Experience in catering for patients with cerebral palsy during comprehensive rehabilitation at the Federal center

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Introduction. The formation of an adequate diet in children with cerebral palsy (CP) is associated with a number of difficulties, including the assessment of nutritional status and the need for nutrients and energy, the presence of dysphagia and other disorders. At the same time, dietary support for these children is critical for improving their somatic status and, consequently, their rehabilitation potential. According to the 2017 ESPGHNG recommendations, an individual approach is required to optimize dietary measures and monitor their effectiveness in CP children, including evaluating body composition indices. The purpose of the study is to optimize the nutritional support of CP children in conditions of a comprehensive rehabilitation in the Federal center.

Materials and methods. In the study performed in the National Medical Research Center for Children’s Health, there were observed 27 CP children (G80) with concomitant protein-energy malnutrition (PEM), including 11 (40.7 per cent) of girls aged 5-11 years (average age of 7.4 (5.7; 8.0) years). The assessment of anthropometric data was carried out using the software «WHO AnthroPlus», bioimpedance analysis of the component composition of the body was carried out on the device-analyzer «ABC-01 Medass», the assessment of the chemical composition of the diet was carried out using the software “Diet”. Dietary support consisted of correcting the basic diet, prescribing specialized hypercaloric mixtures and medication therapy. Dynamic control of the nutritional status of observed patients was performed after 2 months of complex nutritional correction.

Results. At the beginning of this study, patients were distributed according to the degree of PEM as follows: mild — in 17 (63.0%), moderate — in 5 (18.5%), severe-in 5 (18.5%); after a two-month course of drug therapy and nutritional correction — 22 (81.5%), 2 (7.4%) and 3 (11.1%), respectively. The integrated use of drug therapy and nutritional correction has resulted in 55.5% of patients with rapid improvement in nutritional status, which was manifested by an imroved appetite, weight gain, positive dynamics of anthropometric indices, normalization of the signal, including affecting performance, and thus on the rehabilitation potential of the child.

Conclusion. The obtained data indicate the possibilities of nutritional support in the complex treatment of children with cerebral palsy to be underestimated and indicate the need to include in the diagnostic and treatment algorithms of CP children consultations by a dietitian and appropriate therapeutic measures.

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About the authors

L. A. Pak

National Medical Research Center for Children’s Health

Email: makarova@nczd.ru
ORCID iD: 0000-0003-1346-1351

Russian Federation, Moscow

MD, Ph.D., DSc.

S. G. Makarova

National Medical Research Center for Children’s Health; N.I. Pirogov Russian National Research Medical University; M.V. Lomonosov Moscow State University

Author for correspondence.
Email: makarova@nczd.ru
ORCID iD: 0000-0002-3056-403X

Russian Federation, Moscow


A. P. Fisenko

National Medical Research Center for Children’s Health

Email: makarova@nczd.ru
ORCID iD: 0000-0001-8586-7946

Russian Federation, Moscow

MD, Ph.D., DSc., Prof.

L. M. Kuzenkova

National Medical Research Center for Children’s Health; N.F. Filatov Clinical Institute of Children's Health, I.M. Sechnov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)

Email: makarova@nczd.ru
ORCID iD: 0000-0002-9562-3774

Russian Federation, Moscow

MD, Ph.D., DSc.

T. R. Chumbadze

National Medical Research Center for Children’s Health

Email: makarova@nczd.ru
ORCID iD: 0000-0002-8172-5710

Russian Federation, Moscow


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Copyright (c) 2020 Pak L.A., Makarova S.G., Fisenko A.P., Kuzenkova L.M., Chumbadze T.R.

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