Determinants for prevention of muscle loss in cerebral palsy

To date, little is known about accelerated ageing in people with cerebral palsy (CP), let alone what factors influence muscle loss in this population.

It is known however that individuals with CP, already at young age, have smaller muscles and muscle atrophy.1 2 Moreover, many people with CP also experience a decline in gross motor function when they grow older.3 4 This potentially links to loss of muscle mass. The clinical observation of muscle wasting has prompted a comparison with sarcopenia in older adults.

The Journal of Cachexia, Sarcopenia and Muscle recently published ‘Determinants of muscle preservation in individuals with cerebral palsy across the lifespan; a narrative review of the literature’.

This narrative review describes:
1. The characteristics of accelerated musculoskeletal aging in people with CP;
2. The pathophysiology of sarcopenia in elderly and parallels with CP;
3. The possible therapeutic approaches for CP based on established approaches for sarcopenia.

Future research should investigate the effect of a nutritional intervention (combined with exercise training) as a preventive strategy among persons with CP.

The review is a collaboration between Danone Nutricia Research and the Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus and De Hoogstraat Rehabilitation, Utrecht, the Netherlands and 3 experts in the field from Australia and the US.

About CP
Cerebral Palsy is a physical disability that affects movement and posture and it is the most common cause of physical disability in childhood. The authors of the paper state cerebral palsy is the most common paediatric‐onset physical disability, with a prevalence of 1.7–3.1 per 1000 livebirths in high‐income countries and higher prevalence in low‐income countries. CP is a life-long condition and is caused by damage to the developing brain. People with CP have poor muscle control, which can be a potential risk for undernourishment as it may hamper a child’s ability to e.g. chew or swallow.

Click here to read more and here for a poster about getting older with CP (in Dutch). The links refer to De BOSK, a Dutch organisation uniting people with CP.

Herskind A, Ritterband-Rosenbaum A, Willerslev-Olsen M, Lorentzen J, Hanson L, Lichtwark G, et al. Muscle growth is reduced in 15-month-old children with cerebral palsy. Dev Med Child Neurol 2015;58:485–491. .
Barber L, Hastings-Ison T, Baker R, Kerr Graham H, Barrett R, Lichtwark G. Journal of Cachexia, Sarcopenia and Muscle 2018 DOI: 10.1002/jcsm.12287 The effects of botulinum toxin injection frequency on calf muscle growth in young children with spastic cerebral palsy: a 12-month prospective study. Journal of Children’s Orthopaedics 2013;7:425–433.
Murphy KP, Molnar GE, Lankasky K. Employment and social issues in adults with cerebral palsy. Arch Phys Med Rehabil 2000;81:807–811.
Bottos M, Feliciangeli A, Sciuto L, Gericke C, Vianello A. Functional status of adults with cerebral palsy and implications for ttreatment of children. Dev Med Child Neurol 2001;43:516–528.