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  1. Article ; Online: Growth and nutrition disorders in children with cerebral palsy.

    Kuperminc, Michelle N / Stevenson, Richard D

    Developmental disabilities research reviews

    2008  Volume 14, Issue 2, Page(s) 137–146

    Abstract: Growth and nutrition disorders are common secondary health conditions in children with cerebral palsy (CP). Poor growth and malnutrition in CP merit study because of their impact on health, including psychological and physiological function, healthcare ... ...

    Abstract Growth and nutrition disorders are common secondary health conditions in children with cerebral palsy (CP). Poor growth and malnutrition in CP merit study because of their impact on health, including psychological and physiological function, healthcare utilization, societal participation, motor function, and survival. Understanding the etiology of poor growth has led to a variety of interventions to improve growth. One of the major causes of poor growth, malnutrition, is the best-studied contributor to poor growth; scientific evidence regarding malnutrition has contributed to improvements in clinical management and, in turn, survival over the last 20 years. Increased recognition and understanding of neurological, endocrinological, and environmental factors have begun to shape care for children with CP, as well. The investigation of these factors relies on advances made in the assessment methods available to address the challenges inherent in measuring growth in children with CP. Descriptive growth charts and norms of body composition provide information that may help clinicians to interpret growth and intervene to improve growth and nutrition in children with CP. Linking growth to measures of health will be necessary to develop growth standards for children with CP in order to optimize health and well-being.
    MeSH term(s) Body Weight ; Bone Density/physiology ; Bone Diseases/epidemiology ; Bone Diseases/physiopathology ; Bone Diseases/therapy ; Cerebral Palsy/epidemiology ; Child ; Endocrine System Diseases/epidemiology ; Endocrine System Diseases/physiopathology ; Gastrostomy ; Growth Disorders/epidemiology ; Humans ; Nutrition Disorders/epidemiology ; Nutrition Disorders/surgery
    Language English
    Publishing date 2008-06-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Review
    ZDB-ID 2421523-5
    ISSN 1940-5529 ; 1940-5510
    ISSN (online) 1940-5529
    ISSN 1940-5510
    DOI 10.1002/ddrr.14
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Accuracy of skinfold and bioelectrical impedance assessments of body fat percentage in ambulatory individuals with cerebral palsy.

    Oeffinger, Donna J / Gurka, Matthew J / Kuperminc, Michelle / Hassani, Sahar / Buhr, Neeley / Tylkowski, Chester

    Developmental medicine and child neurology

    2014  Volume 56, Issue 5, Page(s) 475–481

    Abstract: ... with CP (Gross Motor Function Classification System [GMFCS] levels I (n=6), II (n=46), and III (n=19 ...

    Abstract Aim: This study assessed the accuracy of measurements of body fat percentage in ambulatory individuals with cerebral palsy (CP) from bioelectrical impedance analysis (BIA) and skinfold equations.
    Method: One hundred and twenty-eight individuals (65 males, 63 females; mean age 12y, SD 3, range 6-18y) with CP (Gross Motor Function Classification System [GMFCS] levels I (n=6), II (n=46), and III (n=19) participated. Body fat percentage was estimated from (1) BIA using standing height and estimated heights (knee height and tibial length) and (2) triceps and subscapular skinfolds using standard and CP-specific equations. All estimates of body fat percentage were compared with body fat percentage from dual-energy X-ray absorptiometry (DXA) scans. Differences between DXA, BIA, and skinfold body fat percentage were analyzed by comparing mean differences. Agreement was assessed by Bland-Altman plots and concordance correlation coefficients (CCC).
    Results: BMI was moderately correlated with DXA (Pearson's r=0.53). BIA body fat percentage was significantly different from DXA when using estimated heights (95% confidence intervals [CIs] do not contain 0) but not standing height (95% CI -1.9 to 0.4). CCCs for all BIA comparisons indicated good to excellent agreement (0.75-0.82) with DXA. Body fat percentage from skinfold measurements and CP-specific equations was not significantly different from DXA (mean 0.8%; SD 5.3%; 95% CI -0.2 to 1.7) and demonstrated strong agreement with DXA (CCC 0.86).
    Interpretation: Accurate measures of body fat percentage can be obtained using BIA and two skinfold measurements (CP-specific equations) in ambulatory individuals with CP. These findings should encourage assessments of body fat in clinical and research practices.
    MeSH term(s) Absorptiometry, Photon ; Adipose Tissue/physiopathology ; Adolescent ; Anthropometry ; Body Mass Index ; Cerebral Palsy/pathology ; Cerebral Palsy/physiopathology ; Child ; Electric Impedance ; Female ; Humans ; Male ; Skinfold Thickness ; Statistics as Topic
    Language English
    Publishing date 2014-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/dmcn.12342
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  3. Article: Puberty, statural growth, and growth hormone release in children with cerebral palsy.

