The Investigation of the Relationship between Nutritional Behaviors and Nutrition Levels of Spastic Quadriparetic Cerebral Palsy Children

Year 2018, , 281 - 287, 14.10.2018

Seda Ayaz Taş Tamer Çankaya

https://doi.org/10.17681/hsp.336157

Abstract

Objectives: To investigate the relationship between feeding
behavior and nutritional status of children with spastic quadriparetic cerebral
palsy. Materials
and Methods: 56 children between the ages of 2 to 15 years with
spastic quadriparetic cerebral palsy participated in the study. The ages,
heights, body weights, body mass indexes, birth weights and gestational ages of
the children were recorded. Their feeding behavior was examined by using
Behavioral Pediatrics Feeding Assessment Scale. Their gross motor function
levels was designated based on the Gross Motor Function Classification System.
Their nutritional status were estimated by using age for body mass indexes
percentile curves. Results: Three groups were formed
out of 56 children based on the Gross Motor Function Classification System,
namely 10 children at level 3 (17.9%), 12 at level 4 (21.4%) and 34 at level 5
(60.7%). There was a significant difference found between inadequate nutrition,
normal nutrition, overweight and obese groups according to total frequency
score (p<0,0001) and total problem score (p=0,0005) of feeding behavior in
these children. Moreover, there was a significant difference found between
Gross Motor Function Classification System level 3, level 4, level 5 according
to total frequency score (p=0,004). Conclusion: Along with many studies on behavior problems in children
with cerebral palsy, there is little evidence on the feeding behavior of these
children. In our study, we found that worsening of the gross motor function
level of children with quadriparetic cerebral palsy increased feeding behavior
problems and stressed on the family/caregiver in accordance with the
literature. It was also observed that the feeding behavior of the children also
affected the nutritional levels. Feeding behavior was worsened and increased
stress of parents as Gross Motor Function Classification System levels
increased. Besides, feeding behavior affected nutritional status. Feeding
behavior of spastic quadriparetic cerebral palsy created stress on parents and
affected their nutritional status.

Keywords

Feeding behavior, Nutritional status, Gross motor function level, Oral motor disfunction, Serebral palsy.

Spastik Kuadriparetik Serebral Palsili Çocuklarin Beslenme Davranişlari İle Beslenme Düzeyleri Arasindaki İlişkinin Araştırılması

Abstract

Amaç: Spastik Kuadriparetik Serebral Palsi’li çocuklarda
beslenme davranışlarının araştırılıp, bunların beslenme düzeyleri ve kaba motor
fonksiyon seviyesiyle ilişkisinin belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Spastik Kuadriparetik Serebral
Palsi’li, 2-15 yaş aralığında 56 çocuk dahil edildi. Çocukların yaş, boy
uzunluğu, vücut ağırlığı, vücut kütle indeksi (VKİ) ile doğum kilosu ve
gestasyonel yaşları kaydedildi. Bireylerin beslenme davranışını değerlendirmek
üzere Davranışsal Pediatrik Beslenme Değerlendirme Skalası uygulandı. Kaba
motor fonksiyon seviyeleri, Kaba Motor Fonksiyon Sınıflandırma Sistemi’ne göre
belirlendi. Beslenme düzeyleri ise; yaşa göre vücut kütle indeksi persentil
eğrileri kullanılarak saptandı. Bulgular:
Kaba motor fonksiyon seviyesine göre, 56 çocuktan 10’u seviye 3 (%17.9), 12’si
seviye 4 (%21.4) ve 34’ü seviye 5’ti (%60.7). Yetersiz beslenme, normal
beslenme, kilolu ve obez grupları arasında, beslenme davranışları ile ilgili
olarak toplam sıklık skoru (p<0,0001) ve toplam problem skoru (p=0,0005)
değerleri açısından anlamlı fark bulundu. Kaba motor fonksiyon seviyesine göre
seviye 3, seviye 4 ve seviye 5 grupları arasında toplam sıklık skoru açısından
anlamlı fark bulundu (p=0,004). Sonuç:
Serebral Palsi’li çocuklarda davranış problemlerini inceleyen birçok çalışma
olmakla birlikte bu çocukların beslenme davranışları üzerine oldukça az kanıt
vardır. Çalışmamızda literatürle uyumlu olarak, Kuadriparetik Serebral Palsi’li
çocukların kaba motor fonksiyon seviyesinin kötüleşmesinin beslenme davranış
problemlerini artırdığı ve bu durumun bakım veren üzerinde stres oluşturduğu
bulundu. Ayrıca çocukların beslenme davranışlarının beslenme düzeylerini de
etkilediği görüldü. Yani sağlıklı bir büyüme gelişmenin temeli olan beslenme
düzeyi, beslenme davranışı kötü olan bireylerde olumsuz etkilenebilmektedir.

