Research Article
BibTex RIS Cite

Nutritional Habits and Problems in Children with Cerebral Palsy: A Cross-Sectional Study

Year 2022, Issue: 18, 812 - 828, 31.12.2022
https://doi.org/10.38079/igusabder.1039373

Abstract

Aim: There are limited studies on the dietary habits and nutritional problems of children with Cerebral Palsy (CP). The aim of this study is to evaluate the dietary habits and determine the nutritional problems of children with CP between the ages of 4-16 years applied to a private clinic.
Method: The study was carried out with 50 children with CP by a questionnaire based on the literature. SPSS 22.00 Program was used to analyze the data and the p-value was taken as 0,05.
Results: Almost all the patients have an additional disease to CP, the most common disease was gastroesophageal reflux (84%). The rate of patients eating a normal diet orally is 18%, and the most common nutritional problem is dysphagia (76%). 5-6 days per week, nearly half of all children (50,0%) consume dairy products (50%), eggs (46%), and vegetables (40%). While feeding patterns of children with CP are not associated with gender, age group, or father's educational status (p>0,05); it is significantly associated with the mother’s educational status and gross motor function classification system (p<0,05).
Conclusion: Since children with CP are at risk for nutritional deficiencies, they should be followed up by a multidisciplinary team including a dietitian, their nutritional status should be monitored, and their families should be informed.

