researchers. The demographic and health information of the children were asked, the classification was made according to the gross motor function classification system. The presence of nutritional problems (vomiting, spitting, difficulty in chewing, swallowing disorder, aspiration, tongue thrusting, etc.), main and snack consumption status, nutritional habits such as eating, skipping meals, the frequency of consumption of foods consumed in snacks and at night were questioned. Body weight (kg), height (cm), triceps skinfold thickness (mm) and upper middle arm circumference (cm) measurements were taken from all participants. Results: While 41.1% of 68 children (35 boys, 33 girls) participating in the study were at the level 1 of gross motor function classification system, half of them (%50) had nutritional problems. Although chewing difficulty is the most common (22.1%) in every age group and gender as a nutritional problem, constipation rate is also very high (89%) in every age and group. Almost all of the children (96.1%) consume three or more main meals and 95.6% make snacks. The choices of children for snacks included milk, yoghurt, cheese (82.4%) fruit and fruit juices (75%) and nuts (57.4%). Conclusion: It was observed that the rate of malnutrition and obesity of the children participating in the study is low. This result is thought to be due to reasons such as the fact that the study was conducted in a private center, the awareness of the families was high, and the children were constantly monitored. For this reason, it is recommended that children with CP work with a team including a dietician to improve both their growth and nutritional habits.

