scholarly journals Potentials of bioimpedance method for nutritional status assessment in children with cerebral palsy

Author(s):  
O. V. Perfilova ◽  
E. B. Khramova ◽  
A. V. Shaitarova

Objectives: To study the potential of the bioimpedance method for nutritional status assessment in children with cerebral palsy.Material and methods. There were examined 89 children with cerebral palsy (average age: 10,24 years±3,6 years). Such anthropometric indicators as body height (cm), body weight (kg) and body mass index (BMI, kg/m2) were investigated. The scientists formed two comparison groups: Group 1: 40 children without malnutrition (z-score BMI over 1), Group 2: 49 children with malnutrition (z-score BMI is 1,1 and less). The body composition was evaluated by bioimpedancemetry in both groups of comparison.Results. The scientist found significant differences in body composition in terms of fat mass between boys and girls with cerebral palsy, both with malnutrition and without nutritional deficiency. They determined that children with cerebral palsy without malnutrition demonstrate various changes in the parameters of the body composition comparable to those in patients with trophic deficiency, even before the anthropometry indicators change. According to the parameters of lean mass, active cell mass in the group of children without malnutrition, the results of 40% of boys and girls were below the normative values, which indicated an altered tissue composition of the body and existing deficiency of the protein component.Conclusion. The scientists determined unidirectional changes in the body component composition in children with cerebral palsy and malnutrition and in children without trophic deficiency. The assessment of the body by bioimpedance measurement can serve as an effective tool for the diagnosis of nutritional disorders in children with cerebral palsy.

2018 ◽  
Vol 55 (4) ◽  
pp. 352-357 ◽  
Author(s):  
Deise Cristina Oliva CARAMICO-FAVERO ◽  
Zelita Caldeira Ferreira GUEDES ◽  
Mauro Batista de MORAIS

ABSTRACT BACKGROUND: Cerebral palsy may be associated with comorbidities such as undernutrition, impaired growth and gastrointestinal symptoms. Children with cerebral palsy exhibit eating problems due to the effect on the anatomical and functional structures involved in the eating function resulting in malnutrition. OBJECTIVE: The aim of this study was to investigate the association between food intake, nutritional status and gastrointestinal symptoms in children with cerebral palsy. METHODS: Cross-sectional study that included 40 children with cerebral palsy (35 with spastic tetraparetic form and 5 with non-spastic choreoathetoid form of cerebral palsy, all requiring wheelchairs or bedridden) aged from 4 to 10 years. The dietary assessment with the parents was performed using the usual household food intake inquiry. Anthropometric data were collected. Gastrointestinal symptoms associated with deglutition disorders, gastroesophageal reflux and chronic constipation were also recorded. RESULTS: The median of height-for-age Z-score (-4.05) was lower (P<0.05) than the median of weight-for-age (-3.29) and weight-for-height (-0.94). There was no statistical difference between weight-for-age and weight-for-height Z-scores. Three patients with cerebral palsy (7.5%) exhibited mild anemia, with normal ferritin levels in two. Symptoms of dysphagia, gastroesophageal reflux, and constipation were found in 82.5% (n=33), 40.0% (n=16), and 60.0% (n=24) of the sample, respectively. The patients with symptoms of dysphagia exhibited lower daily energy (1280.2±454.8 Kcal vs 1890.3±847.1 Kcal, P=0.009), carbohydrate (median: 170.9 g vs 234.5 g, P=0.023) and fluid intake (483.1±294.9 mL vs 992.9±292.2 mL, P=0.001). The patients with symptoms of gastrointestinal reflux exhibited greater daily fluid intake (720.0±362.9 mL) than the patients without symptoms of gastroesophageal reflux (483.7±320.0 mL, P=0.042) and a greater height-for-age deficit (Z-score: -4.9±1.7 vs 3.7±1.5, P=0.033). The patients with symptoms of constipation exhibited lower daily dietary fiber (9.2±4.3 g vs 12.3±4.3 g, P=0.031) and fluid (456.5±283.1 mL vs 741.1±379.2 mL, P=0.013) intake. CONCLUSION: Children with cerebral palsy exhibited wide variability in food intake which may partially account for their severe impaired growth and malnutrition. Symptoms of dysphagia, gastroesophageal reflux, and constipation are associated with different food intake patterns. Therefore, nutritional intervention should be tailored considering the gastrointestinal symptoms and nutritional status.