References

  • Sankar C, Mundkur N. Cerebral palsy-definition, classification, etiology and early diagnosis. Ind J Pediatr. 2005;72:865-868. doi:10.1007/BF02731117.
  • Serdaroǧlu A, Cansu A, Özkan S, Tezcan S. Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Develop Med Child Neurol. 2006;48(6):413-416. doi:10.1017/S0012162206000910.
  • Erdem Sultanoğlu T, Ünlü Akyüz E, Çevikol A, Sultanoğlu H. Serebral palsili hastaların demografik ve klinik özellikleri. Ege Tıp Dergisi. 2019;58(3):265-273. doi:10.19161/etd.608467.
  • Vitrikas K, Dalton H, Breish D. Cerebral palsy: An overview. American Family Physician. 2020;101(4):213-220.
  • Özal C, Kerem Günel M. Spastik serebral palsili çocuklarda gövde kontrolü ile fonksiyonel mobilite ve denge arasındaki ilişkinin incelenmesi. J Exer Therapy Rehab. 2014;1(1):1-8.
  • Bax M, Goldstein M, Rosenbaun P, et al. Proposed definition and classification of cerebral palsy. Develop Med Child Neurol. 2005;47(8):571. doi:10.1017/S001216220500112X.
  • Cantero MJP, Medinilla EEM, Martínez AC, Gutiérrez SG. Comprehensive approach to children with cerebral palsy. Anales de Pediatría (English Ed.). 2021;95(4):276.e1-276.e11. doi:10.1016/j.anpede.2021.07.002.
  • Kuperminc MN, Stevenson RD. Growth and nutrition disorders in children with cerebral palsy. Develop Disab Res Rev. 2008;14(2):137-146. doi:10.1002/ddrr.14.
  • Almuneef AR, Almajwal A, Alam I, et al. Malnutrition is common in children with cerebral palsy in Saudi Arabia - A cross-sectional clinical observational study. BMC Neurology. 2019;19(1):317-26. doi:10.1186/s12883-019-1553-6.
  • Sullivan PB, Andrew MJ. Gastrointestinal problems in children with cerebral palsy. In: Panteliadis CP, ed. Cerebral Palsy: A Multidisciplinary Approach. Springer International Publishing; 2018:309-317. doi:10.1007/978-3-319-67858-0_30.
  • Rempel G. The importance of good nutrition in children with cerebral palsy. Physical Medicine and Rehabilitation Clinics. 2015;26(1):39-56. doi:10.1016/j.pmr.2014.09.001.
  • Tel Adıgüzel K, Yıldız E, Kaner G, Adıgüzel E, Balaban B. Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi’nde izlenen serebral palsi’li çocuklarda malnütrisyon sıklığının belirlenmesi. Beslenme ve Diyet Dergisi. 2014;42(3):181-187.
  • Kerem Gunel M, Mutlu A, Livanelioglu A, et al. Kaba motor fonksiyon sınıflandırma sistemi (genişletilmiş ve yeniden düzenlenmiş şekli). Develop Med Child Neurol.1997;39:214-223. www.canchild.ca. Erişim tarihi 18 Ekim 2021.
  • Almajwal AM, Alam I. Progress in nutrition in cerebral palsy children - A literature review. Progress in Nutrition. 2020;22(2):378-387. doi:10.23751/pn.v22i2.7929.
  • Malik B, Zafar S, Razzaq A, Butt M, Khan M, Mughal S. Frequently associated problems of cerebral palsy. Annals of Punjab Medical College (APMC). 2007;1(2):14-18.
  • Wallace SJ. Epilepsy in cerebral palsy. Develop Med Child Neurol. 2001;43(10):713-717. doi:10.1111/J.1469-8749.2001.TB00147.X.
  • Carlsson M, Hagberg G, Olsson I. Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Develop Med Child Neurol. 2003;45(6):371-376. doi:10.1017/S0012162203000719.
  • Gürkan F, Gökben S, Serin HM, Yılmaz S, Aktan G, Tekgül H. Determining risk factors of epilepsy in children with cerebral palsy: A retrospective study. J Ped Res. 2018;5(2):76-81. doi:10.4274/jpr.24471.
  • Fernando T, Goldman RD. Management of gastroesophageal reflux disease in pediatric patients with cerebral palsy. Canadian Family Physician. 2019;65(11):796.
  • Bozkurt M, Tutuncuoglu S, Serdaroglu G, Tekgul H, Aydogdu S. Gastroesophageal reflux in children with cerebral palsy: Efficacy of cisapride. J Child Neurol. 2004;19(12):973-976.
  • Scarpato E, Staiano A, Molteni M, Terrone G, Mazzocchi A, Agostoni C. Nutritional assessment and intervention in children with cerebral palsy: A practical approach. Int J Food Sci Nutr. 2017;68(6):763-770. doi:10.1080/09637486.2017.1289502.