References

  • AHRQ. 2012. “Evidence-Based Practice Center Comparative Effectiveness Review Protocol Project Title : Feeding and Nutrition Interventions in Cerebral Palsy I . Background and Objectives for the Systematic Review Cerebral Palsy ( CP ) Is “ a Group of Permanent Disorder.” Agency for Healthcare Research and Quality: 21–23.
  • Al-Hammad NS. "Dietary Practices in Saudi Cerebral Palsy Children." Pakistan Journal Of Medical Sciences. 2015 Jul-Aug;31(4):860-4. Aydin, Kursad et al. 2018. “A Multicenter Cross-Sectional Study to Evaluate the Clinical Characteristics and Nutritional Status of Children with Cerebral Palsy.” Clinical Nutrition ESPEN 26: 27–34.
  • Bell, K. L., and L. Samson-Fang. 2013. “Nutritional Management of Children with Cerebral Palsy.” European Journal of Clinical Nutrition 67(2): S13–16.
  • Benfer, Katherine A et al. 2013. “Oropharyngeal Dysphagia and Gross Motor Skills in Children With Cerebral Palsy.” Pediatrics 131(5): e1553 LP-e1562.
  • Calis, Elsbeth A.C. et al. 2010. “Energy Intake Does Not Correlate with Nutritional State in Children with Severe Generalized Cerebral Palsy and Intellectual Disability.” Clinical Nutrition 29(5): 617–21.
  • Caramico-Favero, Deise Cristina Oliva, Zelita Caldeira Ferreira Guedes, and Mauro Batista Morais. 2018. “Food Intake, Nutritional Status and Gastrointestinal Symptoms in Children with Cerebral Palsy.” Arquivos de Gastroenterologia 55(4): 352–57.
  • Caselli, Thaisa Barboza, Elizete Aparecida Lomazi, Maria Augusta Santos Montenegro, and Maria Angela Bellomo-Brandão. 2017. “Estudo Comparativo Entre Gastrostomia e Alimentação via Oral Em Crianças e Adolescentes Com Paralisia Cerebral Tetraespástica.” Arquivos de Gastroenterologia 54(4): 292–96.
  • Dahlseng, Magnus Odin et al. 2012. “Feeding Problems, Growth and Nutritional Status in Children with Cerebral Palsy.” Acta Paediatrica, International Journal of Paediatrics 101(1): 92–98.
  • Graham, Kerr et al. 2016. “Cerebral Palsy.” Nature Reviews Disease Primers 2: 15082.
  • Hallman-Cooper, Jamika L., and William Gossman. 2020. StatPearls Cerebral Palsy. StatPearls Publishing.
  • Irish Nutrition and Dietetic Institute. 2013. “Cerebral Palsy: Meeting Nutritional Needs - INDI.” Indi.
  • Kangalgil, Melda, and Ayşe Özfer Özçelik. 2018. “Serebral Palsili Çocukların Beslenme Durumunun Değerlendirilmesi.” Guncel Pediatri 16(1): 69–84.
  • Kim, Hyo-Jung, Ha-Neul Choi, and Jung-Eun Yim. 2018. “Food Habits, Dietary Intake, and Body Composition in Children with Cerebral Palsy.” Clinical Nutrition Research 7(4): 266.
  • Leonard, M. et al. 2020. “Nutritional Status of Neurologically Impaired Children: Impact on Comorbidity.” Archives de Pediatrie 27(2): 95–103.
  • Lopes, Patrícia Ayrosa C et al. 2013. “Food Pattern and Nutritional Status of Children with Cerebral Palsy.” Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 31(3): 344–49.
  • Pekcan, Gülden. 2013. 7. baskı Diyet El Kitabı Beslenme Durumunun Saptanması.
  • Rempel, Gina. 2015. “The Importance of Good Nutrition in Children with Cerebral Palsy.” Physical Medicine and Rehabilitation Clinics of North America 26(1): 39–56.
  • Rogozinski, Benjamin M et al. 2007. “Prevalence of Obesity in Ambulatory Children with Cerebral Palsy.” The Journal of bone and joint surgery. American volume 89(11): 2421–26.
  • Rosenbaum, Peter et al. 2007. “A Report: The Definition and Classification of Cerebral Palsy April 2006.” Developmental Medicine and Child Neurology 49(SUPPL. 2): 8–14.
  • Şimşek, Tülay Tarsuslu, and Gamze Tuç. 2014. “Serebral Palsili Çocuklarda Beslenme Problemleri ve Büyüme Üzerine Etkisi.” Guncel Pediatri 12(2): 73–80.
  • Tel Adıgüzel, Kübra et al. 2014. “Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi’nde İzlenen Serebral Palsi’li Çocuklarda Malnütrisyon Sıklığının Belirlenmesi.” 42(3): 181–87.
  • Tomoum, Hoda Y, Nagia B Badawy, Nayera E Hassan, and Khadija M Alian. 2010. “Anthropometry and Body Composition Analysis in Children with Cerebral Palsy.” Clinical nutrition (Edinburgh, Scotland) 29(4): 477–81.
  • Troughton, K. E.V., and A. E. Hill. 2001. “Relation between Objectively Measured Feeding Competence and Nutrition in Children with Cerebral Palsy.” Developmental Medicine and Child Neurology 43(3): 187–90.
  • Vik, T., M. S. Skrove, H. Døllner, and G. Helland. 2001. “Feeding Problems and Growth Disorders among Children with Cerebral Palsy in South and North Trondelag.” Tidsskrift for den Norske Laegeforening 121(13): 1570–74.

Serebral Palsili Çocuklarda Beslenmenin Büyüme ve Gelişme Üzerine Etkisi

Year 2021, Volume: 2 Issue: 2, 37 - 50, 30.08.2021

Abstract

Amaç: Serebral Palsi; kas tonusu, postür ve hareket bozukluğu ile karakterize nörogelişimsel bir bozukluktur. Bu çalışmanın amacı; özel bir eğitim ve rehabilitasyon merkezine başvuran, 4-16 yaş aralığındaki Serebral Palsi tanılı çocukların beslenme durumlarının büyüme ve gelişme üzerine etkisini saptamaktır. Yöntem: Çalışma, araştırmacılar tarafından hazırlanan ve yüz yüze uygulanan anket yöntemi ile gerçekleştirilmiştir. Anket kapsamında çalışmaya katılan çocukların demografik bilgileri, sağlık bilgileri sorulmuş, kaba motor fonksiyon sınıflandırma sistemine göre sınıflandırması yapılmış, beslenme problemi varlığı (kusma, tükürme, çiğneme güçlüğü, yutma bozukluğu, aspirasyon, dil itme, gibi.), ana ve ara öğün tüketim durumu, öğün atlama durumu, ara ve gece öğününde tüketilen besinlerin tüketim sıklıkları gibi beslenme alışkanlıkları sorgulanmış, ayrıca tüm katılımcılardan vücut ağırlığı (kg), boy uzunluğu (cm), triseps deri kıvrım kalınlığı (mm) ve üst orta kol çevresi (cm) ölçümleri alınmıştır. Bulgular: Çalışmaya katılan 68 çocuğun (erkek 35, kız 33) %41.1'i kaba motor fonksiyon sınıflandırma sisteminin 1 seviyesinde olup, yarısında (%50) beslenme problemi bulunmaktadır. Beslenme problemi olarak her yaş grubu ve cinsiyette en fazla çiğneme güçlüğü (%22.1) görülmekle beraber, araştırmaya katılan SP’li çocuklarda kabızlık (%89) oranı da çok yüksektir. Çocukların tamamına yakını (%96.1) üç ve daha fazla ana öğün, %95.6’sı da ara öğün tüketmektedir. Çocukların ara öğünlerde en fazla süt, yoğurt, peynir (%82.4) meyve ve meyve suları (%75) ve yağlı tohumları (%57.4) tükettiği bulunmuştur. Malnütrisyon göstergeleri olarak; az sayıda çocuğun boy uzunluğu (%26.5), vücut ağırlığı (%19.1), Beden Kütle İndeksi (%23.5), triseps deri kıvrım kalınlığı (%7.3), üst orta kol çevresi (%4.4) persentil değerleri, düşük olarak kabul edilen ≤3. persentilin altındadır. Sonuç: Araştırmaya katılan çocukların malnütrisyon ve obezite oranının düşük olduğu, bu sonucun da çalışmanın özel bir merkezde yapılması, ailelerin farkındalığının yüksekliği ve çocukların devamlı takip altında olması gibi sebeplere bağlı olduğu düşünülmektedir. Bu nedenle SP’li çocukların hem büyüme gelişmelerinin hem de beslenme alışkanlıklarının olumlu olarak gelişmesi için diyetisyenin de olduğu bir ekiple çalışması önerilmektedir.

