Association of Functional Ability with Nutritional Status Among Children with Cerebral Palsy

Abstract

Cerebral palsy (CP) is the most common physical disability in childhood. Children with CP are particularly vulnerable to malnutrition. There is a paucity of studies among these individuals to find the association between functional ability with nutritional status. In this study our objective was to find out the association between functional ability (functional level measured by four functional classification systems) and nutritional status in children with cerebral palsy (CP) attending in a tertiary care hospital in Bangladesh. We performed a cross-sectional study on 127 children (aged 18 months to 12 years) with a diagnosis of CP who were attending outpatient and inpatient department of National Institute of Neurosciences & Hospital, Dhaka, Bangladesh (January 2020–December 2020). Functional ability was assessed by standard CP classification systems (GMFCS, MACS, CFCS, EDACS, Level I through level V). Nutritional status was evaluated and classified according to the WHO growth charts. To find out the association, Spearmann-rho correlation analysis were applied. Sixty five patients (51%) were found underweight, 86 (67.7%) were stunted and 40 (31.5%) were wasted. Among them, severe underweight, severe stunting and severe wasting were found in 21.3%, 41.7% and 11.8% cases respectively. Severe thinness measured by BMI was found in 81.1% cases. Forty one percent (41.1%), 40.2%, 11%, 7.9% patients were functionally leveled as severe in GMFCS, MACS, CFCS and EDACS, although CFCS and EDACS were not applicable for all ages (36.2%, 37.8%). A significant negative association was found between weight for height, weight for age, BMI and functional level measured by GMFCS, MACS, CFCS and EDACS (P value <0.05 to<0.001) but no significant negative association was found between height for age and functional level measured by GMFCS, MACS. Stunting and wasting are more common among pediatric patients with CP. In our study stunting was more prevalent. We found significant negative association between functional level and nutritional status as measured by scales applied in this study.