Longitudinal change in muscle and fat thickness in children and adolescents with cerebral palsy

Abstract

In a prospective, longitudinal study, we investigated the influence of the severity of motor impairment on changes in body characteristics in children with moderate-to-severe cerebral palsy (CP). Twenty-six single children and adolescents (15 females, 11 males; mean age 10y 6mo, SD 3y 3mo) with spastic (quadriplegia, hemiplegia, or diplegia), athetotic, or hypotonic CP at Gross Motor Function Classification System (GMFCS) levels III to V participated. They were categorized into moderate (GMFCS levels III or IV, n=11) and severe (GMFCS level V, n=15) groups. Muscle thickness of the quadriceps femoris (MTQ) and fat thickness of the anterior thigh (FTA) measured using ultrasound images, together with weight and height, were obtained at annual measurements over 3 years. Significant increases in all variables were found in both groups. The areas under the curve (AUCs: an index of the gain) for weight, MTQ, and FTA were significantly higher in the moderate group. The AUC for weight, adjusted for height, was significantly correlated with the AUC for MTQ in the moderate group, and with the AUC for FTA in the severe group. Weight gain in children with severe CP does not necessarily reflect muscle growth.