References

  • AHRQ. 2012. “Evidence-Based Practice Center Comparative Effectiveness Review Protocol Project Title : Feeding and Nutrition Interventions in Cerebral Palsy I . Background and Objectives for the Systematic Review Cerebral Palsy ( CP ) Is “ a Group of Permanent Disorder.” Agency for Healthcare Research and Quality: 21–23.
  • Al-Hammad NS. "Dietary Practices in Saudi Cerebral Palsy Children." Pakistan Journal Of Medical Sciences. 2015 Jul-Aug;31(4):860-4. Aydin, Kursad et al. 2018. “A Multicenter Cross-Sectional Study to Evaluate the Clinical Characteristics and Nutritional Status of Children with Cerebral Palsy.” Clinical Nutrition ESPEN 26: 27–34.
  • Bell, K. L., and L. Samson-Fang. 2013. “Nutritional Management of Children with Cerebral Palsy.” European Journal of Clinical Nutrition 67(2): S13–16.
  • Benfer, Katherine A et al. 2013. “Oropharyngeal Dysphagia and Gross Motor Skills in Children With Cerebral Palsy.” Pediatrics 131(5): e1553 LP-e1562.
  • Calis, Elsbeth A.C. et al. 2010. “Energy Intake Does Not Correlate with Nutritional State in Children with Severe Generalized Cerebral Palsy and Intellectual Disability.” Clinical Nutrition 29(5): 617–21.
  • Caramico-Favero, Deise Cristina Oliva, Zelita Caldeira Ferreira Guedes, and Mauro Batista Morais. 2018. “Food Intake, Nutritional Status and Gastrointestinal Symptoms in Children with Cerebral Palsy.” Arquivos de Gastroenterologia 55(4): 352–57.
  • Caselli, Thaisa Barboza, Elizete Aparecida Lomazi, Maria Augusta Santos Montenegro, and Maria Angela Bellomo-Brandão. 2017. “Estudo Comparativo Entre Gastrostomia e Alimentação via Oral Em Crianças e Adolescentes Com Paralisia Cerebral Tetraespástica.” Arquivos de Gastroenterologia 54(4): 292–96.
  • Dahlseng, Magnus Odin et al. 2012. “Feeding Problems, Growth and Nutritional Status in Children with Cerebral Palsy.” Acta Paediatrica, International Journal of Paediatrics 101(1): 92–98.
  • Graham, Kerr et al. 2016. “Cerebral Palsy.” Nature Reviews Disease Primers 2: 15082.
  • Hallman-Cooper, Jamika L., and William Gossman. 2020. StatPearls Cerebral Palsy. StatPearls Publishing.
  • Irish Nutrition and Dietetic Institute. 2013. “Cerebral Palsy: Meeting Nutritional Needs - INDI.” Indi.
  • Kangalgil, Melda, and Ayşe Özfer Özçelik. 2018. “Serebral Palsili Çocukların Beslenme Durumunun Değerlendirilmesi.” Guncel Pediatri 16(1): 69–84.
  • Kim, Hyo-Jung, Ha-Neul Choi, and Jung-Eun Yim. 2018. “Food Habits, Dietary Intake, and Body Composition in Children with Cerebral Palsy.” Clinical Nutrition Research 7(4): 266.
  • Leonard, M. et al. 2020. “Nutritional Status of Neurologically Impaired Children: Impact on Comorbidity.” Archives de Pediatrie 27(2): 95–103.
  • Lopes, Patrícia Ayrosa C et al. 2013. “Food Pattern and Nutritional Status of Children with Cerebral Palsy.” Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 31(3): 344–49.
  • Pekcan, Gülden. 2013. 7. baskı Diyet El Kitabı Beslenme Durumunun Saptanması.
  • Rempel, Gina. 2015. “The Importance of Good Nutrition in Children with Cerebral Palsy.” Physical Medicine and Rehabilitation Clinics of North America 26(1): 39–56.
  • Rogozinski, Benjamin M et al. 2007. “Prevalence of Obesity in Ambulatory Children with Cerebral Palsy.” The Journal of bone and joint surgery. American volume 89(11): 2421–26.
  • Rosenbaum, Peter et al. 2007. “A Report: The Definition and Classification of Cerebral Palsy April 2006.” Developmental Medicine and Child Neurology 49(SUPPL. 2): 8–14.
  • Şimşek, Tülay Tarsuslu, and Gamze Tuç. 2014. “Serebral Palsili Çocuklarda Beslenme Problemleri ve Büyüme Üzerine Etkisi.” Guncel Pediatri 12(2): 73–80.
  • Tel Adıgüzel, Kübra et al. 2014. “Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi’nde İzlenen Serebral Palsi’li Çocuklarda Malnütrisyon Sıklığının Belirlenmesi.” 42(3): 181–87.
  • Tomoum, Hoda Y, Nagia B Badawy, Nayera E Hassan, and Khadija M Alian. 2010. “Anthropometry and Body Composition Analysis in Children with Cerebral Palsy.” Clinical nutrition (Edinburgh, Scotland) 29(4): 477–81.
  • Troughton, K. E.V., and A. E. Hill. 2001. “Relation between Objectively Measured Feeding Competence and Nutrition in Children with Cerebral Palsy.” Developmental Medicine and Child Neurology 43(3): 187–90.
  • Vik, T., M. S. Skrove, H. Døllner, and G. Helland. 2001. “Feeding Problems and Growth Disorders among Children with Cerebral Palsy in South and North Trondelag.” Tidsskrift for den Norske Laegeforening 121(13): 1570–74.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Merve Şenkula This is me 0000-0002-8086-7194

Merve Pehlivan 0000-0002-5863-5258

Gülgün Ersoy 0000-0001-8345-5489

Publication Date August 30, 2021
Submission Date May 8, 2021
Acceptance Date August 20, 2021
Published in Issue Year 2021 Volume: 2 Issue: 2

Cite

APA Şenkula, M., Pehlivan, M., & Ersoy, G. (2021). Serebral Palsili Çocuklarda Beslenmenin Büyüme ve Gelişme Üzerine Etkisi. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi, 2(2), 37-50.