    Kuperminc, Michelle N / Gurka, Matthew J / Houlihan, Christine M / Henderson, Richard C / Roemmich, James N / Rogol, Alan D / Stevenson, Richard D

    Journal of pediatric rehabilitation medicine

    2010  Volume 2, Issue 2, Page(s) 131–141

    Abstract: Objective: Children with cerebral palsy (CP) are smaller than normally growing children.. The association between the growth hormone (GH) axis and growth in children with CP during puberty is unknown. We compared growth and markers of the GH axis in pre- ...

    Abstract Objective: Children with cerebral palsy (CP) are smaller than normally growing children.. The association between the growth hormone (GH) axis and growth in children with CP during puberty is unknown. We compared growth and markers of the GH axis in pre-pubertal and pubertal children with moderate to severe CP and without CP over a three-year period.
    Study design: Twenty children with CP, ages 6-18, Gross Motor Function Classification System levels III-V, were compared to a group of sixty-three normally growing children of similar age. Anthropometry, Tanner stage, bone age, and laboratory analyses were performed every six months for three years. Laboratory values included spontaneous overnight GH release, fasting IGF-1 and IGFBP-3. Repeated measures models were used to evaluate interactions among Tanner stage and group (children with CP vs. reference children), taking into account gender, age, and nutritional status.
    Results: Children with CP grew more slowly than those without CP at all Tanner stages (p<0.01). Patterns of IGF-1 and GH secretion in children with CP were similar to those of the reference group; however, the concentrations of IGF-1 (p<0.01) and GH (p<0.01) were lower in girls with CP, with a similar trend for boys (p=0.10 and 0.14, respectively).
    Conclusions: Diminished circulating IGF-1 and GH concentrations may explain the differences in growth between the two groups.
    Language English
    Publishing date 2010-03-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2403637-7
    ISSN 1875-8894 ; 1874-5393
    ISSN (online) 1875-8894
    ISSN 1874-5393
    DOI 10.3233/PRM-2009-0072
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Anthropometric measures: poor predictors of body fat in children with moderate to severe cerebral palsy.

    Kuperminc, Michelle N / Gurka, Matthew J / Bennis, Jacey A / Busby, Marjorie G / Grossberg, Richard I / Henderson, Richard C / Stevenson, Richard D

    Developmental medicine and child neurology

    2010  Volume 52, Issue 9, Page(s) 824–830

    Abstract: Aim: This purpose of our study was to assess and compare anthropometric measures of adiposity and direct measurement of percentage body fat by dual emission X-ray absorptiometry (DXA) in children with cerebral palsy (CP). We also compared our results in ...

    Abstract Aim: This purpose of our study was to assess and compare anthropometric measures of adiposity and direct measurement of percentage body fat by dual emission X-ray absorptiometry (DXA) in children with cerebral palsy (CP). We also compared our results in children with CP with results from a national sample of typically developing children from the National Health and Nutrition Examination Survey.
    Method: Anthropometry and DXA were obtained from 58 participants with CP (25 females, 33 males; Gross Motor Function Classification System levels III-V; mean age 13 y 1 mo [SD 3 y], range 8-18 y). Height was estimated from knee height, which was measured with knee height calipers; weight was measured on a sitting scale. The relation between percentage body fat measured by DXA and z-scores of each of the anthropometric measures (body mass index, mid-upper arm circumference, triceps skinfold, and mid-upper arm fat area) was assessed by linear models. Agreement analysis was performed to assess the ability of each anthropometric measure to predict percentage body fat by DXA.
    Results: None of the anthropometric measures were adequately associated with percentage body fat by DXA. All anthropometric methods tended to underestimate percentage body fat in children with CP.
    Interpretation: Single anthropometric measures do not perform well in predicting percentage body fat in children with or without CP. Further work is needed to develop clinically useful and simple assessments that will predict percentage body fat and to determine the relation between percentage body fat and health to guide clinical practice.
    MeSH term(s) Absorptiometry, Photon ; Adipose Tissue ; Adolescent ; Anthropometry/methods ; Arm/pathology ; Body Height ; Body Mass Index ; Body Weight ; Case-Control Studies ; Cerebral Palsy/diagnosis ; Cerebral Palsy/pathology ; Child ; Databases, Factual ; Female ; Humans ; Linear Models ; Male ; Severity of Illness Index
    Language English
    Publishing date 2010-09
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/j.1469-8749.2010.03694.x
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  5. Article ; Online: Neuropsychological recovery and quality-of-life in children and adolescents with growth hormone deficiency following TBI: a preliminary study.

