Cerebral Palsy Growth Charts versus Standard Growth Charts for Assessing Growth in Children with Cerebral Palsy.

ABSTRACT

Background: In 2011 the American Life Expectancy Project created growth charts specifically designed for use in children with cerebral palsy (Brooks et al., 2011). The charts differ from the standard Royal College of Paediatrics and Child Health (RCPCH) growth charts as they are based upon the measured growth of children with cerebral palsy and are divided by gross motor function classification system (GMFCS). This research aims to determine the differences in plotted growth between the cerebral palsy growth chart and the standard RCPCH growth charts for children with cerebral palsy. Methods: Children with a primary diagnosis of cerebral palsy attending special schools in Islington were identified by their electronic patient records. Ethical approval was not needed as research was limited to secondary use of anonymous information. The children were stratified based on GMFCS and given a score from 1-5, with 5 being divided between tube fed and non tube fed (Day et al., 2007). Growth was then retrospectively plotted on both a RCPCH standard growth chart and a cerebral palsy growth chart. One weight was plotted for every six months of the data collected. Excel was used to convert the data to centiles and calculate how many centiles each plotted growth was away from the 50th, with the 50th being classified as 0. Mean centiles for each age group were calculated for both the cerebral palsy and RCPCH growth charts and variations between the two charts were determined. Results: In total 36 children were identified ranging in age from two to 18 years, with the mean age 11.6 years + 4.2. Stastical analysis was only done on children with GMFCS score of 4 or 5 as sample sizes for GMFCS 1-3 were too small. Plotted data on the cerebral palsy growth charts showed that on average children were 1 centile + 0.96 above the 50th centile whilst RCPCH growth chart shows that they were 3 centiles + 1.00 below the 50th centile. Discussion: The results show a clear difference between growth centiles for weight of children with cerebral palsy when plotted on the two different charts. These outcomes mirror those discovered by Day et al. (2007) however, the results from this research show that there is more variation between centiles as age increases which was not found by Day et al. [2]. Conclusion: This study shows that there is a difference in plotted growth between the cerebral palsy growth chart and the standard RCPCH growth charts however further research is needed to determine whether this difference is significant.