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Abstract：
The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.
摘要：
对脑瘫（CP）儿童的监测应包括对营养状况的精确评估，以确定有营养障碍风险的儿童和青少年。评估CP儿童营养状况的现有研究主要集中在身体成分与运动障碍并存之间的关系。经常忽视肌肉张力的作用。因此,本研究的目的是评估CP患儿身体成分与肌张力之间的关系.在一项病例对照研究中(n=118；平均年龄11岁；SD=3.8)，患有CP的儿童表现出不同阶段的功能能力，对应于粗大运动功能分类系统(GMFSC)中的所有级别，和所有等级的Ashworth量表描述的肌肉张力。对照组为健康儿童和青少年,严格匹配性别和年龄1:1病例对照方式。发现患有CP的儿童的无脂肪质量的平均值显着降低（FFMkg=29.2vs.34.5，p<0.001)，肌肉质量（MMkg=18.6vs.22.6，p<0.001)，身体细胞质量(BCMkg=15.1vs.18.3，p<0.001)，和全身水分(TBWL=23.0vs.26.7，p<0.001）。在性别方面确定了身体组成的相同差异（分别为p<0.01）。此外，发现肌张力较高（Ashworth量表得分较高）的儿童的脂肪量（FM）值显着较低，FFM,MM,BCM,和TBW(p<0.05)。研究结果表明，与健康儿童相比，CP儿童的身体成分参数较低，在研究组中，参数的降低与较高的肌肉张力相吻合。该观察结果表明，有必要在评估CP儿童的营养状况时测量肌肉张力。