    Wamstad, Julia B / Norwood, Kenneth W / Rogol, Alan D / Gurka, Matthew J / Deboer, Mark D / Blackman, James A / Buck, Marcia L / Kuperminc, Michelle N / Darring, Jodi G / Patrick, Peter D

    Brain injury

    2013  Volume 27, Issue 2, Page(s) 200–208

    Abstract: Objective: To compare neurocognition and quality-of-life (QoL) in a group of children and adolescents with or without growth hormone deficiency (GHD) following moderate-to-severe traumatic brain injury (TBI).: Study designs: Thirty-two children and ... ...

    Abstract Objective: To compare neurocognition and quality-of-life (QoL) in a group of children and adolescents with or without growth hormone deficiency (GHD) following moderate-to-severe traumatic brain injury (TBI).
    Study designs: Thirty-two children and adolescents were recruited from the TBI clinic at a children's hospital. Growth hormone (GH) was measured by both spontaneous overnight testing and following arginine/glucagon stimulation administration. Twenty-nine subjects participated in extensive neuropsychological assessment.
    Results: GHD as measured on overnight testing was significantly associated with a variety of neurocognitive and QoL measures. Specifically, subjects with GHD had significantly (p < 0.05) lower scores on measures of visual memory and health-related quality-of-life. These scores were not explained by severity of injury or IQ (p > 0.05). GHD noted in response to provocative testing was not associated with any neurocognitive or QoL measures.
    Conclusions: GHD following TBI is common in children and adolescents. Deficits in neurocognition and QoL impact recovery after TBI. It is important to assess potential neurocognitive and QoL changes that may occur as a result of GHD. It is also important to consider the potential added benefit of overnight GH testing as compared to stimulation testing in predicting changes in neurocognition or QoL.
    MeSH term(s) Adolescent ; Arginine/therapeutic use ; Brain Injuries/complications ; Brain Injuries/drug therapy ; Brain Injuries/metabolism ; Brain Injuries/psychology ; Child ; Cognition Disorders/etiology ; Cognition Disorders/physiopathology ; Female ; Follow-Up Studies ; Glucagon/therapeutic use ; Hormones/therapeutic use ; Human Growth Hormone/deficiency ; Humans ; Male ; Pituitary Gland/physiopathology ; Predictive Value of Tests ; Prospective Studies ; Quality of Life ; Recovery of Function ; Young Adult
    Chemical Substances Hormones ; Human Growth Hormone (12629-01-5) ; Glucagon (9007-92-5) ; Arginine (94ZLA3W45F)
    Language English
    Publishing date 2013-02-05
    Publishing country England
    Document type Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639115-1
    ISSN 1362-301X ; 0269-9052
    ISSN (online) 1362-301X
    ISSN 0269-9052
    DOI 10.3109/02699052.2012.672786
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  6. Article ; Online: Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy.

    Gurka, Matthew J / Kuperminc, Michelle N / Busby, Marjorie G / Bennis, Jacey A / Grossberg, Richard I / Houlihan, Christine M / Stevenson, Richard D / Henderson, Richard C

    Developmental medicine and child neurology

    2009  Volume 52, Issue 2, Page(s) e35–41

    Abstract: Aim: To assess the accuracy of skinfold equations in estimating percentage body fat in children with cerebral palsy (CP), compared with assessment of body fat from dual energy X-ray absorptiometry (DXA).: Method: Data were collected from 71 ... ...

