Growth

The literature describes children with CP who are shorter and lighter than the reference standard. This may be the result of several factors. Individuals with CP have alterations in muscle tone affecting their limbs and torso, depending on the level of severity and topography. They often exhibit muscle contractures, depending on the type of CP; muscle spasticity may retard bone growth. Limited physical activity may impede growth. Immobilization may be required after orthopedic surgery. Immobilization inhibits bone formation and longitudinal growth and results in suppression of certain growth-stimulating hormones. It has been suggested that dysregulation of growth hormone secretion may be another factor affecting growth.

A growth reference for children with spastic quad-riplegia has been developed to facilitate uniformity in clinical appraisal as well as to simplify comparative interpretation of growth data. These growth curves can be seen in Figures 1-6. It is important to view the velocity of rate of growth from one measurement to another to aid clinical management. The rate of growth in children with CP is slower so that as they get older, the difference from the standard becomes greater.

Both nutritional and nonnutritional factors influence growth in children with CP. Nonnutritional

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