Effect of a Nutritional Support System for Improving Gross Motor Function in Cerebral Palsy

Background: Most patients with cerebral palsy (CP) are dependent on parents due to the spasticity and limitations in their gross motor function. Additionally, many of them do not respond to physical therapy due to deterioration in their nutritional status, which is secondary to gastrointestinal disorders, parasitosis, dysbiosis and the catabolic state of the disease itself. Evidence suggests that greater independence and better clinical response can be achieved by correcting the nutritional status. However, basic treatments only contemplate the calculation of energy requirements and do not consider important nutrients in particular, supplementation with glutamine, arginine, zinc, selenium, colecalciferol, nicotinic acid, spirulina, omega 3, ascorbic acid, vegetal protein or even probiotics.

Objective: To determine the effect of using a nutritional support system (NSS) diet, supplements and probiotic on the gross motor function in children with CP with spastic diparesic and Gross Motor Function Classification System III (GMFCS III).

Material and methods: In an exploratory study with controlled clinical trial design, 30 patients were randomly assigned to receive: 1) dietary surveillance and conventional therapy (FG), 2) deworming and WHO diet (CG), or 3) deworming and the NSS (IG). The patients were recruited from the Children´s Telethon Rehabilitation Center (CRIT) in Tlalnepantla Estado de México. Males and females aged 4-12 years were included with CP and spastic diparesic GMFCS III, who had a full-time caregiver and whose parents agreed to participate. They were studied for thirteen weeks. Gross motor function was evaluated at baseline and at 7 and 13 weeks after therapy using the GMFM scale.

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Key information

Conditions

Nutrition Disorder, Child Child Nutrition Disorders Diet Modification Gross Motor Development Delay Neuro: Cerebral Palsy Nutrition Disorders Nutritional and Metabolic Diseases Probiotics

Age range

4 year–12 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients with CP with spastic diparesia and GMFCS III
Re-entry
Presence and support of a full-time caregiver
To tolerate oral feeding
Parents or guardians agree in writing to participate in the project
Patients treated at the CRIT of Tlalnepantla Edo. Mex
That the children, in the case of being able to write, accept in writing to participate in the project

Exclusion criteria

Presence of any other catabolic disease, which further increases the risk of malnutrition (renal, cardiovascular, pulmonary, hepatic, immunological)
Have had infectious problems or have received antibiotic treatment 15 days prior to the start of the study.
Have received botulinum toxin therapy in the last 4 months
Muscle relaxants in the last 6 months
Severe gastroesophageal reflux
Patients with any type of surgery performed with a period shorter than 9 months
That can walk by themselves

Treatment and study plan

Nutritional support system (NSS)

Dietary Supplement

Envelope 1 4.9g of Spirulina, 100mg ascorbic acid, 5mg folic acid and 10mg of glutamine. Was to be added to shake 1 during the first 10 days. Envelope 2 1g PUFAs n-3 and was to be added to shake 2 which was given throughout the intervention. Envelope 3 4.9g of Spirulina Maximum, 100mg ascorbic acid, 5mg folic acid, 5.2g vegetable protein, 125mg nicotinic acid, 50mg zinc, 100 mcg selenium and 800 UI cholecalciferol. Was to be added to shake 1 from day 11 until the end of week 6, after which it was suspended for 10 days and substituted for envelope 5 and then to be retaken until the end of the intervention. Envelope 4. 1g arginine and was to be added to shake 3 from day 8 until the end of the intervention. Envelope 5 contained the same ingredients as envelope 3 with an additional 10mg glutamine and was to be added to shake 1 from the start of week 7 for 10 days, after which envelope 3 was restarted. Probiotic at a dosage of 200 mg every 12 hours for 3 days at the beginning and week 6

Other names: Intervention treatment

deworming

Other

nitazoxanide at a dosage of 7.5 mg / kg every 12 hours for 3 days.

recommended diet

Other

WHO Diet

Primary outcomes

Change from Gross Motor function Measure at 7 and 13 weeks

Time frame: The GMFM scale was performed at baseline time and weeks 7 and 13 after intervention.
This scale assesses five general parameters:
- Lying (decubitus) and rolling over (GMFAV),
- Sitting (GMFB),
- Crawling and kneeling (GMFC),
- Standing (GMFD),
- Walking (GMFE) and one final total item (GMFF).
The scoring system consists of 88 items and each one is valued based on the following criteria:

0= No,
- start,
- Partially Complete,
- Complete, NE= Not evaluated

Sponsors and collaborators

Lead sponsor

Anahuac University

Other

Registry information

Official study title

CONTROLLED, RANDOMIZED, BLIND CLINICAL TRIAL OF EFFECT OF A NUTRITIONAL SUPPORT SYSTEM (DIET, SUPPLEMENTS AND PROBIOTIC) FOR IMPROVING GROSS MOTOR FUNCTION IN CEREBRAL PALSY

Acronym: ENSSIGMCP

Important dates

Study start: 2015
Primary completion: 2015
Study completion: 2017
First posted: May 1, 2019
Registry last updated: May 1, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed