Study On The Correlations Between The Levels Of Gross Motor Function Classification,eating And Drinking Ability Classification For Children With Cerebral Palsy And Their Nutritional Status

Purpose Study the correlations among the levels of gross motor function classification system（GMFCS）,eating and drinking ability classification system（EDACS）for children with cerebral palsy（CP）,and their nutritional status assessed with Subjective Global Nutritional Assessment（SGNA）and World Health Organization Child Growth Standards Z score,respectively.Compare the strengths of the correlations,and find the differences between these function classification systems and nutrition assessment methods.Provide helpful reference for the clinical applications of these methods,especially the new one,such as EDACS and SGNA.Methods 81 children with CP were adopted and treated in the Department of Pediatric Rehabilitation of Anhui Children’s Hospital from January 2021 to April 2021.EDACS and GMFCS are used to classify their function level,and SGNA and Z score were applied to assess their nutritional status.Kendall tau_b coefficient is used to analyze the correlations between EDACS and GMFCS levels.Weighted-Kappa coefficient is used to analyze the consistency between SGNA and Z score.Chi test is used to analyze the correlations between EDACS（or GMFCS）levels and the nutritional status verified with SGNA（or Z score）.Results 1.The Kendall tau_b coefficient between EDACS and GMFCS is Kτ=0.345,P（2-tailed）=0.001,showing weak positive correlations on 0.01 significance level.2.The weighted-Kappa coefficient between SGNA and Z score is κ=0.709（95% CI:0.569-0.850）,the consistency is relatively strong.3.Chi test of EDACS and malnutrition（Z scores）shows the Pearson Chi value ofχ2=6.359 > χ20.05（1）= 3.841,P（2-tailed）=0.012,i.e.EDACS is correlated with Z score malnutrition on the significance level of 0.05.Chi test of EDACS and SGNA malnutrition shows the Pearson Chi value of χ2=10.104 > χ20.005（1）= 7.879,P（2-tailed）=0.001,i.e.EDACS is correlated with SGNA malnutrition on the significance level of 0.005.4.Chi test of GMFCS and Z score malnutrition shows the Pearson Chi value ofχ2=7.088 > χ20.01（1）= 6.635,P（2-tailed）=0.008,i.e.GMFCS is correlated with Z score malnutrition on the significance level of 0.01.Chi test of GMFCS and SGNA malnutrition shows the Pearson Chi value of χ2=3.961 > χ20.05（1）= 3.841,P（2-tailed）=0.047,i.e.GMFCS is correlated with SGNA malnutrition on the significance level of 0.05.Conclusion For children with CP,EDACS levels are weakly and positively correlated with GMFCS levels.SGNA and Z score nutrition assessments are in relatively strong consistency.EDACS has stronger correlation with SGNA than GMFCS,but has weaker correlation with Z score than GMFCS.As new tools of assessing the eating function and nutrition status for children with CP,EDACS and SGNA are helpful complementary methods besides traditional GMFCS and Z score.They provide new and efficiency assessment methods for children with CP who have potential malnutrition risk.The results of these studies imply that it is necessary to perform full assessment on children with CP.It will make the nutritional diagnosis for children with CP more accurate,and the malnutrition problem can be found earlier.Thus,the children with CP who has malnutrition problem can be nutritionally intervened in time,which is helpful for their prognosis.