A cross-sectional study determining the relationship between eating and drinking skills and functional independence levels of patients with cerebral palsy: Eating and drinking function in children with CP

Hulya  Sirzai; Emine Ahi  Dundar

doi:10.28982/josam.1050835

Authors

Hulya Sirzai Romatem Fulya Physical Medicine and Rehabilitation Center, Istanbul, Turkey https://orcid.org/0000-0002-7320-3074
Emine Ahi Dundar Kocaeli Health and Technology Sciences, Physiotherapy and Rehabilitation, Private Medar Hospital, Kocaeli, Turkey https://orcid.org/0000-0001-6417-5406

DOI:

https://doi.org/10.28982/josam.1050835

Keywords:

Cerebral palsy, Eating and Drinking Abilities Classification System, Gross Motor Function Classification System, Manuel Ability Classification System, Pediatric Evaluation of Disability Inventory

Abstract

Background/Aim: In cerebral palsy (CP), drinking/eating disorders are considered common. To evaluate these disorders, a very detailed and lengthy evaluation is required. Few tools are available to identify children who need to be evaluated. This study determined whether the functional independence level of children with CP is sufficient to predict their drinking/eating skills and to determine the relationship between this functional level and these skills.

Methods: A total of 105 children with CP aged 4–8 years participated in a cross-sectional study in our outpatient clinic. Functional classification was assigned using the Gross Motor Function Classification System and Manuel Ability Classification System (GMFCS and MACS, respectively). For a functional assessment of daily life, the Pediatric Evaluation of Disability Inventory (PEDI) was performed by asking a relative of the child. The Eating and Drinking Abilities Classification System (EDACS) level was added to the study after asking the caregivers of the patients for eating/drinking evaluations.

Results: According to the current results, we found a negative correlation between EDACS and PEDI scores. As the EDACS grade increased, the PEDI subscale and total scores decreased in a statistically significant manner (P < 0.001), while the GMFCS and MACS scale increased statistically (P < 0.001). As the PEDI subscale and total scores increased, the levels of GMFCS and MACS decreased statistically significantly (P < 0.001).

Conclusions: The performances of children with CP in terms of activities of daily living are closely related to their performance in eating/drinking activities. If children are independent in their mobility, social functions, and daily self-care, they are also more independent in terms of eating/drinking.

Downloads

Download data is not yet available.

References

Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020;6:1505–18.

Richards CL, Handb FM. Cerebral palsy: definition, assessment and rehabilitation. Clin Neurol. 2013;111:183-95.

Paulson A, Vargus-Adams J. Overview of Four Functional Classification Systems Commonly Used in Cerebral Palsy. Children. 2017Apr 24;4(4):30. DOI: https://doi.org/10.3390/children4040030

Gormley ME. Treatment of neuromuscular and musculoskeletal problems in cerebral palsy. Pediatr Rehabil. 2001 Jan-Mar;4(1):5-16. DOI: https://doi.org/10.1080/13638490151068393

Wimalasundera N, Stevenson V L. Cerebral palsy. Pract Neurol 2016;16:184–94. DOI: https://doi.org/10.1136/practneurol-2015-001184

Rethlefsen SA, Ryan DD, Kay RM. Classification Systems in Cerebral Palsy. Orthop Clin North Am. 2010 Oct;41(4):457-67. DOI: https://doi.org/10.1016/j.ocl.2010.06.005

Richards C L, Malouin F. Cerebral palsy. Pediatric Neurology 2013; Part I:183–95. DOI: https://doi.org/10.1016/B978-0-444-52891-9.00018-X

Haley SM, Coster WJ, Ludlow LH, Haltiwanger JT, Andrellos PJ. Pediatric Evaluation of Disability Inventory (PEDI): development, standardization, and administration manual. Boston: PEDI Resarch Group; 1992. DOI: https://doi.org/10.1037/t08316-000

Kim K, Kang JY, Jang DH, Relationship Between Mobility and Self-Care Activity in Children With Cerebral Palsy. Ann Rehabil Med. 2017;41(2):266-72. DOI: https://doi.org/10.5535/arm.2017.41.2.266

Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020;16:1505–18. DOI: https://doi.org/10.2147/NDT.S235165

Caramico-Favero DCO, Guedes ZCF, Morais MB. Food intake, nutritional status and gastrointestinal symptoms in children with cerebral palsy. Arq Gastroenterol. 2018 Oct-Dec;55(4):352-7. DOI: https://doi.org/10.1590/s0004-2803.201800000-78

Erkin G, Culha C, Ozel S, Kirbiyik EG. Feeding and gastrointestinal problems in children with cerebral palsy. Int J Rehabil Res. 2010 Sep;33(3):218-24. DOI: https://doi.org/10.1097/MRR.0b013e3283375e10

Bell KL, Benfer KA, Ware RS, Patrao TA, Garvey JJ, Arvedson JC, et al. Development and validation of a screening tool for feeding/swallowing difficulties and undernutrition in children with cerebral palsy. Dev Med Child Neurol. 2019;61:1175–81. DOI: https://doi.org/10.1111/dmcn.14220

Sellers D, Mandy A, Pennington L, Hankins M, Morris C. Development and reliability of a system to classify the eating and drinking ability of peoplewith cerebral palsy. Dev Med Child Neurol. 2014;56:245–51. DOI: https://doi.org/10.1111/dmcn.12352

Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. The eating and drinking ability classification system in a population-based sampleof preschool children with cerebral palsy. Dev Med Child Neurol. 2017 Jun;59(6):647-54. DOI: https://doi.org/10.1111/dmcn.13403

Sellers D, Bryant E, Hunter A, Campbell V, Morris C. The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time. J Pediatr Rehabil Med. 2019;12(2):123-31.