Author(s):  
R. F. Rakhmaeva ◽  
A. A. Kamalova ◽  
V. A. Ayupova

Children with cerebral palsy (CP) often develop nutritional disorders, their incidence reaches 80% (according to the literature data).Purpose. To analyze the frequency of nutritional disorders and features of nutritional status in children with CP.Characteristics of children and research methods. We studied the anthropometric indicators (weight, height, body mass index, triceps and subscapular skin fold thickness), physical development characteristics depending on the motor abilities of the child according to the Gross Motor Function Classification System scale and body composition by bioelectrical impedance.Results. Nutritional status disorders were detected in 88.8% of patients, while the diagnostic was based on a reduced physical development in 55.5% of patients. 22.2% of patients had protein-energy deficiency of the first degree, 15.5% of patients had protein-energy deficiency of the second degree, 6.7% of patients had protein-energy deficiency of the third degree, 11.1% of patients suffered from overweight. Besides, nutritional disorders were diagnosed in 33.3% of patients with normal physical development, but with altered body composition, namely, with the imbalance of fat and lean body weight, the isolated increase of the percentage of fat mass, the decrease of active cellular and musculoskeletal weight. These patients also require nutritional correction.Conclusion. These data confirm the dependence of physical development and body composition on the patient’s motor activity and demonstrate the need for complex comprehensive study of nutritional status in children with CP.


Author(s):  
A. A. Kamalova ◽  
R. F. Rakhmaeva ◽  
E. M. Ahmadullina ◽  
L. I. Basanova

The frequency of underweight in children with cerebral palsy is about 60–70%. A benefit of nutritional support in children with cerebral palsy are underestimated. The use of nutritional support during active physical rehabilitation can have a positive effect on not only body weight, but also the component composition of the body and their rehabilitation potential.The aim of our study was to evaluate the effectiveness of nutritional support – a hypercaloric (1,5 kcal/ml) polymer formula with fibers (Pediashure 1,5 Fiber, Abbott) in children with cerebral palsy.Characteristics of children and research methods. Anthropometric indicators (body weight, height, body mass index, triceps skinfold thickness, subscapular skinfold thickness, mid-upper arm circumference, shoulder muscle circumference) and body composition were studied in 15 underweight children with cerebral palsy aged 4–10 years with the level of motor disorders GMFCSIII–IV. They were prescribed of nutritional support with a hyper caloric mixture (1,5kcal/ml) with fiber lasting 3months during active physical rehabilitation.Results. Against the background of nutritional support, there was a significant increase in body weight, height, z-score of body weight, mainly due to musculoskeletal, active cell and lean mass. In addition to correcting the nutritional status of children with cerebral palsy, an improvement in their motor abilities was noted.


2021 ◽  
pp. 62-67
Author(s):  
D. A. Polunina ◽  
M. E. Bagaeva ◽  
E. V. Pavlovskaya ◽  
T. V. Strokova

Aim. To study the features of the nutritional status, including physical growth, body composition, energy value of the diet and the amount of cholesterol consumed with food, in children with familial hypercholesterolemia (FH).Patients and methods. The study included 39 children (19 girls, 20 boys) with familial hypercholesterolemia, both genetically confirmed (n = 11) and established on the basis of Simon Broome criteria (n = 28), aged 9.9 [6.0; 12.9] years. All children were assessed for physical growth based on the Z-score BMI, Z-score height, Z-score body weight/height calculated using the programs Anthro and Anthro plus; analysis of actual nutrition using a standard application program; study of body composition using the InBody 770 bioimpedance analyzer, the basal metabolic rate measured by indirect calorimetry.Results. 55 % of children with FH had harmonious physical growth, 27 % had a body weight deficit, 18 % were overweight or obese. 53 % of patients consumed more than 200 mg of cholesterol per day, while half of them consumed more than 300 mg of cholesterol per day. The range of excess consumption of cholesterol in comparison to the recommended physiological needs for patints with FH ranged from 24 to 67 %. The fat mass according to the body composition in 47 % of patients with FH is within the normal range, in 39 % it is reduced by 18-74 %, in 14 % it is increased by 14-197 %. The median fat percentage was 17.8 [12.7; 22.4]%. According to indirect calorimetry, it was found that the level of resting energy needs corresponded to age needs in 21 % patients, in 8 % it was decreased of 2-26 %, in 2/3 of children its increase was recorded by 3-69 %. The rate of fat oxidation, on the contrary, was increased in 71 % of children by 3-86 % and reduced only in 6 %.Conclusion. The physical growth of children with FH was mainly average, harmonious, while a third of the children had a mass deficit. The level of the main indicators of lipid metabolism did not depend on the physical growth of patients. This pathology in children with normal body weight or with a body weight deficit often remains undiagnosed.


