Comparison of Energy Expenditure of Cerebral Palsy Children with Predicted Energy Expenditure

Abstract

This study was designed to (1) measure the energy expenditure of cerebral palsy (CP) children using indirect calorimetry, and (2) compare the results with the resting energy expenditure (REE) calculated using three other equations. Published formulas used for comparison included the FAO/WHO equation developed for normal children and two equations developed specifically for CP children. None of the published equations for CP children used indirect calorimetry. Six boys and seven girls, 4–22 years old, were studied. The children were non-ambulatory and sole-source tube fed. Recumbent lengths and weights were measured and compared to the NCHS growth charts. The energy intakes of the children were documented. The energy expenditure was measured by indirect calorimetry, after 4 hours of fasting, using a Sensormedic 2900 metabolic cart. Measurements were obtained with a minimum of 5 minutes of steady state (with variation less than 10% VO2 and VCO2). The measured energy expenditure (MEE) of the children was in the range of 5.9 to 12.5kcal/cm height The FAO/WHO equation differed from the MEE by −33% to +67%, while the equations published for CP children differed from the MEE by −10.5% to +112%. A trend was observed between degree of muscle tonicity and MEE. The equations overestimated energy needs for children who were hypotonic by 55% to 112%. It was apparent that neither the FAO/WHO equation nor the CP specific equations were good predictors of the energy expenditure of these children. Therefore, a new equation with physical activity and muscle tone included as factors to determine the energy expenditure of CP children is needed.