Emre CENGİZ, Selen SEREL ARSLAN, Numan DEMIR, Aynur Ayşe KARADUMAN

Motor Functional Level and Quality of Life According to Feeding Types in Children With Cerebral Palsy

Objective: The study aimed to compare motor functions and quality of life of children with cerebral palsy (CP), as well as anxiety and depression levels of caregivers according to the feeding types of the children. Methods: The study included children with CP aged between 5-17 years. There were two groups: children with oral feeding (n=19) and children with non-oral feeding (n=16). Gross Motor Function Classification System (GMFCS) to classify children according to gross motor function, Gross Motor Function Measurement (GMFM) to evaluate gross motor functions, and parent-reported Pediatric Quality of Life Inventory to evaluate the quality of life of children were used. Beck Depression Inventory and Beck Anxiety Inventory were used to measuring caregivers’ anxiety and depression levels. Results: Significant differences were found between groups regarding the GMFCS, GMFM, and parent-reported Pediatric Quality of Life scores of children in favor of children with oral feeding (p<0.05). Depression levels of caregivers of children with non-oral feeding were higher than children with oral feeding (p=0.006). Conclusion: It was concluded that children with CP who fed non-orally had lower motor functional levels and lower quality of life compared to children who fed orally, as well as their caregivers reported higher depression scores.

Keywords:

Cerebral Palsy Deglutition Disorders, Dysphagia, Enteral Nutrition, Motor Skills.,

