Evaluation of malnutrition and nutritional history in children with cerebral palsy
Abstract
Purpose of the study. To reveal the features of the nutritional status of patients with cerebral palsy in various forms of the disease, depending on the violations of the oral-motor function. Materials and methods. We examined 214 children with various forms of cerebral palsy, subdivided according to ICD-10 into 6 topographic forms. The average age of children was 6.7±0.27 years. All patients underwent a comprehensive clinical and neurological monitoring, including clinical observation during hospitalization with an assessment of the influence of the neurological status of a patient with cerebral palsy on the severity of changes in nutritional status. The Eating and Drinking Ability Classification System (EDACS) is applied to assess the functional skills and abilities to take fluids and food in daily life; The Drooling Impact Scale (DIS) was used to assess the severity of sialorrhea. Results. The study of oral function showed that 36.9% of children with cerebral palsy had a sensory type of impairment, and 29.9% had a motor type. An analysis of the nutritional history revealed significant differences in the frequency of malnutrition (chewing, swallowing, sucking, introducing complementary foods, etc.) between the examined children with cerebral palsy, depending on the form of the disease, with a predominance of severe disorders in the G 80.0 form in 65.1% of children. The highest percentage of occurrence of oral-motor dysfunction was noted at G 80.3 (80.1%), while the lowest - at G 80.2 (13.1%). A pronounced degree of salivation was significantly more often noted in the forms G 80.0 (38.4±3.8 points; P <0.01), G 80.3 (37.9±3.4 points; P<0.01) and with G 80.8 (28.7±3.2 points; P<0.01) in relation to other forms of cerebral palsy. In general, 72% of children with cerebral palsy over the age of 3 years had some degree of disturbance in the intake of food and liquids in accordance with the EDACS scale.