Relationship Between Gross Motor Function and Nutritional Status of Children with Cerebral Palsy-A cross-sectional study in a Tertiary Care Hospital of Bangladesh
Abstract:
Background: Cerebral Palsy (CP) is one of the most common
causes of chronic disability in children. Childhood
malnutrition is a major public health issue in low- and middleincome
countries. The gross motor function of children with
CP can easily be assessed by the tool Gross Motor Function
Classification System- Expanded &Revised (GMFCS-E&R).
This study aimed to determine the relationship between
GMFCS and nutritional status in children with cerebral palsy.
Materials & Method: This cross-sectional observational study
was conducted in the Department of Pediatric Neurology,
IPNA, BSMMU from October 2019 to August 2020. All the
patients aged 2-12 years were diagnosed as CP by clinical
criteria and classified by GMFCS. Nutritional status (weight
for age, height for age, weight for height, BMI) is assessed
and classiûed according to the World Health Organization
growth charts. Then linear and multinomial logistic
regression methods to determine the associations between
GMFCS and nutritional status. The correlation between
motor function and nutritional status was assessed.
Results: Among the 50 children 68% were male and 32%
were female. The mean age of the CP children was 4.90±3.05
years. Most patients (66.0%) came from poor families followed
by 24% from the middle class. Functionally majority of
patients were in GMFCS level IV (28.0% ) and level V
(20.0%). Maximum patients in spastic quadriplegia 42%,
spastic hemiplegia 16%. The level of GMFCS was associated
with nutritional status, as determined by anthropometry.
Moderate and severe underweight significantly related with
GMFC level IV and V. Moderate and severe stunted was
significantly related with IV and V GMFC level. Moderate
wasted was significantly related to GMFC levels III and IV.
Mild malnutrition was significantly with GMFC level II
and III. Severe malnutrition is significantly related to
GMFC level IV and V.
Conclusion: This study showed majority of cerebral palsy
cases had severe functional gross motor disability and also
severe grade of malnutrition. A significant association
between severe grade of malnutrition and severe grade of
motor disability was found.