Growth and nutritional status in residential center versus home-living children and adolescents with quadriplegic cerebral palsy

Objective To describe growth and nutrition in nonambulatory youth (<19 years of age) with cerebral palsy (CP) living in residential centers compared with similar youth living at home. Study design A multicenter, cross-sectional, single observational assessment of 75 subjects living in a residential care facility compared with 205 subjects living at home Primary outcome measures included anthropometric measures of height, weight, triceps, and subscapular skinfolds, and mid-upper-ann muscle area. Z scores were calculated from reference values for healthy children. Age, use of a feeding tube, and Gross Motor Functional Classification System (GMFCS) level were included as important confounders. Results Use of a feeding tube was associated with higher shinfold Z scores, and a significantly higher percentage of the residential sul jects had a feeding tube. Height, weight, and arm-muscle area Z scores all diverged (negatively) from reference values with age, and the residential sul jects were on average older than the home-living sub jects. After controlling for age, GMFCS level and use of a feeding tube, residential living was associated with significantly greater weight, height, skinfold thielmesses, and mid-arm muscle area Z scores. Conclusion Poor growth and nutrition in children with CP is a prevalent, important, and complex problem. Although factors intrinsic to the condition of CP likely play a significant role, it is also clear that environmental factors, including the living situation of the child, can have an impact.