Keywords

Beslenme davranışı, Beslenme düzeyi, Kaba motor fonksiyon seviyesi, Oral motor disfonksiyon, Serebral palsi

References

• 1. Vargün R, Ulu HÖ, Duman R, Yağmurlu A. Serebral palsili çocuklarda beslenme problemleri ve tedavisi [Feeding Problems and Treatment in Children With Cerebral Palsy]. Ankara Üniversitesi Tıp Fakültesi Mecmuası [Journal of Ankara University Faculty of Medicine]. 2004;57:257-265.
• 2. Tekin F. Serebral Palsili çocuklarda nörogelişimsel tedavi (Bobath tedavisi) yaklaşımı’nın Postüral kontrol ve denge üzerine etkisi. [Effectiveness Of Neurodevelopmental Treatment (Bobath Concept) On Postural Control And Balance In Cerebral Palsied Children ]. [Yüksek Lisans Tezi]. Pamukkale Üniversitesi Sağlık Bilimleri Enstitüsü [Institute of Medical Sciences, Pamukkale University], Denizli, Türkiye, 2016.
• 3. Erkin G, Kacar S. Serebral Palsili Hastalarda Gastrointestinal Sistem ve Beslenme Problemleri [Gastrointestinal System and Feeding Problems in Patients with Cerebral Palsy]. Türkiye Fiziksel Tıp Rehabilitasyon Dergisi [The Turkish Journal of Physical Medicine and Rehabilitation]. 2005;51:150-155.
• 4. Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Developmental disabilities research reviews. 2008;14:118-27.
• 5. Sullivan P. Nutrition and growth in children with cerebral palsy: setting the scene. European journal of clinical nutrition. 2013;67:S3-S4.
• 6. Samara M, Johnson S, Lamberts K, Marlow N, Wolke D. Eating problems at age 6 years in a whole population sample of extremely preterm children. Developmental Medicine & Child Neurology. 2010;52:16-22.
• 7. Welch K, Pianta RC, Marvin RS, Saft EW. Feeding interactions for children with cerebral palsy: contributions of mothers' psychological state and children's skills and abilities. Journal of Developmental & Behavioral Pediatrics. 2000;21:123-29.
• 8. Balandin S, Hemsley B, Hanley L, Sheppard JJ. Understanding mealtime changes for adults with cerebral palsy and the implications for support services. Journal of Intellectual and Developmental Disability. 2009;34:197-206.
• 9. Veness C, Reilly S. Mealtime interaction patterns between young children with cerebral palsy and their mothers: characteristics and relationship to feeding impairment. Child: care, health and development. 2008;34:815-24.
• 10. Morrow A, Quine S, Craig J. Health professionals’ perceptions of feeding‐related quality of life in children with quadriplegic cerebral palsy. Child: care, health and development. 2007;33:529-38.
• 11. Cerro N, Zeunert S, Simmer K, Daniels L. Eating behaviour of children 1.5–3.5 years born preterm: Parents’ perceptions. Journal of paediatrics and child health. 2002;38:72-78.
• 12. Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. [Weight, height, head circumference and body mass index references for Turkish children]. Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51:1-14.
• 13. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology. 1997;39:214-23.
• 14. McDowell B. The gross motor function classification system–expanded and revised. Developmental Medicine & Child Neurology. 2008;50:725-25.
• 15. 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. Disability and rehabilitation. 2012;34:1030-33.
• 16. Evans M. Administration of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) to Parents of High-Risk Infants: How to Best Identify Those at Risk for Feeding Difficulties. [Master’s Thesis]. Georgia State University, Atlanta, 2012.
• 17. Parkes J, Caravale B, Marcelli M, Franco F, Colver A. Parenting stress and children with cerebral palsy: a European cross‐sectional survey. Developmental Medicine & Child Neurology. 2011;53:815-21.
• 18. Vik T, Skrove M, Døllner H, Helland G. Feeding problems and growth disorders among children with cerebral palsy in south and north Trondelag. Journal of the Norwegian Medical Association 2001;121:1570-74.
• 19. Gisel EG, Tessier M-J, Lapierre G, Seidman E, Drouin E, Filion G. Feeding management of children with severe cerebral palsy and eating impairment: an exploratory study. Physical & occupational therapy in pediatrics. 2003;23:19-44.
• 20. Gisel E, Patrick J. Identification of children with cerebral palsy unable to maintain a normal nutritional state. The Lancet. 1988;331:283-86.
• 21. Gangil A, Patwari A, Aneja S, Ahuja B, Anand V. Feeding problems in children with cerebral palsy. Indian pediatrics. 2001;38:839-46.
• 22. Sipal R, Schuengel C, Voorman J, Van Eck M, Becher J. Course of behaviour problems of children with cerebral palsy: the role of parental stress and support. Child: care, health and development. 2010;36:74-84.