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Use of Segmental Measures to Estimate Stature in Children With Cerebral Palsy

Use of Segmental Measures to Estimate Stature in Children With Cerebral Palsy Abstract Background: The assessment of stature in children with cerebral palsy is difficult. This study tested the clinical utility of the segmental measures of upper-arm length, tibial length, and knee height as proxies for stature in children with cerebral palsy. Methods: The study included 211 sets of measurements made in 172 children with cerebral palsy attending an outpatient clinic at a pediatric rehabilitation center during a 2-year period. Forty-three percent were female, 20% black, 31% diplegic or hemiplegic, and 52% nonambulatory. An observer measured weight, head circumference, recumbent length or standing height, upper-arm length, tibial length, knee height, midarm circumference, triceps skinfold, and subscapular skinfold. Results: The correlation coefficients were as follows: upper-arm length and stature,.97 (95% confidence interval,.95 to.98) (R2=.94); tibial length and stature,.97 (95% confidence interval,.96 to.98) (R2=.94); and knee height and stature,.98 (95% confidence interval, .98 to .99) (R2=.97). The linear regression equations were used to develop formulas for the estimation of stature from a segmental measure. Conclusions: Upper-arm length, tibial length, and knee height are all reliable and valid proxies for stature in children with cerebral palsy up to 12 years of age. We recommend that either knee height or tibial length be measured in the routine anthropometry of children with cerebral palsy who cannot be measured by standard techniques. Estimates of stature can then be calculated and plotted on standard growth charts.(Arch Pediatr Adolesc Med. 1995;149:658-662) References 1. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy . Arch Phys Med Rehabil . 1961;42:475-481. 2. Spender QW, Cronk CE, Charney EB, Stallings VA. Assessment of linear growth of children in cerebral palsy: use of alternative measures to height or length . Dev Med Child Neurol . 1989;31:206-214.Crossref 3. Davies JC, Antonucci DL, Charney EB, Stallings VA. Use of upper-arm length and per cent body fat for nutritional assessment of children with cerebral palsy . Dev Med Child Neurol . 1989;31 ( (suppl) ):39-40. 4. Johnson RK, Ferrara MS. Estimating stature from knee height for persons with cerebral palsy: an evaluation of estimation equations . J Am Diet Assoc . 1991; 91:1293-1294. 5. Appendix 8—skinfold grids—Children: other anthropometry standards . In: Ekvall SW, ed. Pediatric Nutrition in Chronic Diseases and Developmental Disorders: Prevention, Assessment and Treatment . New York, NY: Oxford University Press; 1993:489-491. 6. Cameron N. The methods of auxological anthropology . In: Falkner F, Tanner JM, eds. Human Growth: A Comprehensive Treatise . New York, NY: Plenum Press; 1986:3. 7. Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual . Champaign, Ill: Human Kinetics Books; 1988. 8. Norusis MJ. SPSS/PC+ Base Manual, Version 4.0 . Chicago, Ill: SPSS Inc; 1990. 9. Dean AG, Dean JA, Burton AH, Dicker RC. Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Microcomputers . Stone Mountain, Ga: USD Inc; 1990. 10. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles . Am J Clin Nutr . 1979; 32:607-629. 11. Rempel GR, Colwell SO, Nelson RP. Growth in children with cerebral palsy fed via gastrostomy . Pediatrics . 1988;82:857-862. 12. Pryor HB, Thelander HE. Growth deviations in handicapped children: an anthropometric study . Clin Pediatr . 1967;6:501-512.Crossref 13. Sanders KD, Cox K, Cannon R, et al. Growth response to enteral feeding by children with cerebral palsy . J Parenteral Enteral Nutr . 1990;14:23-26.Crossref 14. Shapiro BK, Green P, Krick J, Allen D, Capute AJ. Growth of severely impaired children: neurological versus nutritional factors . Dev Med Child Neurol . 1986; 28:729-733.Crossref 15. Patrick J, Gisel E. Nutrition for the feeding impaired child . J Neurol Rehabil . 1990;4:115-119. 16. Stevenson RD, Hayes RP, Cater LV, Blackman JA. Clinical correlates of linear growth in children with cerebral palsy . Dev Med Child Neurol . 1994;36:135-142.Crossref 17. Stallings VA, Charney EB, Davies JC, Cronk CE. Nutritional status and growth of children with diplegic or hemiplegic cerebral palsy . Dev Med Child Neurol . 1993;35:997-1006.Crossref 18. Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age . Pediatrics . 1988;81:102-110. 19. Appendix 2: Growth Grids for Special Conditions . In: Ekvall SW, ed. Pediatric Nutrition in Chronic Diseases and Developmental Disorders: Prevention, Assessment and Treatment . New York, NY: Oxford University Press; 1993:430-441. 20. Kline AD, Barr M, Jackson LG. Growth manifestations in the Brachmann—de Lange syndrome . Am J Med Genet . 1993;47:1042-1049.Crossref 21. Naureckas SM, Christoffel KK. Nasogastric or gastrostomy feedings in children with neurologic disabilities . Clin Pediatr . 1994;33:353-359.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Use of Segmental Measures to Estimate Stature in Children With Cerebral Palsy

