The Relationship Between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study.

Paweł Więch,Agnieszka Ćwirlej-Sozańska,Justyna Kilian,Ewa Lenart-Domka,Bartosz Korczowski,Agnieszka Wiśniowska-Szurlej,Bernard Sozański,Agnieszka Bejer,Elżbieta Domka-Jopek

doi:10.3390/nu12030864

Paweł Więch, Agnieszka Ćwirlej-Sozańska + Show 7 more

Open Access

https://doi.org/10.3390/nu12030864

Copy DOI

Journal: Nutrients	Publication Date: Mar 24, 2020
Citations: 15	License type: CC BY 4.0

Affiliation: Rzeszów University

Abstract

The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

Highlights

Cerebral palsy (CP) is considered a non-progressive dysfunction of the central nervous system that is largely associated with motor control centers [1]
The findings showed no significant correlations between the scores in Ashworth scale and the values of BCMI and PA
In a study involving 69 Spanish children with cerebral palsy (CP) representing a similar age group (10.46 y ± 0.43) and type of the condition, the findings showed significantly lower values of body weight in the group with the lowest level of functional capacities according to GMFCS, which correlated with lower values of fat free mass (FFM) [34]

Summary

Introduction

Cerebral palsy (CP) is considered a non-progressive dysfunction of the central nervous system that is largely associated with motor control centers [1]. This injury often involves the descending pathways of the central nervous system, causing inappropriate muscle activation and hypertonicity as a consequence [2]. It is believed that hypertonicity causes increased energy consumption during movement, and muscle contractures negatively affect the gait pattern [5] These changes directly affect general health, mobility, and independence in everyday life, increasing the level of disability in children with CP [6,7]

Objectives

Methods

Discussion

Conclusion