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Obesity on Rise in Ambulatory Cerebral Palsy Patients

January 1, 2008
Written by: , Filed in: Pediatric Radiology
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Background
The prevalence of obesity in children and adolescents has more than tripled in the past three decades, according to the Centers for Disease Control and Prevention (CDC). Approximately 17% of children ages 2-19 years are obese.

Historically, children with cerebral palsy were small in height and weight for their age. Recently, however, obesity is observed more frequently in these children.

The Study
A retrospective chart review from January 1994 to December 2004 was conducted in order to document the prevalence of obesity in ambulatory children with cerebral palsy.

The study Results show that the rising prevalence of obesity may have a major impact on the general health and functional abilities of cerebral palsy patients as they reach adulthood.

Methodology
Records were reviewed for age, weight, height, gender, race, physical classification of cerebral palsy, and functional level (Gross Motor Function Classification System; GMFCS) ranging from levels I to V.

Obesity was determined according to the CDC’s gender-specific body mass index (BMI)-for-age-growth chart. Data were grouped into three periods
1994-1997, 1998-2002, and 2003-2004.

Results
649 children were included in the study. The prevalence of obesity was 7.7% in 1994-1997 and 16.5% in 2003-2004. There was also a significant rise in mean height (P <0.001) and mean weight (P =0.005). The percentage of hemiplegics also increased significantly over time, from 23.5% in 1994-1997 to 38.3% in 2003-2004. There was a decrease over time in subjects with GMFCS level-I function (31.8% in 1994-1997; 13.4% in 2002-2003) and an increase over time in subjects with level-III function (15.9% in 1994-1997; 28.3% in 2002-2003). There was a trend to increased obesity in the 8-10 years and 10-and-older age groups, but this trend did not reach statistical significance. In females, obesity increased significantly (P =0.015), and in males, only a trend was detected. No significant difference was found in patients with diplegia, triplegia, and quadriplegia. The groups with GMFCS levels I and II demonstrated an increase in obesity over time; this association was significant in level II (P =0.003). The period was independently associated with obesity when controlled for age, type of cerebral palsy, and GMFCS level. Conclusions
The prevalence of obesity in ambulatory patients with cerebral palsy has risen over the last decade from 7.7% to 16.5%. This is similar to that seen in the general pediatric patient population in the United States.

Reviewer’s Comments
I am not surprised that the prevalence of obesity has risen over time in this specific patient group because parents of cerebral palsy patients probably not differ significantly from regular parents. Therefore, eating habits would also be expected to be similar.

Author: : Cornelia Wenokor, MD

Reference:
Rogozinski BM, Davids JR, et al. Prevalence of Obesity in Ambulatory Children With Cerebral Palsy. J Bone Joint Surg Am; 2007; 89 (November): 2421-2426

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