Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System
Introduction and objectives: Digestive disorders are one of the most common comorbidities among children with cerebral palsy (CP). The aim of this study is to examine the nutritional status of patients with CP, the prevalence of dysphagia by degree of motor impairment, and the impact of digestive di...
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| Format: | Article |
| Language: | English |
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Elsevier España
2023-01-01
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| Series: | Neurología (English Edition) |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2173580821001802 |
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| author | A. García Ron R.M. González Toboso M. Bote Gascón M.T. de Santos R. Vecino A. Bodas Pinedo |
| author_facet | A. García Ron R.M. González Toboso M. Bote Gascón M.T. de Santos R. Vecino A. Bodas Pinedo |
| author_sort | A. García Ron |
| collection | DOAJ |
| description | Introduction and objectives: Digestive disorders are one of the most common comorbidities among children with cerebral palsy (CP). The aim of this study is to examine the nutritional status of patients with CP, the prevalence of dysphagia by degree of motor impairment, and the impact of digestive disorders on quality of life. Material and methods: We conducted a descriptive, cross-sectional, open-label study of out-patients with CP from a tertiary hospital in the Region of Madrid using a structured interview, classifying dysphagia using the Eating and Drinking Ability Classification System (EDACS). We gathered demographical and anthropometric data, and analysed the correlation between severity of dysphagia and functional status as measured with the Gross Motor Function Classification System (GMFCS). Results: Our sample included 44 patients (65.9% boys), with a mean (standard deviation) age of 9.34 (5) years and a mean BMI of 18.5 (4.9). Forty-three percent presented safety and efficiency limitations (EDACS level > II). Safety and efficiency limitations were associated with more extensive motor involvement (60% had tetraparesis), more varied clinical manifestations (87% had mixed forms) and poorer functional capacity (100% on GMFCS V). The impact on nutritional status increased with higher EDACS and GMFCS scores. Conclusions: This is the first study into the usefulness of the EDACS scale in a representative sample of Spanish children and adolescents with CP. Our findings underscore the importance of screening for dysphagia in these patients, regardless of the level of motor impairment, and the need for early treatment to prevent the potential consequences: malnutrition (impaired growth, micronutrient deficiencies, osteopaenia, etc.), microaspiration, or recurrent infections that may worsen patients’ neurological status. Resumen: Introducción y objetivos: La enfermedad digestiva es una de las comorbilidades más frecuentes en niños con parálisis cerebral infantil (PCI). Nuestro objetivo es analizar el estado nutricional de los pacientes PCI, la prevalencia de disfagia según afectación motriz (GMFCS) y su repercusión en la calidad de vida. Material y métodos: Estudio descriptivo transversal y abierto en pacientes con PCI seguidos en un Hospital Terciario de la Comunidad de Madrid mediante entrevista estructurada y clasificación de disfagia según la escala Eating and Drinking Ability Classification System (EDACS). Recogimos datos demográficos y antropométricos y relacionamos el nivel de disfagia con el nivel funcional según el Gross Motor Function Classification System (GMFCS). Resultados: La muestra incluyó 44 pacientes (65,9% varones), con una edad media de 9,34 ± 5 años y un IMC de 18,5 ± 4,9. El 43% tenía limitaciones en seguridad y/o eficiencia (EDACS > II). El porcentaje de pacientes afectados fue mayor cuanto más extensa desde el punto de vista topográfico (tetraparesia 60%), más variada semiología clínica (87% en formas mixtas) y peor nivel funcional (100% en GMFCS V). La repercusión nutricional fue mayor cuanto mayor nivel EDACS y GMFCS. Conclusiones: Presentamos el primer estudio sobre la utilidad de la escala EDACS en una muestra representativa de niños y adolescentes españoles con PCI. Los resultados deben hacernos reflexionar sobre la importancia del screening de disfagia en estos pacientes, independientemente del grado de afectación motriz y la necesidad de una intervención precoz para evitar sus principales consecuencias: desnutrición (hipocrecimiento, déficit de micronutrientes, osteopenia, etc.), microaspiraciones o infecciones de repetición que empeoran el estado neurológico. |
| first_indexed | 2024-04-10T22:21:04Z |
| format | Article |
| id | doaj.art-8ceccd7042ab41c6b55643aa0bf2f3bd |
| institution | Directory Open Access Journal |
| issn | 2173-5808 |
| language | English |
| last_indexed | 2024-04-10T22:21:04Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Neurología (English Edition) |