  • O’Connor B, Kerr C, Shields N, Imms C. Understanding allied health practitioners’ use of evidence-based assessments for children with cerebral palsy: A mixed methods study. Disability and Rehabilitation. 2019;41(1):53-65. doi:10.1080/09638288.2017.1373376.
  • Evidence-based Practice Center Comparative Effectiveness Review Protocol. Project Title : Feeding and Nutrition Interventions in Cerebral Palsy. https://effectivehealthcare.ahrq.gov/. Yayınlanma tarihi 12 Haziran 2012. Erişim tarihi 20 Ekim 2021.
  • Asgarshirazi M, Farokhzadeh-Soltani M, Keihanidost Z, Shariat M. Evaluation of feeding disorders including gastro-esophageal reflux and oropharyngeal dysfunction in children with cerebral palsy. The Journal of Family & Reproductive Health. 2017;11(4):197-201.
  • Ayrosa Lopes PC, Maria Amancio OS, Faria Araújo RC, Sylvia de Vitalle MS, Aparecida Braga JP. Food pattern and nutritional status of children with cerebral palsy. Revista Paulista de Pediatria. 2013;31(3):344-353.
  • Aydin K, Akbas Y, Unay B, et al. A multicenter cross-sectional study to evaluate the clinical characteristics and nutritional status of children with cerebral palsy. Clin Nutr ESPEN. 2018;26:27-34. doi:10.1016/j.clnesp.2018.05.002.
  • Araújo LA, Silva LR, Mendes FAA. Digestive tract neural control and gastrointestinal disorders in cerebral palsy. J Pediatr (Rio J). 2012;88(6):455-464. doi:10.2223/JPED.2241.
  • Nadeem M, Ahmed Awan W. Prevalence and risk factors associated with constipation cerebral palsy children in Pakistan. J Rehab Med. 2019;3(2):121-125. doi:10.52567/trj.v3i02.18.
  • Şenkula M, Pehlivan M, Ersoy G. Serebral palsili çocuklarda beslenmenin büyüme ve gelişme üzerine etkisi. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi. 2021;2:37-50.
  • Al-Hammad NS. Dietary practices in Saudi cerebral palsy children. Pak J Med Sci. 2015;31(4):860-864. doi:10.12669/pjms.314.7812.
  • Kangalgil M, Özçelik AÖ. Serebral palsili çocukların beslenme durumunun değerlendirilmesi. Güncel Pediatri. 2018;16(1):69-84.
  • Özder F, Serel Arslan S. Serebral palsi’li çocuklarda çiğneme bozuklukları ve ilişkili beslenme problemleri. J Acad Nutr Diet. 2021;49(2):83-89. doi:10.33076/2021.bdd.1460.
  • Weir KA, Bell KL, Caristo F, et al. Reported eating ability of young children with cerebral palsy: Is there an association with gross motor function? Arch Phy Med Rehab. 2013;94(3):495-502. doi:10.1016/j.apmr.2012.10.007.
  • Nur FT, Handryastuti S, Poesponegoro HD. Feeding difficulties in children with cerebral palsy: Prevalence and risk factor. KnE Life Sciences. 2019;4(12):206-14. doi:10.18502/kls.v4i12.4175.
  • Kabubo-Mariara J, Ndenge GK, Mwabu DK. Determinants of children’s nutritional status in Kenya: Evidence from demographic and health surveys. J Afr Econ. 2009;18(3):363-387. doi:10.1093/jae/ejn024.
  • Abuya BA, Onsomu EO, Kimani JK, Moore D. Influence of maternal education on child immunization and stunting in Kenya. Matern Child Health J. 2011;15(8):1389-1399. doi:10.1007/s10995-010-0670-z.
  • Abuya BA, Ciera J, Kimani-Murage E. Effect of mother’s education on child’s nutritional status in the slums of Nairobi. BMC Pediatrics. 2012;12(1):1-10.
  • Mazumder MSI, Rahman E, Mollah MAH, et al. Knowledge about child nutrition among mothers of children with cerebral palsy. Asian Pacific Journal of Health Sciences. 2015;2(1):197-202. doi:10.21276/apjhs.2015.2.1.34.
  • Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. Pediatrics. 2013;131(5):1553-1562. doi:10.1542/peds.2012-3093.
  • Pencharz PB. Protein and energy requirements for “optimal” catch-up growth. Eur J Clin Nutr. 2010;64(1):5-7. doi:10.1038/EJCN.2010.39.

Serebral Palsili Çocuklarda Beslenme Alışkanlıkları ve Sorunları: Kesitsel Bir Çalışma

Year 2022, Issue: 18, 812 - 828, 31.12.2022
https://doi.org/10.38079/igusabder.1039373

Abstract

Amaç: Serebral Palsi’li (SP) çocuklarda beslenme sorunları yetersiz ve dengesiz beslenmeye neden olmanın yanı sıra günlük yaşamı ve psikososyal gelişimi de olumsuz etkileyebilmektedir. Bu çalışmanın amacı; özel bir kliniğe başvuran SP tanısı almış 6-14 yaş aralığındaki çocukların beslenme alışkanlıklarını değerlendirmek ve yaşadıkları beslenme sorunlarını saptamaktır.
Yöntem: Çalışma, literatür taranarak hazırlanan anket formu kullanılarak 50 SP tanılı çocuk ile gerçekleştirilmiştir. Anket formunda tanımlayıcı bilgilerin yanı sıra çocuğun beslenmesine ayrılan süre (dk), tüketilen ara öğün ve ana öğün sayısı, tüketilen su miktarı gibi beslenme alışkanlıklarına yönelik sorular yer almaktadır. Ayrıca çocuklar Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS)’ne göre değerlendirilmiştir. Besin tüketim sıklığı formu ile hangi besinin ne sıklıkla tüketildiği saptanmıştır. Verilerin analizinde SPSS 22.0 Programı kullanılmıştır ve p değeri 0,05 olarak kabul edilmiştir.
Bulgular: Hastaların tamamına yakınının SP’ye ek bir hastalığı bulunmakta olup en sık görülen hastalık gastroözofageal reflü (%84,0) olarak saptanmıştır. Oral yoldan normal diyetle beslenen hastaların oranı %18,0; en sık görülen beslenme sorunu yutma güçlüğüdür (%76,0). Çocukların yarısına yakını haftanın 5-6 günü süt ve süt ürünleri (%50,0), yumurta (%46,0) ve sebze (%40,0) tüketmektedir. Çalışmaya katılan SP tanılı çocukların beslenme şekilleri; cinsiyet, yaş grubu ve babanın eğitim durumu ile ilişkili bulunmazken (p>0,05), annenin eğitim durumu ve kaba motor fonksiyon sınıflandırma sistemi ile aralarında anlamlı ilişki saptanmıştır (p<0,05).
Sonuç: Serebral palsili çocuklar beslenme yetersizliği açısından risk altında olmaları nedeniyle diyetisyeni de içeren multidisipliner bir ekip tarafından takip edilmeli, beslenme durumları izlenmeli ve aileleri bilgilendirilmelidir. 