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170190068012
Publisher site
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Abstract

Abstract Background: The assessment of stature in children with cerebral palsy is difficult. This study tested the clinical utility of the segmental measures of upper-arm length, tibial length, and knee height as proxies for stature in children with cerebral palsy. Methods: The study included 211 sets of measurements made in 172 children with cerebral palsy attending an outpatient clinic at a pediatric rehabilitation center during a 2-year period. Forty-three percent were female, 20% black, 31% diplegic or hemiplegic, and 52% nonambulatory. An observer measured weight, head circumference, recumbent length or standing height, upper-arm length, tibial length, knee height, midarm circumference, triceps skinfold, and subscapular skinfold. Results: The correlation coefficients were as follows: upper-arm length and stature,.97 (95% confidence interval,.95 to.98) (R2=.94); tibial length and stature,.97 (95% confidence interval,.96 to.98) (R2=.94); and knee height and stature,.98 (95% confidence interval, .98 to .99) (R2=.97). The linear regression equations were used to develop formulas for the estimation of stature from a segmental measure. Conclusions: Upper-arm length, tibial length, and knee height are all reliable and valid proxies for stature in children with cerebral palsy up to 12 years of age. We recommend that either knee height or tibial length be measured in the routine anthropometry of children with cerebral palsy who cannot be measured by standard techniques. Estimates of stature can then be calculated and plotted on standard growth charts.(Arch Pediatr Adolesc Med. 1995;149:658-662) References 1. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy . Arch Phys Med Rehabil . 1961;42:475-481. 2. Spender QW, Cronk CE, Charney EB, Stallings VA. Assessment of linear growth of children in cerebral palsy: use of alternative measures to height or length . Dev Med Child Neurol . 1989;31:206-214.Crossref 3. Davies JC, Antonucci DL, Charney EB, Stallings VA. Use of upper-arm length and per cent body fat for nutritional assessment of children with cerebral palsy . Dev Med Child Neurol . 1989;31 ( (suppl) ):39-40. 4. Johnson RK, Ferrara MS. Estimating stature from knee height for persons with cerebral palsy: an evaluation of estimation equations . J Am Diet Assoc . 1991; 91:1293-1294. 5. Appendix 8—skinfold grids—Children: other anthropometry standards . In: Ekvall SW, ed. Pediatric Nutrition in Chronic Diseases and Developmental Disorders: Prevention, Assessment and Treatment . New York, NY: Oxford University Press; 1993:489-491. 6. Cameron N. The methods of auxological anthropology . In: Falkner F, Tanner JM, eds. Human Growth: A Comprehensive Treatise . New York, NY: Plenum Press; 1986:3. 7. Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual . Champaign, Ill: Human Kinetics Books; 1988. 8. Norusis MJ. SPSS/PC+ Base Manual, Version 4.0 . Chicago, Ill: SPSS Inc; 1990. 9. Dean AG, Dean JA, Burton AH, Dicker RC. Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Microcomputers . Stone Mountain, Ga: USD Inc; 1990. 10. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles . Am J Clin Nutr . 1979; 32:607-629. 11. Rempel GR, Colwell SO, Nelson RP. Growth in children with cerebral palsy fed via gastrostomy . Pediatrics . 1988;82:857-862. 12. Pryor HB, Thelander HE. Growth deviations in handicapped children: an anthropometric study . Clin Pediatr . 1967;6:501-512.Crossref 13. Sanders KD, Cox K, Cannon R, et al. Growth response to enteral feeding by children with cerebral palsy . J Parenteral Enteral Nutr . 1990;14:23-26.Crossref 14. Shapiro BK, Green P, Krick J, Allen D, Capute AJ. Growth of severely impaired children: neurological versus nutritional factors . Dev Med Child Neurol . 1986; 28:729-733.Crossref 15. Patrick J, Gisel E. Nutrition for the feeding impaired child . J Neurol Rehabil . 1990;4:115-119. 16. Stevenson RD, Hayes RP, Cater LV, Blackman JA. Clinical correlates of linear growth in children with cerebral palsy . Dev Med Child Neurol . 1994;36:135-142.Crossref 17. Stallings VA, Charney EB, Davies JC, Cronk CE. Nutritional status and growth of children with diplegic or hemiplegic cerebral palsy . Dev Med Child Neurol . 1993;35:997-1006.Crossref 18. Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age . Pediatrics . 1988;81:102-110. 19. Appendix 2: Growth Grids for Special Conditions . In: Ekvall SW, ed. Pediatric Nutrition in Chronic Diseases and Developmental Disorders: Prevention, Assessment and Treatment . New York, NY: Oxford University Press; 1993:430-441. 20. Kline AD, Barr M, Jackson LG. Growth manifestations in the Brachmann—de Lange syndrome . Am J Med Genet . 1993;47:1042-1049.Crossref 21. Naureckas SM, Christoffel KK. Nasogastric or gastrostomy feedings in children with neurologic disabilities . Clin Pediatr . 1994;33:353-359.Crossref

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Jun 1, 1995

References