    Abstract Aim: To assess the accuracy of skinfold equations in estimating percentage body fat in children with cerebral palsy (CP), compared with assessment of body fat from dual energy X-ray absorptiometry (DXA).
    Method: Data were collected from 71 participants (30 females, 41 males) with CP (Gross Motor Function Classification System [GMFCS] levels I-V) between the ages of 8 and 18 years. Estimated percentage body fat was computed using established (Slaughter) equations based on the triceps and subscapular skinfolds. A linear model was fitted to assess the use of a simple correction to these equations for children with CP.
    Results: Slaughter's equations consistently underestimated percentage body fat (mean difference compared with DXA percentage body fat -9.6/100 [SD 6.2]; 95% confidence interval [CI] -11.0 to -8.1). New equations were developed in which a correction factor was added to the existing equations based on sex, race, GMFCS level, size, and pubertal status. These corrected equations for children with CP agree better with DXA (mean difference 0.2/100 [SD=4.8]; 95% CI -1.0 to 1.3) than existing equations.
    Interpretation: A simple correction factor to commonly used equations substantially improves the ability to estimate percentage body fat from two skinfold measures in children with CP.
    MeSH term(s) Absorptiometry, Photon/methods ; Adipose Tissue/pathology ; Adolescent ; Algorithms ; Anthropometry/methods ; Cerebral Palsy/diagnosis ; Cerebral Palsy/pathology ; Child ; Disability Evaluation ; Female ; Humans ; Male ; Regression Analysis ; Reproducibility of Results ; Sensitivity and Specificity ; Skinfold Thickness
    Language English
    Publishing date 2009-10-07
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/j.1469-8749.2009.03474.x
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  7. Article ; Online: Traumatic brain injury in children and adolescents: surveillance for pituitary dysfunction.

    Norwood, Kenneth W / Deboer, Mark D / Gurka, Matthew J / Kuperminc, Michelle N / Rogol, Alan D / Blackman, James A / Wamstad, Julia B / Buck, Marcia L / Patrick, Peter D

    Clinical pediatrics

    2010  Volume 49, Issue 11, Page(s) 1044–1049

    Abstract: Background: Children who sustain traumatic brain injury (TBI) are at risk for developing hypopituitarism, of which growth hormone deficiency (GHD) is the most common manifestation.: Objective: To determine the prevalence of GHD and associated ... ...

    Abstract Background: Children who sustain traumatic brain injury (TBI) are at risk for developing hypopituitarism, of which growth hormone deficiency (GHD) is the most common manifestation.
    Objective: To determine the prevalence of GHD and associated features following TBI among children and adolescents.
    Study design: A total of 32 children and adolescents were recruited from a pediatric TBI clinic. Participants were diagnosed with GHD based on insufficient growth hormone release during both spontaneous overnight testing and following arginine/glucagon administration.
    Results: GHD was diagnosed in 5/32 participants (16%). Those with GHD exhibited more rapid weight gain following injury than those without GHD and had lower levels of free thyroxine and follicle-stimulating hormone. Males with GHD had lower testosterone levels.
    Conclusions: GHD following TBI is common in children and adolescents, underscoring the importance of assessing for GHD, including evaluating height and weight velocities after TBI. Children and adolescents with GHD may further exhibit absence or intermediate function for other pituitary hormones.
    MeSH term(s) Adolescent ; Arginine/administration & dosage ; Brain Injuries/complications ; Brain Injuries/metabolism ; Child ; Female ; Follicle Stimulating Hormone/blood ; Glucagon/administration & dosage ; Human Growth Hormone/deficiency ; Human Growth Hormone/metabolism ; Humans ; Hypopituitarism/etiology ; Male ; Pituitary Gland/metabolism ; Prevalence ; Risk Factors ; Sex Factors ; Testosterone/blood ; Thyroxine/blood ; Weight Gain ; Young Adult
    Chemical Substances Human Growth Hormone (12629-01-5) ; Testosterone (3XMK78S47O) ; Follicle Stimulating Hormone (9002-68-0) ; Glucagon (9007-92-5) ; Arginine (94ZLA3W45F) ; Thyroxine (Q51BO43MG4)
    Language English
    Publishing date 2010-08-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 207678-0
    ISSN 1938-2707 ; 0009-9228
    ISSN (online) 1938-2707
    ISSN 0009-9228
    DOI 10.1177/0009922810376234
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