Eating and drinking ability level and its relationship with postural and swallowing characteristics in children with cerebral palsy.

Abstract

During meal, children and teenagers with cerebral palsy (CP) present difficulties that may lead to affect growth and body composition.

The objective of this study was to establish the relationship between the eating and drinking ability level (according to the Eating and Drinking Ability Classification System, EDACS), and postural and swallowing observable characteristics during meals. The participants were 2019 children and teenagers with CP at the therapeutic center F.A.R.O.S. from Córdoba.

Observational, cross-sectional study. Observations of children and teenagers were made during lunch within the facility, using an ad hoc observation guide. The sampling was intentionally designed. The variables were EDACS levels, nutritional status, postural and swallowing observable characteristics during mealtime. Normal variables were described in means with their SD, those not normal in medians with their ranges and discretes in percentages with CI95%. To analyze the association between variables, Fisher's Exact Test was performed (p<0.05). Statistical calculations were accomplished with MedCalc software version 12.5.0.0. It was approved by the Health Research Ethics Evaluation Board (REPIS No. 3262/3236) and participants gave their informed consent.

Sample composed by 27 children/teenagers, aged 7 between 19 years old, who attend the facility. 18 children showed less commitment (EDACS level I-II) (66.70% [46.07-83.51]), and 9 more commitment (EDACS level III-IV) (33.30% [16.5-53.9]) swallowing levels. 18 children showed undernutrition (66.6% [46.1-83.5]), mainly in EDACS level III-IV. EDACS level I-II and III-IV were compared, to analyze significant differences between both groups. Those with EDACS level I-II could balance their head (p = 0.000035) and align it with the neck and spine to a greater extent (p=0.000004) at mealtime. Those with EDACS level III-IV had cough (p=0.01) and sialorrhea during lunch (p=0.04). Constant sialorrhea was not associated with EDACS levels (p=0.42).

There are observable variables related to posture and swallowing that may be linked to the eating and drinking ability level in children with CP, which may prove useful for clinical evaluation.