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MON-P221: The Correlation of Gross Motor Function and Dysphagia with the Body Composition in Children with Cerebral Palsy
S234 Rationale: Malnutrition in paediatric inpatients can be prevented, if nutritional risk screening, with valid tools, is systematically applied. This study aimed to evaluate the efficacy of two nutritional risk screening tools and to estimate the prevalence of nutritional risk at hospital admission, in a sample of paediatric patients. Methods: In this study 1506 paediatric patients, 1–16 years, who were hospitalized in paediatric and surgical wards at the two biggest paediatric hospitals in Athens, were included. Nutritional screening was performed using the Paediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) tools, completed based either on the World Health Organization (WHO) criteria for underweight or on the Hellenic growth charts (HGC). Additionally, the dietitians of the hospitals estimated the nutritional risk in a subset of the total sample, based on their clinical judgment and a combined index for malnutrition risk was also calculated. Statistical analysis was used to determine sensitivity, specificity, positive (PPV) and negative (NPV) predictive value by results of the screening tools divided into low and moderate-high risk of malnutrition compared to results from the combined index. Results: PYMS_HGC showed the higher agreement with the combined index (k = 0.84), followed by PYMS-WHO (k = 0.83). STAMP showed lower agreement (k = 0.53 for STAMP-HGC and k = 0.54 for STAMP-WHO). PYMS-HGC had the highest sensitivity (95.7%), high NPV (98.2%), specificity (92.4%) and PPV (83.4%). Prevalence of the high-moderate nutritional risk, based on the PYMS-HGC was 30.6%. Conclusion: PYMS tool based on Hellenic growth charts, was evaluated as the most effective screening tool in identifying children at nutritional risk during hospital admission, and is suggested to be adopted in the daily clinical practice. Disclosure of Interest: None declared
MON-P221 THE CORRELATION OF GROSS MOTOR FUNCTION AND DYSPHAGIA WITH THE BODY COMPOSITION IN CHILDREN WITH CEREBRAL PALSY N. Majdič1, K. Groleger Sršen1, B. Korošec1, V. Marot1, M. Dolinar1. 1University Rehabilitation Institute, Republic of Slovenia - Soča, Ljubljana, Slovenia Rationale: Feeding and swallowing disorders are frequent in children with cerebral palsy (CP) and correlate with the level of motor dysfunction (level of The Gross Motor Function Classification System, GMFCS). We wanted to explore the possible value of bioelectrical impedance analysis of body composition in CP children for different GMFCS levels. Methods: Children with CP were classified by GMFCS and their body composition was analysed (Bodystat(R) QuadScan 4000). Differences in body composition between groups were tested using Analysis of variance (ANOVA). For assessing association between illness marker and phase angle on one side and GMFCS level on the other, Pearson correlation (r) was used. Results: 52 children with the CP, from 4 to 16 years of age, were included in the study. We found significant differences in GMFCS levels (level I in comparison with other levels) changed body composition: higher fat indices (mean value of % above the norms - level I (5.8%), II (14.3%), III (12.8%), IV (11.5%) and V
Poster (10.8%)) and lower lean tissue indices (mean value of % below the norms - level I (4.4%), II (10.6%), III (7.7%), IV (10.8%) and V (8.5 8%)). Only children in GMFCS level I had close to normal body composition. Illness marker and phase angle also correlated well with GMFCS level. Conclusion: Children at GMFCS levels II to V are having changed body composition. We believe they should be early and closely assessed for dysphagia, so that appropriate diet and feeding mode can be introduced (especially those in GMFCS levels IV and V). Besides also more specific physical activities could be advised for those children, that are having less gross motor difficulties (GMFCS II and III). Disclosure of Interest: None declared
MON-P222 THE ASSESSMENT OF THE CONCORDANCE BETWEEN THE WEIGHT GAIN DURING THE PREGNANCY AND THE ANTHROPOMETRIC PARAMETERS OF THE PREGNANT WOMAN O. I. Marginean1, C. Marginean2, L. Melit3, M. O. Marginean4. 1 Pediatrics, University of Medicine and Pharmacy, 2Obstetrics, 3 Pediatrics, University of Medicine and Pharmacy Tirgu Mures, 4 University of Medicine and Pharmacy, Tirgu Mures, Romania Rationale: The aim of the paper is to assess the manner in which the weight gain during pregnancy is correlated with the bioimpedance, anthropometric and laboratory parameters and the consequences on the newborns’ weight. Methods: We performed a prospective study on 200 mothers admitted in a tertiary hospital. The patients were divided into two groups: Group 1 (83 with GWG over the admitted limits of the Institute of Medicine) and Group 2, the control group – 117 with normal weight gain during the pregnancy. There were evaluated comparatively in the two groups, the anthropometric parameters (weight (W), height (H), body mass index (BMI), middle upper arm circumference (MUAC), tricipital skinfold thickness (TST), Fat mass (FM), muscle mass (MM) and total body water (TBW) evaluated through bioimpedance, and the laboratory data (cholesterol, triglycerides, GOT, GPT). Results: TST, weight and BMI were significantly higher in the group of women with the GWG over the limits ( p < 0.001 for all parameters). The study group had significantly higher percent of fat mass (FM) (31.31 ± 6.09 vs 26.66 ± 7.13; p < 0.01), muscle mass (MM) (49.09 ± 6.27 vs 43.88 ± 4.71; p < 0.01), bone mass (BM) (2.51 ± 0.52 vs 2.15 ± 0.37; p < 0.01) and significantly higher percent of total body water (TBW) (36.96 ± 4.92 vs 32.67 ± 3.95; p = 0.01) compared with Group 2. The children women in the study group had bigger weight than the children of those from the control group (3688.48 ± 621.71 gr vs 3148.98 ± 582.78 gr, p = 0.02). Conclusion: Pregnant women with higher GWG had children with bigger birth weight, having a higher risk of becoming overweight/obese. The exploration through bioimpedance evaluates better the nutritional status of the pregnant women, providing important information on body composition and allows monitoring of nutritional risk. Disclosure of Interest: None declared
MON-P221 THE CORRELATION OF GROSS MOTOR FUNCTION AND DYSPHAGIA WITH THE BODY COMPOSITION IN CHILDREN WITH CEREBRAL PALSY N. Majdič1, K. Groleger Sršen1, B. Korošec1, V. Marot1, M. Dolinar1. 1University Rehabilitation Institute, Republic of Slovenia - Soča, Ljubljana, Slovenia Rationale: Feeding and swallowing disorders are frequent in children with cerebral palsy (CP) and correlate with the level of motor dysfunction (level of The Gross Motor Function Classification System, GMFCS). We wanted to explore the possible value of bioelectrical impedance analysis of body composition in CP children for different GMFCS levels. Methods: Children with CP were classified by GMFCS and their body composition was analysed (Bodystat(R) QuadScan 4000). Differences in body composition between groups were tested using Analysis of variance (ANOVA). For assessing association between illness marker and phase angle on one side and GMFCS level on the other, Pearson correlation (r) was used. Results: 52 children with the CP, from 4 to 16 years of age, were included in the study. We found significant differences in GMFCS levels (level I in comparison with other levels) changed body composition: higher fat indices (mean value of % above the norms - level I (5.8%), II (14.3%), III (12.8%), IV (11.5%) and V
Poster (10.8%)) and lower lean tissue indices (mean value of % below the norms - level I (4.4%), II (10.6%), III (7.7%), IV (10.8%) and V (8.5 8%)). Only children in GMFCS level I had close to normal body composition. Illness marker and phase angle also correlated well with GMFCS level. Conclusion: Children at GMFCS levels II to V are having changed body composition. We believe they should be early and closely assessed for dysphagia, so that appropriate diet and feeding mode can be introduced (especially those in GMFCS levels IV and V). Besides also more specific physical activities could be advised for those children, that are having less gross motor difficulties (GMFCS II and III). Disclosure of Interest: None declared
MON-P222 THE ASSESSMENT OF THE CONCORDANCE BETWEEN THE WEIGHT GAIN DURING THE PREGNANCY AND THE ANTHROPOMETRIC PARAMETERS OF THE PREGNANT WOMAN O. I. Marginean1, C. Marginean2, L. Melit3, M. O. Marginean4. 1 Pediatrics, University of Medicine and Pharmacy, 2Obstetrics, 3 Pediatrics, University of Medicine and Pharmacy Tirgu Mures, 4 University of Medicine and Pharmacy, Tirgu Mures, Romania Rationale: The aim of the paper is to assess the manner in which the weight gain during pregnancy is correlated with the bioimpedance, anthropometric and laboratory parameters and the consequences on the newborns’ weight. Methods: We performed a prospective study on 200 mothers admitted in a tertiary hospital. The patients were divided into two groups: Group 1 (83 with GWG over the admitted limits of the Institute of Medicine) and Group 2, the control group – 117 with normal weight gain during the pregnancy. There were evaluated comparatively in the two groups, the anthropometric parameters (weight (W), height (H), body mass index (BMI), middle upper arm circumference (MUAC), tricipital skinfold thickness (TST), Fat mass (FM), muscle mass (MM) and total body water (TBW) evaluated through bioimpedance, and the laboratory data (cholesterol, triglycerides, GOT, GPT). Results: TST, weight and BMI were significantly higher in the group of women with the GWG over the limits ( p < 0.001 for all parameters). The study group had significantly higher percent of fat mass (FM) (31.31 ± 6.09 vs 26.66 ± 7.13; p < 0.01), muscle mass (MM) (49.09 ± 6.27 vs 43.88 ± 4.71; p < 0.01), bone mass (BM) (2.51 ± 0.52 vs 2.15 ± 0.37; p < 0.01) and significantly higher percent of total body water (TBW) (36.96 ± 4.92 vs 32.67 ± 3.95; p = 0.01) compared with Group 2. The children women in the study group had bigger weight than the children of those from the control group (3688.48 ± 621.71 gr vs 3148.98 ± 582.78 gr, p = 0.02). Conclusion: Pregnant women with higher GWG had children with bigger birth weight, having a higher risk of becoming overweight/obese. The exploration through bioimpedance evaluates better the nutritional status of the pregnant women, providing important information on body composition and allows monitoring of nutritional risk. Disclosure of Interest: None declared