Cargando…

Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study

BACKGROUND: Overweight is reported as a side effect of SDR. The aims were to study the development of weight, height and body mass index (BMI) during five years after SDR. METHODS: This prospective, longitudinal and practice-based study included all 56 children with CP spastic diplegia undergoing SD...

Descripción completa

Detalles Bibliográficos
Autores principales: Westbom, Lena, Lundkvist Josenby, Annika, Wagner, Philippe, Nordmark, Eva
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913912/
https://www.ncbi.nlm.nih.gov/pubmed/20594320
http://dx.doi.org/10.1186/1471-2377-10-57
_version_ 1782184703289196544
author Westbom, Lena
Lundkvist Josenby, Annika
Wagner, Philippe
Nordmark, Eva
author_facet Westbom, Lena
Lundkvist Josenby, Annika
Wagner, Philippe
Nordmark, Eva
author_sort Westbom, Lena
collection PubMed
description BACKGROUND: Overweight is reported as a side effect of SDR. The aims were to study the development of weight, height and body mass index (BMI) during five years after SDR. METHODS: This prospective, longitudinal and practice-based study included all 56 children with CP spastic diplegia undergoing SDR from the start in March 1993 to April 2003 in our hospital. The preoperative Gross Motor Function Classification System (GMFCS) levels were I-II in 17, III in 15, IV-V in 24 children. Median age at SDR was 4.3 years (range 2.4-7.4 years). Weight and height/recumbent length were measured. Swedish growth charts for typically developing children generated weight, height and BMI z-scores for age and gender. RESULTS: The preoperative median z-scores were for height -1.92 and for body mass index (BMI) -0.22. Five years later, the median BMI z-score was increased by + 0.57 (p < 0.05). The occurrence of thinness (BMI < -2 SD) was decreased (n.s.) and obesity (BMI > + 2 SD) increased (p < 0.05). Baseline BMI and age at the start of follow-up influenced the BMI change during the five years (p < 0.001 and p < 0.05 respectively). The individual growth was highly variable, but a tendency towards increasing stunting with age was seen in severe gross motor dysfunction (GMFCS levels IV-V) and the opposite, a slight catch-up of height in children with walking ability (GMFCS levels I-III). CONCLUSIONS: These are the first available subtype- and GMFCS-specific longitudinal growth data for children with CP spastic diplegia. Their growth potential according to these data should be regarded as a minimum, as some children were undernourished. It is unknown whether the spasticity reduction through SDR increased the weight gain velocity, or if the relative weight increase was part of the general "obesity epidemic". For some children the weight increase was highly desirable. In others, it resulted in overweight and obesity with risk of negative health effects. Weight and height should be monitored to enable early prevention of weight aberrations also causing problems with mobility, activity and participation.
format Text
id pubmed-2913912
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-29139122010-08-03 Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study Westbom, Lena Lundkvist Josenby, Annika Wagner, Philippe Nordmark, Eva BMC Neurol Research Article BACKGROUND: Overweight is reported as a side effect of SDR. The aims were to study the development of weight, height and body mass index (BMI) during five years after SDR. METHODS: This prospective, longitudinal and practice-based study included all 56 children with CP spastic diplegia undergoing SDR from the start in March 1993 to April 2003 in our hospital. The preoperative Gross Motor Function Classification System (GMFCS) levels were I-II in 17, III in 15, IV-V in 24 children. Median age at SDR was 4.3 years (range 2.4-7.4 years). Weight and height/recumbent length were measured. Swedish growth charts for typically developing children generated weight, height and BMI z-scores for age and gender. RESULTS: The preoperative median z-scores were for height -1.92 and for body mass index (BMI) -0.22. Five years later, the median BMI z-score was increased by + 0.57 (p < 0.05). The occurrence of thinness (BMI < -2 SD) was decreased (n.s.) and obesity (BMI > + 2 SD) increased (p < 0.05). Baseline BMI and age at the start of follow-up influenced the BMI change during the five years (p < 0.001 and p < 0.05 respectively). The individual growth was highly variable, but a tendency towards increasing stunting with age was seen in severe gross motor dysfunction (GMFCS levels IV-V) and the opposite, a slight catch-up of height in children with walking ability (GMFCS levels I-III). CONCLUSIONS: These are the first available subtype- and GMFCS-specific longitudinal growth data for children with CP spastic diplegia. Their growth potential according to these data should be regarded as a minimum, as some children were undernourished. It is unknown whether the spasticity reduction through SDR increased the weight gain velocity, or if the relative weight increase was part of the general "obesity epidemic". For some children the weight increase was highly desirable. In others, it resulted in overweight and obesity with risk of negative health effects. Weight and height should be monitored to enable early prevention of weight aberrations also causing problems with mobility, activity and participation. BioMed Central 2010-07-01 /pmc/articles/PMC2913912/ /pubmed/20594320 http://dx.doi.org/10.1186/1471-2377-10-57 Text en Copyright ©2010 Westbom et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Westbom, Lena
Lundkvist Josenby, Annika
Wagner, Philippe
Nordmark, Eva
Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title_full Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title_fullStr Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title_full_unstemmed Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title_short Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study
title_sort growth in children with cerebral palsy during five years after selective dorsal rhizotomy: a practice-based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913912/
https://www.ncbi.nlm.nih.gov/pubmed/20594320
http://dx.doi.org/10.1186/1471-2377-10-57
work_keys_str_mv AT westbomlena growthinchildrenwithcerebralpalsyduringfiveyearsafterselectivedorsalrhizotomyapracticebasedstudy
AT lundkvistjosenbyannika growthinchildrenwithcerebralpalsyduringfiveyearsafterselectivedorsalrhizotomyapracticebasedstudy
AT wagnerphilippe growthinchildrenwithcerebralpalsyduringfiveyearsafterselectivedorsalrhizotomyapracticebasedstudy
AT nordmarkeva growthinchildrenwithcerebralpalsyduringfiveyearsafterselectivedorsalrhizotomyapracticebasedstudy