Body mass index measures in children with cerebral palsy related to gross motor function classification: a clinic-based study.

OBJECTIVE: To investigate the prevalence of overweight in a clinic-based population of children with cerebral palsy (CP) and its association with gross motor function status. DESIGN: Retrospective chart review. We calculated body mass index (BMI; kg/m2) from charted height and weight and recorded Gross Motor Function Classification Scale (GMFCS levels I-V) on the basis of clinical descriptions in clinic notes for 137 children (2-18 yrs old) with CP seen in a pediatric rehabilitation clinic at an academic medical center. BMI percentiles were reported according to sex-specific age group standards for growth set by the U.S. Centers for Disease Control and Prevention (CDC). Associations were modeled by Pearson's chi2 distribution. RESULTS: Out of the total CP subject group, 29.1% were considered overweight (>95th percentile) or at risk for overweight (85th to 95th percentile). Ambulatory children (GMFCS levels I and II) showed a trend (Pearson's chi2, P = 0.06) toward higher prevalence of overweight (22.7%) compared with nonambulatory children (levels IV and V, 9.6%). Underweight was more prevalent in nonambulatory children (P < 0.01). Logistic regression analysis did not identify any significant predictors for overweight. CONCLUSIONS: In our patient population, analysis of BMI suggests that children with CP have a high rate of overweight and are at risk of overweight, particularly among ambulatory children. More study is needed, using measures more accurate than BMI, to clarify risk.

Cerebral palsy.

Cerebral palsy (CP) is the leading cause of childhood disability. This article reviews common presentations of CP and its possible causes. The management of common problems seen in affected children is discussed in a system-based approach. Many treatment options are available for CP, with varying degrees of evidence and acceptance. As individuals who have CP transition into adulthood, they face unique issues that are not well recognized in the medical community. This article briefly reviews the psychosocial impact of this chronic disease on individuals and their caregivers and family.

Assessment of habitual physical activity and paretic arm mobility among stroke survivors by accelerometry.

A major goal for many stroke survivors is a return to ambulatory activities, but there is not much known about the physical activity profiles of stroke survivors. Improved function in the paretic arm is also a major goal of rehabilitation, but there are few good measures of daily arm use. Accelerometers are devices that measure body movements in terms of acceleration. Accelerometers have been found to be useful indicators of movement in a number of studies involving different patient populations. They are able to detect habitual physical activity levels in subjects with low levels or activity and altered gait patterns. Different systems of multiple accelerometers have been used successfully to detect arm usage in individuals with hemiparesis from stroke, as well as with other disabilities that affect the upper extremities.

Amantadine in pediatric patients with traumatic brain injury: a retrospective, case-controlled study.

OBJECTIVE: To determine if amantadine use in pediatric patients with traumatic brain injury is well tolerated and to attempt to assess its effectiveness. DESIGN: This was a retrospective, case-controlled study. RESULTS: Of the 54 patients, aged 3-18 yrs, who were administered amantadine, five (9%) had side effects that might have been related to the drug. These included hallucinations, delusions, increased aggression, and nausea/vomiting. The side effects were reversed when the medication was stopped or the dosage decreased. Patients in the amantadine group had a greater increase in Ranchos Los Amigos level during their admission than those in the control group (median, 3 vs. 2; P < 0.01). This difference may be, at least in part, explained by the fact that the amantadine group started at a lower Ranchos Los Amigos level (median, 3 vs. 4; P < 0.01). There were subjective improvements noted in 29 of the 46 patients (63%) in the amantadine group whose full charts were available for review. CONCLUSION: Amantadine is a well tolerated medication when it is used in pediatric patients with traumatic brain injury. Subjective improvements were noted in the majority of the patients administered amantadine, and the amantadine group showed a greater improvement in Ranchos Los Amigos level during admission, suggesting that it may be effective.