Author(s):  
A. A. Kamalova ◽  
R. F. Rahmaeva

It is quite a challenge to evaluate the nutritional status of children with infantile cerebral palsy. The violation of the growth and development of this category of children has a polyfactorial genesis, and the approach to nutritional correction must be comprehensive. Only a complex solution with a verified algorithm for evaluation of the anthropometric indicators, knowledge of the features of physical development, actual nutrition, body composition and laboratory markers in children with cerebral palsy can reflect the real patient’s nutritional status and help to carry out the necessary correction.


Author(s):  
L. A. Pak ◽  
S. G. Makarova ◽  
T. R. Chumbadze ◽  
A. P. Fisenko

The authors present the results of their own clinical study of the nutritional status of cerebral palsy (CP) children. The chemical composition of the diet of the observed patients and the body composition of patients were analyzed with bioimpedance analysis. The results of the dynamic control of the analyzed indices after the nutritive correction are presented. Aim of the study. To study the nutritional status of CP patients and evaluation of its dynamic changes with the help of bioimpendancemetry after carrying out remedial measures. Material and methods. We observed 27 CP children aged from 5 to 11 years, who were diagnosed with a protein-energy deficiency. Examination of patients included physical examination, the assessment of anthropometric indices using the “WHO Anthro+” and a body composition analysis using bioimpendancemetry. Evaluation of the actual nutrition included the study of the diet, the calculation of the chemical composition of the diet, the state of appetite and the nature of the feces. All studies were conducted in CP children twice: at the time of admission to the hospital and in the following-up period after the correction of the diet and the appointment of treatment with metabolic and vitamin preparations for 2 months. Results and conclusion. The protein-energy deficiency in CP children being associated with a disorder of the diet, decreased appetite, lack of basic macronutrients, needs the nutritive correction, including the introduction of the supplemental nutrition in their diet. The study showed that against the background of the basic drug therapy and nutritional correction there is a positive dynamics in the form of increasing Z-score body weight, Z-score ratio of body weight to age, normalization of appetite, which correlates with the normalization of the main study using bioimpedance analysis of body composition.


Author(s):  
Joanna M. Bukowska ◽  
Małgorzata Jekiełek ◽  
Dariusz Kruczkowski ◽  
Tadeusz Ambroży ◽  
Jarosław Jaszczur-Nowicki

Background: The aim of the study is to assess the body balance and podological parameters and body composition of young footballers in the context of the control of football training. Methods: The study examined the distribution of the pressure of the part of the foot on the ground, the arch of the foot, and the analysis of the body composition of the boys. The pressure center for both feet and the whole body was also examined. The study involved 90 youth footballers from Olsztyn and Barczewo in three age groups: 8–10 years, 11–13 years old, and 14–16 years. The study used the Inbody 270 body composition analyzer and the EPSR1, a mat that measures the pressure distribution of the feet on the ground. Results: The results showed statistically significant differences in almost every case for each area of the foot between the groups of the examined boys. The most significant differences were observed for the metatarsal area and the left heel. In the case of stabilization of the whole body, statistically significant differences were noted between all study groups. In the case of the body composition parameters, in the examined boys, a coherent direction of changes was noticed for most of them. The relationships and correlations between the examined parameters were also investigated. The significance level in the study was set at p < 0.05. Conclusions: Under the training rigor, a statistically significant increase in stability was observed with age. The total length of the longitudinal arch of both feet of the examined boys showed a tendency to flatten in direct proportion to the age of the examined boys. Mean values of the body composition parameters reflect changes with the ontogenetic development, basic somatic parameters (body height and weight) and training experience, and thus with the intensity and volume of training. This indicates a correct training process that does not interfere with the proper development of the body in terms of tissue and biochemical composition.


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