References

  • Sankar C, Mundkur N. Cerebral palsy-definition, classification, etiology and early diagnosis. Ind J Pediatr. 2005;72:865-868. doi:10.1007/BF02731117.
  • Serdaroǧlu A, Cansu A, Özkan S, Tezcan S. Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Develop Med Child Neurol. 2006;48(6):413-416. doi:10.1017/S0012162206000910.
  • Erdem Sultanoğlu T, Ünlü Akyüz E, Çevikol A, Sultanoğlu H. Serebral palsili hastaların demografik ve klinik özellikleri. Ege Tıp Dergisi. 2019;58(3):265-273. doi:10.19161/etd.608467.
  • Vitrikas K, Dalton H, Breish D. Cerebral palsy: An overview. American Family Physician. 2020;101(4):213-220.
  • Özal C, Kerem Günel M. Spastik serebral palsili çocuklarda gövde kontrolü ile fonksiyonel mobilite ve denge arasındaki ilişkinin incelenmesi. J Exer Therapy Rehab. 2014;1(1):1-8.
  • Bax M, Goldstein M, Rosenbaun P, et al. Proposed definition and classification of cerebral palsy. Develop Med Child Neurol. 2005;47(8):571. doi:10.1017/S001216220500112X.
  • Cantero MJP, Medinilla EEM, Martínez AC, Gutiérrez SG. Comprehensive approach to children with cerebral palsy. Anales de Pediatría (English Ed.). 2021;95(4):276.e1-276.e11. doi:10.1016/j.anpede.2021.07.002.
  • Kuperminc MN, Stevenson RD. Growth and nutrition disorders in children with cerebral palsy. Develop Disab Res Rev. 2008;14(2):137-146. doi:10.1002/ddrr.14.
  • Almuneef AR, Almajwal A, Alam I, et al. Malnutrition is common in children with cerebral palsy in Saudi Arabia - A cross-sectional clinical observational study. BMC Neurology. 2019;19(1):317-26. doi:10.1186/s12883-019-1553-6.
  • Sullivan PB, Andrew MJ. Gastrointestinal problems in children with cerebral palsy. In: Panteliadis CP, ed. Cerebral Palsy: A Multidisciplinary Approach. Springer International Publishing; 2018:309-317. doi:10.1007/978-3-319-67858-0_30.
  • Rempel G. The importance of good nutrition in children with cerebral palsy. Physical Medicine and Rehabilitation Clinics. 2015;26(1):39-56. doi:10.1016/j.pmr.2014.09.001.
  • Tel Adıgüzel K, Yıldız E, Kaner G, Adıgüzel E, Balaban B. Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi’nde izlenen serebral palsi’li çocuklarda malnütrisyon sıklığının belirlenmesi. Beslenme ve Diyet Dergisi. 2014;42(3):181-187.
  • Kerem Gunel M, Mutlu A, Livanelioglu A, et al. Kaba motor fonksiyon sınıflandırma sistemi (genişletilmiş ve yeniden düzenlenmiş şekli). Develop Med Child Neurol.1997;39:214-223. www.canchild.ca. Erişim tarihi 18 Ekim 2021.
  • Almajwal AM, Alam I. Progress in nutrition in cerebral palsy children - A literature review. Progress in Nutrition. 2020;22(2):378-387. doi:10.23751/pn.v22i2.7929.
  • Malik B, Zafar S, Razzaq A, Butt M, Khan M, Mughal S. Frequently associated problems of cerebral palsy. Annals of Punjab Medical College (APMC). 2007;1(2):14-18.
  • Wallace SJ. Epilepsy in cerebral palsy. Develop Med Child Neurol. 2001;43(10):713-717. doi:10.1111/J.1469-8749.2001.TB00147.X.
  • Carlsson M, Hagberg G, Olsson I. Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Develop Med Child Neurol. 2003;45(6):371-376. doi:10.1017/S0012162203000719.
  • Gürkan F, Gökben S, Serin HM, Yılmaz S, Aktan G, Tekgül H. Determining risk factors of epilepsy in children with cerebral palsy: A retrospective study. J Ped Res. 2018;5(2):76-81. doi:10.4274/jpr.24471.
  • Fernando T, Goldman RD. Management of gastroesophageal reflux disease in pediatric patients with cerebral palsy. Canadian Family Physician. 2019;65(11):796.
  • Bozkurt M, Tutuncuoglu S, Serdaroglu G, Tekgul H, Aydogdu S. Gastroesophageal reflux in children with cerebral palsy: Efficacy of cisapride. J Child Neurol. 2004;19(12):973-976.
  • Scarpato E, Staiano A, Molteni M, Terrone G, Mazzocchi A, Agostoni C. Nutritional assessment and intervention in children with cerebral palsy: A practical approach. Int J Food Sci Nutr. 2017;68(6):763-770. doi:10.1080/09637486.2017.1289502.
  • O’Connor B, Kerr C, Shields N, Imms C. Understanding allied health practitioners’ use of evidence-based assessments for children with cerebral palsy: A mixed methods study. Disability and Rehabilitation. 2019;41(1):53-65. doi:10.1080/09638288.2017.1373376.
  • Evidence-based Practice Center Comparative Effectiveness Review Protocol. Project Title : Feeding and Nutrition Interventions in Cerebral Palsy. https://effectivehealthcare.ahrq.gov/. Yayınlanma tarihi 12 Haziran 2012. Erişim tarihi 20 Ekim 2021.
  • Asgarshirazi M, Farokhzadeh-Soltani M, Keihanidost Z, Shariat M. Evaluation of feeding disorders including gastro-esophageal reflux and oropharyngeal dysfunction in children with cerebral palsy. The Journal of Family & Reproductive Health. 2017;11(4):197-201.
  • Ayrosa Lopes PC, Maria Amancio OS, Faria Araújo RC, Sylvia de Vitalle MS, Aparecida Braga JP. Food pattern and nutritional status of children with cerebral palsy. Revista Paulista de Pediatria. 2013;31(3):344-353.
  • Aydin K, Akbas Y, Unay B, et al. A multicenter cross-sectional study to evaluate the clinical characteristics and nutritional status of children with cerebral palsy. Clin Nutr ESPEN. 2018;26:27-34. doi:10.1016/j.clnesp.2018.05.002.
  • Araújo LA, Silva LR, Mendes FAA. Digestive tract neural control and gastrointestinal disorders in cerebral palsy. J Pediatr (Rio J). 2012;88(6):455-464. doi:10.2223/JPED.2241.
  • Nadeem M, Ahmed Awan W. Prevalence and risk factors associated with constipation cerebral palsy children in Pakistan. J Rehab Med. 2019;3(2):121-125. doi:10.52567/trj.v3i02.18.
  • Şenkula M, Pehlivan M, Ersoy G. Serebral palsili çocuklarda beslenmenin büyüme ve gelişme üzerine etkisi. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi. 2021;2:37-50.
  • Al-Hammad NS. Dietary practices in Saudi cerebral palsy children. Pak J Med Sci. 2015;31(4):860-864. doi:10.12669/pjms.314.7812.
  • Kangalgil M, Özçelik AÖ. Serebral palsili çocukların beslenme durumunun değerlendirilmesi. Güncel Pediatri. 2018;16(1):69-84.
  • Özder F, Serel Arslan S. Serebral palsi’li çocuklarda çiğneme bozuklukları ve ilişkili beslenme problemleri. J Acad Nutr Diet. 2021;49(2):83-89. doi:10.33076/2021.bdd.1460.
  • Weir KA, Bell KL, Caristo F, et al. Reported eating ability of young children with cerebral palsy: Is there an association with gross motor function? Arch Phy Med Rehab. 2013;94(3):495-502. doi:10.1016/j.apmr.2012.10.007.
  • Nur FT, Handryastuti S, Poesponegoro HD. Feeding difficulties in children with cerebral palsy: Prevalence and risk factor. KnE Life Sciences. 2019;4(12):206-14. doi:10.18502/kls.v4i12.4175.
  • Kabubo-Mariara J, Ndenge GK, Mwabu DK. Determinants of children’s nutritional status in Kenya: Evidence from demographic and health surveys. J Afr Econ. 2009;18(3):363-387. doi:10.1093/jae/ejn024.
  • Abuya BA, Onsomu EO, Kimani JK, Moore D. Influence of maternal education on child immunization and stunting in Kenya. Matern Child Health J. 2011;15(8):1389-1399. doi:10.1007/s10995-010-0670-z.
  • Abuya BA, Ciera J, Kimani-Murage E. Effect of mother’s education on child’s nutritional status in the slums of Nairobi. BMC Pediatrics. 2012;12(1):1-10.
  • Mazumder MSI, Rahman E, Mollah MAH, et al. Knowledge about child nutrition among mothers of children with cerebral palsy. Asian Pacific Journal of Health Sciences. 2015;2(1):197-202. doi:10.21276/apjhs.2015.2.1.34.
  • Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. Pediatrics. 2013;131(5):1553-1562. doi:10.1542/peds.2012-3093.
  • Pencharz PB. Protein and energy requirements for “optimal” catch-up growth. Eur J Clin Nutr. 2010;64(1):5-7. doi:10.1038/EJCN.2010.39.
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Hilal Hızlı Güldemir 0000-0002-3951-5023

Merve Pehlivan 0000-0002-5863-5258

Publication Date December 31, 2022
Acceptance Date December 16, 2022
Published in Issue Year 2022 Issue: 18

Cite

JAMA Hızlı Güldemir H, Pehlivan M. Serebral Palsili Çocuklarda Beslenme Alışkanlıkları ve Sorunları: Kesitsel Bir Çalışma. IGUSABDER. 2022;:812–828.

 Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)