| spelling | doaj.art-8ceccd7042ab41c6b55643aa0bf2f3bd2023-01-18T04:30:22ZengElsevier EspañaNeurología (English Edition)2173-58082023-01-013813540Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification SystemA. García Ron0R.M. González Toboso1M. Bote Gascón2M.T. de Santos3R. Vecino4A. Bodas Pinedo5Unidad de Neuropediatría, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, Spain; Corresponding author.Unidad de Neuropediatría, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, SpainUnidad de Neuropediatría, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, SpainUnidad de Neuropediatría, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, SpainUnidad de Digestivo Infantil, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, SpainUnidad de Digestivo Infantil, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, SpainIntroduction and objectives: Digestive disorders are one of the most common comorbidities among children with cerebral palsy (CP). The aim of this study is to examine the nutritional status of patients with CP, the prevalence of dysphagia by degree of motor impairment, and the impact of digestive disorders on quality of life. Material and methods: We conducted a descriptive, cross-sectional, open-label study of out-patients with CP from a tertiary hospital in the Region of Madrid using a structured interview, classifying dysphagia using the Eating and Drinking Ability Classification System (EDACS). We gathered demographical and anthropometric data, and analysed the correlation between severity of dysphagia and functional status as measured with the Gross Motor Function Classification System (GMFCS). Results: Our sample included 44 patients (65.9% boys), with a mean (standard deviation) age of 9.34 (5) years and a mean BMI of 18.5 (4.9). Forty-three percent presented safety and efficiency limitations (EDACS level > II). Safety and efficiency limitations were associated with more extensive motor involvement (60% had tetraparesis), more varied clinical manifestations (87% had mixed forms) and poorer functional capacity (100% on GMFCS V). The impact on nutritional status increased with higher EDACS and GMFCS scores. Conclusions: This is the first study into the usefulness of the EDACS scale in a representative sample of Spanish children and adolescents with CP. Our findings underscore the importance of screening for dysphagia in these patients, regardless of the level of motor impairment, and the need for early treatment to prevent the potential consequences: malnutrition (impaired growth, micronutrient deficiencies, osteopaenia, etc.), microaspiration, or recurrent infections that may worsen patients’ neurological status. Resumen: Introducción y objetivos: La enfermedad digestiva es una de las comorbilidades más frecuentes en niños con parálisis cerebral infantil (PCI). Nuestro objetivo es analizar el estado nutricional de los pacientes PCI, la prevalencia de disfagia según afectación motriz (GMFCS) y su repercusión en la calidad de vida. Material y métodos: Estudio descriptivo transversal y abierto en pacientes con PCI seguidos en un Hospital Terciario de la Comunidad de Madrid mediante entrevista estructurada y clasificación de disfagia según la escala Eating and Drinking Ability Classification System (EDACS). Recogimos datos demográficos y antropométricos y relacionamos el nivel de disfagia con el nivel funcional según el Gross Motor Function Classification System (GMFCS). Resultados: La muestra incluyó 44 pacientes (65,9% varones), con una edad media de 9,34 ± 5 años y un IMC de 18,5 ± 4,9. El 43% tenía limitaciones en seguridad y/o eficiencia (EDACS > II). El porcentaje de pacientes afectados fue mayor cuanto más extensa desde el punto de vista topográfico (tetraparesia 60%), más variada semiología clínica (87% en formas mixtas) y peor nivel funcional (100% en GMFCS V). La repercusión nutricional fue mayor cuanto mayor nivel EDACS y GMFCS. Conclusiones: Presentamos el primer estudio sobre la utilidad de la escala EDACS en una muestra representativa de niños y adolescentes españoles con PCI. Los resultados deben hacernos reflexionar sobre la importancia del screening de disfagia en estos pacientes, independientemente del grado de afectación motriz y la necesidad de una intervención precoz para evitar sus principales consecuencias: desnutrición (hipocrecimiento, déficit de micronutrientes, osteopenia, etc.), microaspiraciones o infecciones de repetición que empeoran el estado neurológico.http://www.sciencedirect.com/science/article/pii/S2173580821001802Parálisis cerebralDisfagiaDificultades de alimentaciónValoración nutricionalNutrición enteralDesnutrición |
| spellingShingle | A. García Ron R.M. González Toboso M. Bote Gascón M.T. de Santos R. Vecino A. Bodas Pinedo Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System Neurología (English Edition) Parálisis cerebral Disfagia Dificultades de alimentación Valoración nutricional Nutrición enteral Desnutrición |
| title | Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System |
| title_full | Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System |
| title_fullStr | Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System |
| title_full_unstemmed | Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System |
| title_short | Nutritional status and prevalence of dysphagia in cerebral palsy: usefulness of the Eating and Drinking Ability Classification System scale and correlation with the degree of motor impairment according to the Gross Motor Function Classification System |
| title_sort | nutritional status and prevalence of dysphagia in cerebral palsy usefulness of the eating and drinking ability classification system scale and correlation with the degree of motor impairment according to the gross motor function classification system |
| topic | Parálisis cerebral Disfagia Dificultades de alimentación Valoración nutricional Nutrición enteral Desnutrición |
| url | http://www.sciencedirect.com/science/article/pii/S2173580821001802 |
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