R D Stevenson1. 1. Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, USA.
Abstract
BACKGROUND: The assessment of stature in children with cerebral palsy is difficult. This study tested the clinical utility of the segmental measures of upper-arm length, tibial length, and knee height as proxies for stature in children with cerebral palsy. METHODS: The study included 211 sets of measurements made in 172 children with cerebral palsy attending an outpatient clinic at a pediatric rehabilitation center during a 2-year period. Forty-three percent were female, 20% black, 31% diplegic or hemiplegic, and 52% nonambulatory. An observer measured weight, head circumference, recumbent length or standing height, upper-arm length, tibial length, knee height, midarm circumference, triceps skinfold, and subscapular skinfold. RESULTS: The correlation coefficients were as follows: upper-arm length and stature, .97 (95% confidence interval, .95 to .98) (R2 = .94); tibial length and stature, .97 (95% confidence interval, .96 to .98) (R2 = .94); and knee height and stature, .98 (95% confidence interval, .98 to .99) (R2 = .97). The linear regression equations were used to develop formulas for the estimation of stature from a segmental measure. CONCLUSIONS: Upper-arm length, tibial length, and knee height are all reliable and valid proxies for stature in children with cerebral palsy up to 12 years of age. We recommend that either knee height or tibial length be measured in the routine anthropometry of children with cerebral palsy who cannot be measured by standard techniques. Estimates of stature can then be calculated and plotted on standard growth charts.
BACKGROUND: The assessment of stature in children with cerebral palsy is difficult. This study tested the clinical utility of the segmental measures of upper-arm length, tibial length, and knee height as proxies for stature in children with cerebral palsy. METHODS: The study included 211 sets of measurements made in 172 children with cerebral palsy attending an outpatient clinic at a pediatric rehabilitation center during a 2-year period. Forty-three percent were female, 20% black, 31% diplegic or hemiplegic, and 52% nonambulatory. An observer measured weight, head circumference, recumbent length or standing height, upper-arm length, tibial length, knee height, midarm circumference, triceps skinfold, and subscapular skinfold. RESULTS: The correlation coefficients were as follows: upper-arm length and stature, .97 (95% confidence interval, .95 to .98) (R2 = .94); tibial length and stature, .97 (95% confidence interval, .96 to .98) (R2 = .94); and knee height and stature, .98 (95% confidence interval, .98 to .99) (R2 = .97). The linear regression equations were used to develop formulas for the estimation of stature from a segmental measure. CONCLUSIONS: Upper-arm length, tibial length, and knee height are all reliable and valid proxies for stature in children with cerebral palsy up to 12 years of age. We recommend that either knee height or tibial length be measured in the routine anthropometry of children with cerebral palsy who cannot be measured by standard techniques. Estimates of stature can then be calculated and plotted on standard growth charts.
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