Association between gross motor function and nutritional status in children with cerebral palsy: a cross-sectional study from Colombia

Aim: To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. Method: We conducted a cross-sectional study in 177 children (ages 2–12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012–2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. Results: There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27–14.0) and stunting (OR 8.42; 95% CI 2.90–24.4) than those classified in GMFCS levels I to III. Interpretation: Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction.