PREVALENCE AND RISK FACTORS ASSOCIATED WITH CONSTIPATION CEREBRAL PALSY CHILDREN IN PAKISTAN
Objective: To find prevalence of constipation and associated risk factors among cerebral palsy. Material & Methods: The Cross sectional and case control study was conducted in physiotherapy department of National Institute of Rehabilitation Medicine Islamabad (NIRM) after approval from director of NIRM. The inclusion criteria were CP children with age between 2-12 years and Children with any other systemic co morbidities, physical deformity in GIT, intellectual disability and recent traumatic brain injury were excluded. A total of n=170 subjects fulfilled the inclusion criteria and were part of the study. The data was collected in term of age, gender, body mass index (BMI), types of CP children, fluid, fiber and calories intake. Spasticity and functional independence were also measured through Modified Ashworth scale (MAS) and Gross Motor Function Classification System (GMFCS) respectively. The constipation in CP children was measure through defecation frequency. Defecation frequency measured less than three times a week was considered constipation and Constipation assessment scale (CAS). The data was described in the form of frequency, percentage, mean, standard deviation, correlation, chi-square and p-value. Results: The results showed that all characteristics including age, spasticity, functional independence, fluid intake, calories intake, fiber intake, physiological and topographical type of CP children showed significant association (p<0.05) with defecation frequency and constipation severity except BMI and gender (p≥0.05). Conclusion: Constipation is highly prevalent in cerebral palsy. The early age, increased spasticity, decreased functional independence related to increased constipation CP children. It was also concluded that low fluid, calories and fiber intake were also contributing factor in development of constipation. The children with spastic cerebral palsy and quadriplegia are more related to constipation than other kind of cerebral palsy
Keywords: Cerebral palsy, constipation, constipation severity scale, defecation frequency, modified ashworth scale, gross motor functional classification scale.