The first section of this issue will define cerebral palsy (CP), describe its causes, and review its classification types. Associated deficits related to CP will also be described. The next section will discuss nutrition assessment of children with CP followed by treatment options.
CP is the most common motor disability in childhood. Prevalence estimates from the Centers for Disease Control (CDC) range from 1.5 to more than 4 per 1,000 live births. CP is a term that refers to a number of disorders in the development of movement and posture that result from an injury to the central nervous system (CNS) during early brain development. The brain is unable to regulate muscle tone, strength, and coordination of movement. CP has been classified in different ways, including the level of severity, topographical distribution (parts of the body), physiological classification (motor type), and most recently by gross motor skill function (see Figure 1). The Gross Motor Functional Classification System (GMFCS) is a standardized functional classification system which utilizes an ordinal grading system of gross motor functional performance. Classification systems using the same grading system have also been developed for upper extremity function, communication, and eating/drinking (see Table 1).
CP can manifest in one of three periods: intrauterine, intrapartum, or postnatal. Risk factors for CP include premature birth, low birthweight, disruption of blood and oxygen supply to the developing brain, maternal infection, congenital malformations, multiple gestations, genetic disorders, and other factors. CP is non-progressive, but the manner in which it expresses itself may change over time as the brain matures. CP is a lifelong condition with no cure.
Interdisciplinary treatment and therapeutic intervention will lessen the effects and can assist the individual with CP in functioning successfully in their environment. Health care delivery to children and adolescents who have a developmental disability such as CP requires participation and sharing of expertise among multiple medical, social, therapeutic, and psychological disciplines.5 Members of the interdisciplinary team share the responsibility for making decisions about the patient’s care. The team members typically involved for those with CP may include but are not limited to the following disciplines: Developmental Pediatrics, Gastroenterology, Neurology, Neurosurgery, Orthopedics, Nursing, Nutrition, Physical Therapy, Occupational Therapy, Speech Language Pathology, Social Work, and Child Life.
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Nutrition Implications in Cerebral Palsy
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