Iron deficiency anemia, the most common type of nutritional deficiency, has a negative impact on motor function and muscle strength in children with spastic cerebral palsy, according to a recent study.
The results, “Impact of Iron Deficiency Anemia on Functional Abilities and Muscle Strength in Children with Spastic Cerebral Palsy,” were published in the Pakistan Journal of Biological Sciences.
Iron deficiency anemia is a common type of anemia caused by low ingestion of iron in the diet. Iron is a mineral needed to make hemoglobin, the protein responsible for transporting oxygen in the blood to all tissues in the body, including muscles.
Children with cerebral palsy (CP) are particularly susceptible to malnutrition and dietary deficiencies, due to self-feeding issues, mastication (chewing) and swallowing difficulties associated with muscle impairments, prolonged feeding times, and inadequate diet.
However, no study so far has explored the possible impact of iron deficiency anemia on the development and motor performance of children with CP.
To explore the possible effects of iron deficiency anemia on motor function and muscle strength in children with CP, researchers analyzed and compared the scores of several motor and muscle strength tests in children with the disease with and without anemia.
The study included data from 100 children with spastic CP (both female and male patients) age 4–6 years, who were being followed at the Outpatient Clinic of Pediatrics at the Faculty of Physical Therapy, Cairo University.
Following enrollment, children were divided into two groups: group A included 50 children with spastic CP and anemia (25 hemiplegic and 25 diplegic); and group B included 50 children with spastic CP who did not have anemia (25 hemiplegic and 25 diplegic). Notably, hemiplegic CP is a form of CP that affects only one side of the body, while diplegic CP affects both sides.
Investigators collected blood samples from all children to measure the levels of hemoglobin and iron. Fine and gross motor functions were assessed by locomotion, stationary and grasping sub-tests of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). That test is designed to assess gross and fine motor skills in children from birth until age 5.
The Jamar hydraulic hand dynamometer was used to measure children’s hand grip strength and a Lafayette manual muscle test system assessed their knee extensor strength.
Findings revealed the PDMS-2 sub-test scores were significantly lower (worse) in children with spastic CP and iron deficiency anemia. Likewise, knee extensor and hand grip strength were significantly lower in children with spastic CP and anemia, compared to those with CP but without anemia.
Additionally, statistical analyses found a strong positive correlation between hemoglobin levels, motor skills and muscle strength, as well as between iron levels and all measured variables.
“This study discovered the impact of iron deficiency anemia on functional abilities and muscle strength in children with spastic CP, which can be beneficial for the early identification of iron deficiency anemia in CP children to prevent its neurodevelopmental consequences and to help researchers to approach the critical areas that affect motor abilities and muscular strength in those children that many researchers were not able to explore,” the researchers concluded.