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. Dev Med Child Neurol.1997;39(4):214-23. DOI: https://doi.org/10.1111/j.1469-8749.1997.tb07414.x

Palisano R, Rosenbaum P, Bartlett D, Livingston M. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol.2008 Oct;50(10):744-50. DOI: https://doi.org/10.1111/j.1469-8749.2008.03089.x

Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol. 2000 May;42(5):292-6. DOI: https://doi.org/10.1017/S0012162200000529

Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P,et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA. 2002 Sep 18;288(11):1357-63. DOI: https://doi.org/10.1001/jama.288.11.1357

Eliasson AC, Krumlinde Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall AM, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48:549-54. DOI: https://doi.org/10.1111/j.1469-8749.2006.tb01313.x

Akpinar P, Tezel CG, Eliasson AC, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabil. 2010;32(23):1910-6. DOI: https://doi.org/10.3109/09638281003763796

Erkin G. Aybay C, Elhan A, Şirzai H, Özel S. Validity and reliability of the Turkish translation of the Pediatric Evaluation of Disability Inventory (PEDI) Disabil Rehabil. 2007;29:1271-9. DOI: https://doi.org/10.1080/09638280600964307

Tsai PY, Yang TF, Chan RC, Wong TT. Functional investigation in children with spina bifida- measured by Pediatric Evalutation of disabişlity inventory (PEDI). Child’s Nerv Syst 2002;18:48-53. DOI: https://doi.org/10.1007/s00381-001-0531-6

Nichols DS, Case-Smith J. Reliability and validity of the Pediatric Evaluation of Disability Inventory. Ped Physi Thera. 1996;8(1):15-24. DOI: https://doi.org/10.1097/00001577-199600810-00004

Kerem Günel M, Özal C, Seyhan K, Serel Arslan S, Demir N, Karaduman A. EDACS [internet] [Erişim tarihi: 30.06.2019]. Erişim adresi: https://www.sussexcommunity.nhs.uk/get-involved/research/chailey-research/edacs-request.

Sellersa D, Bryanta E, Huntera A, Campbella V, Christopher M. The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time. J Pediatr Rehabil Med. 2019;12(2):123-31. DOI: https://doi.org/10.3233/PRM-180581

Goh YR, Choi JY, Kim SA, Park J, Park ES. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles. Res Dev Disabil. 2018 Jan;72:248-56. DOI: https://doi.org/10.1016/j.ridd.2017.12.002

Burgess A, Boyd RN, Zıvıanı J, Ware RS, Sakzewskı L. Self-care and manual ability in preschool children with cerebral palsy: a longitudinal study. Dev Med Child Neurol. 2019;61:570–8.

Benfer K, Weir K, Bell K, Davies P, Ware RS, Boyd R. Subtypes of oral motor dysfunction in feeding and its relationship with gross motor skills in young children with cerebral palsy. Dev Med Child Neurol. 2012;54:21.

Benfer KA, Weir KA, Boyd RN. Clinimetrics of measures of oropharyngeal dysphagia for preschool children with cerebral palsy and neurodevelopmental disabilities: a systematic review. Dev Med Child Neurol. 2012;54(9):784–95. DOI: https://doi.org/10.1111/j.1469-8749.2012.04302.x

Parkes J, Hill N, Platt MJ, Donnelly C. Oromotor dysfunction and communication impairments in children with cerebral palsy: a register study. Dev Med Child Neurol. 2010;52:1113–9. DOI: https://doi.org/10.1111/j.1469-8749.2010.03765.x

Selley WG, Parrott LC, Lethbridge PC, Flack FC, Ellis RE, Johnstone KJ, et al. Objective measures of dysphagia complexity in children related to suckle feeding histories, gestational ages and classification of their cerebral palsy. Dysphagia. 2001;16(3):200–7. DOI: https://doi.org/10.1007/s00455-001-0070-z

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):1553-62. DOI: https://doi.org/10.1542/peds.2012-3093

Kuijper MA, van der Wilden GJ, Ketelaar M, Gorter JW. Manual ability classification system for children with cerebral palsy in a school setting andits relationship to home self-care activities. Am J Occup Ther. 2010 Jul-Aug;64(4):614-20. DOI: https://doi.org/10.5014/ajot.2010.08087

Vargus-Adams JN, Martin LK, Maignan SH, Klein AC, Salisbury S. The GMFM, PEDI, and CP-QOL and perspectives on functioning from children with CP, parents, and medical professionals. J Pediatr Rehabil Med. 2011;4(1):3-12. DOI: https://doi.org/10.3233/PRM-2011-0148

Öhrvall Am, Elıasson Ac, Löwıng K, Ödman P, Sundholm LK. Self‐care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications. Dev Med Child Neurol. 2010;52 (11):1048-55. DOI: https://doi.org/10.1111/j.1469-8749.2010.03764.x

Gunel MK, Mutlu A, Tarsuslu T, Livanelioglu A. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr 2009;168:477-85. DOI: https://doi.org/10.1007/s00431-008-0775-1

Bourke-Taylor H. Melbourne Assessment of UnilateralUpper Limb Function: construct validity and correlation with the Pediatric Evaluation of Disability Inventory. Dev Med Child Neurol. 2003;45:92–6. DOI: https://doi.org/10.1111/j.1469-8749.2003.tb00911.x

Burgess A, Boyd RN, Ziviani J, Ware RS, Sakzewski L. Longitudinal Self-Care in Cerebral Palsy Andrea Burgess et al. Dev Med Child Neurol. 2019;61:570–8. DOI: https://doi.org/10.1111/dmcn.14049