PDF

___

Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14.
Arvedson J. Feeding children with cerebral palsy and swallowing difficulties. Eur J Clin Nutr. 2013;67(2):S9-S12.
Erkin G, Culha C, Ozel S, Kirbiyik EG. Feeding and gastrointestinal problems in children with cerebral palsy. Int J Rehabil Res. 2010;33(3):218-24.
Stevenson RD, Conaway M, Chumlea WC, Rosenbaum P, Fung EB, Henderson RC. Growth and health in children with moderate-to-severe cerebral palsy. Pediatrics. 2006;118(3):1010-8.
Rempel G. The importance of good nutrition in children with cerebral palsy. Phys Med Rehabil Clin N Am. 2015;26(1):39-56.
Marchand V, Motil KJ. Nutrition support for neurologically impaired children:A clinical report of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2006;43(1):123-35.
Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev. 2008;14(2):118-27.
Marrara J, Duca A, Dantas R, Trawitzki L, Lima R, Pereira J. Swallowing in children with neurologic disorders: clinical and videofluoroscopic evaluations. Pro Fono. 2008;20(4):231-6.
Sitton M, Arvedson J, Visotcky A, Braun N, Kerschner J, Tarima S. Fiberoptic endoscopic evaluation of swallowing in children: feeding outcomes related to diagnostic groups and endoscopic findings. Int J Pediatr Otorhinolaryngol. 2011;75(8):1024-31.
Gantasala S, Sullivan PB, Thomas AG. Gastrostomy feeding versus oral feeding alone for children with cerebral palsy. Cochrane Database Syst Rev. 2013(7).
Park R, Allison M, Lang Je, Spence E, Morris A, Danesh B. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ. 1992;304(6839):1406-9.
Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Food and fluid texture consumption in a population‐based cohort of preschool children with cerebral palsy: relationship to dietary intake. Dev Med Child Neurol. 2015;57(11):1056-63.
Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia in preschool children with cerebral palsy: oral phase impairments. Res Dev Disabil. 2014;35(12):3469-81.
Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. Pediatrics. 2013;131(5):e1553-e62.
Kim J-S, Han Z-A, Song DH, Oh H-M, Chung ME. Characteristics of dysphagia in children with cerebral palsy, related to gross motor function. Am J Phys Med Rehabil. 2013;92(10):912-9.
Sullivan P, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study. Dev Med Child Neurol. 2000;42(10):674-80.
Davout A, Rech C, Hanachi M, Barthod F, Melchior JC, Crenn P. Feasibility and results of pull-percutaneous endoscopic gastrostomy for enteral nutrition in adults with severe cerebral palsy. Clin Nutr. 2016;35(4):918-23.
Mahant S, Friedman JN, Connolly B, Goia C, Macarthur C. Tube feeding and quality of life in children with severe neurological impairment. Arch Dis Child. 2009;94(9):668-73.
Logemann J. Anatomy and physiology of normal deglutition. Evaluation and treatment of swallowing disorders. 1983:9-36.
El Ö, Baydar M, Berk H, Peker Ö, Koşay C, Demiral Y. Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disabil Rehabil. 2012;34(12):1030-3.
Russell DJ, Rosenbaum PL, Cadman DT, Gowland C, Hardy S, Jarvis S. The gross motor function measure: a means to evaluate the effects of physical therapy. Dev Med Child Neurol. 1989;31(3):341-52.
Varni JW, Seid M, Rode CA. The PedsQL™: measurement model for the pediatric quality of life inventory. Med Care 1999:126-39.
Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi. J Psychol. 1989;7:3-13 (Turkish)
Ulusoy M, Sahin NH, Erkmen H. The Beck anxiety inventory: psychometric properties. J Cogn Psychother. 1998;12(2):163-72.
Franklin D, Luther F, Curzon M. The prevalence of malocclusion in children with cerebral palsy. Eur J Orthod. 1996;18(6):637-43.
de Castilho LS, Abreu MHNG, Pires e Souza LGdA, Romualdo LTdA, Souza e Silva ME, Resende VLS. Factors associated with anterior open bite in children with developmental disabilities. Spec Care Dentist 2018;38(1):46-50.
Martinez-Mihi V, Silvestre FJ, Orellana LM, Silvestre-Rangil J. Resting position of the head and malocclusion in a group of patients with cerebral palsy. J Clin Exp Dent. 2014;6(1):e1.
Bensi C, Costacurta M, Docimo R. Oral health in children with cerebral palsy: A systematic review and meta‐analysis. Spec Care Dentist. 2020;40(5):401-11.
Yogi H, Alves LAC, Guedes R, Ciamponi AL. Determinant factors of malocclusion in children and adolescents with cerebral palsy. Am J Orthod Dentofacial Orthop. 2018;154(3):405-411.
Léonard M, Dain E, Pelc K, Dan B, De Laet C. Nutritional status of neurologically impaired children: Impact on comorbidity. Arch Pediatr. 2020;27(2):95-103.
Acar G, Ejraei N, Turkdoğan D, Enver N, Öztürk G, Aktaş G. The effects of neurodevelopmental therapy on feeding and swallowing activities in children with cerebral palsy. Dysphagia 2021:1-12.
Elema A, Zalmstra TA, Boonstra AM, Narayanan UG, Reinders‐Messelink HA, vd Putten AA. Pain and hospital admissions are important factors associated with quality of life in nonambulatory children. Acta Pediatr. 2016;105(9):e419-e25.
Sullivan PB, Juszczak E, Bachlet AM, Thomas AG, Lambert B, Vernon-Roberts A. Impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy. Dev Med Child Neurol. 2004;46(12):796-800.
Sullivan PB, Juszczak E, Bachlet AM, Lambert B, Vernon-Roberts A, Grant HW. Gastrostomy tube feeding in children with cerebral palsy: A prospective, longitudinal study. Dev Med Child Neurol. 2005;47(2):77-85.
Arslan SS, Ilgaz F, Demir N, Karaduman AA. Yutma bozukluğu olan serebral palsili çocuklarda büyüme yetersizliği ve beslenme şeklinin ebeveynlerin kaygı durumu üzerindeki etkisi. Beslenme ve Diyet Dergisi 2017;45(1):28-34.
Craig G, Carr L, Cass H, Hastings R, Lawson M, Reilly S. Medical, surgical, and health outcomes of gastrostomy feeding. Dev Med Child Neurol. 2006;48(5):353-60.
Sloper P, Turner S. Service needs of families of children with severe physical disability. Child: Care, Health and Development 1992;18(5):259-82.
Pérez PO, Arredondo IV, Rubio ET, López AR, Taillifer PG-H, Navas-López VM. Clinicopathological characterization of children with dysphagia, family impact and health-related quality of life of their caregivers. An Pediatr (Engl Ed). 2022;96(5):431-40.