The Resource Interventions for feeding and nutrition in cerebral palsy, prepared for Agency for Healthcare Research and Quality ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Elizabeth D. Ferluga, Kristin R. Archer, Nila A. Sathe, Shanthi Krishnaswami, Andrea Klint, Mary Lou Lindegren, Melissa L. McPheeters

Interventions for feeding and nutrition in cerebral palsy, prepared for Agency for Healthcare Research and Quality ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Elizabeth D. Ferluga, Kristin R. Archer, Nila A. Sathe, Shanthi Krishnaswami, Andrea Klint, Mary Lou Lindegren, Melissa L. McPheeters

Label
Interventions for feeding and nutrition in cerebral palsy
Title
Interventions for feeding and nutrition in cerebral palsy
Statement of responsibility
prepared for Agency for Healthcare Research and Quality ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Elizabeth D. Ferluga, Kristin R. Archer, Nila A. Sathe, Shanthi Krishnaswami, Andrea Klint, Mary Lou Lindegren, Melissa L. McPheeters
Title variation
  • Feeding and nutrition in cerebral palsy
  • Effective health care program
Creator
Contributor
Author
Subject
Genre
Language
eng
Summary
Objectives: The Vanderbilt Evidence-based Practice Center examined the effects of available interventions for feeding and nutrition problems that have been evaluated in individuals with cerebral palsy (CP). Data sources: MEDLINE via the PubMed interface, PsycINFO (psychology and psychiatry literature), the Educational Resources Information Clearinghousesm, OTSeeker, REHABDATA, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Additional studies were identified from reference lists and technical experts. Review methods: We reviewed studies providing effectiveness data for feeding interventions in populations of any age with CP. We included studies focused on nonsurgical and surgical interventions for feeding and nutrition difficulties. Nonsurgical interventions included positioning, oral appliances, oral stimulation, sensorimotor facilitation, and caregiver training. Surgical interventions included gastrostomy or jejunostomy tubes and fundoplication. We assessed both intermediate/surrogate and patient-centered/health outcomes. Results: Fifteen articles (comprising 13 unique studies) met our inclusion criteria. One good quality systematic review on behavioral interventions for feeding issues in individuals with cerebral palsy was published in 2011 and is updated with one additional study on caregiver education in this review. The existing review included 21 studies with conflicting results related to the effects of sensorimotor interventions on short-term improvements in feeding. Eleven studies (nine case series) of surgical interventions met our inclusion criteria. These studies included 309 children. In all nine studies of gastrostomy (with or without fundoplication), gastrostomy-fed children gained weight. Baseline weight z-scores ranged from -3.56 to -0.39; followup z-scores ranged from -2.63 to -0.33, relative to typically developing populations. Two studies assessed fundoplication for reflux: in one RCT both Nissen fundoplication and vertical gastric plication reduced reflux (reduction in symptoms of 57% and 43%, respectively), while in one case series, reflux recurred within 12-months postfundoplication in 30 percent of children. The highest rates of reported harms in any study were minor site infection (59%), formation of granulation tissue (42%), gastric leakage, recurrent reflux (30%), and aspiration and pneumonia (29%). Even though the reported death rates ranged from 7 percent to 29 percent, the underlying cause of death was most likely not due to the surgical treatment. Conclusions: Evidence for behavioral interventions for feeding disorders in CP consists of mostly small, short-term, pre-post studies, with strength of evidence ranging from insufficient to moderate. Some studies suggest that interventions such as oral appliances may enhance oral sensorimotor skills, but there is a clear need for rigorous, comparative studies. Evidence for surgical interventions is insufficient to low. All studies to date demonstrate significant weight gain with gastrostomy. Results for other growth measures are mixed, and substantial numbers of children remained underweight, although given a lack of appropriate reference standards for the CP population, these results should be interpreted cautiously. Longer term, comprehensive case series are needed, as are prospective cohort studies. More research is needed to understand potential harms in the context of benefits and potential risks of not treating
Member of
Cataloging source
MMU
http://library.link/vocab/creatorName
Ferluga, Elizabeth D
Funding information
Supported by the Vanderbilt Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (AHRQ)
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WL 342
http://library.link/vocab/relatedWorkOrContributorName
  • Archer, Kristin R.
  • Sathe, Nila A.
  • Krishnaswami, Shanthi
  • Klint, Andrea
  • Lindegren, Mary Louise
  • McPheeters, Melissa L.
  • Vanderbilt Evidence-based Practice Center
  • United States
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication,
Series volume
  • no. 94
  • no. 13-EDHC015-EF
http://library.link/vocab/subjectName
  • Cerebral Palsy
  • Nutrition Disorders
  • Comparative Effectiveness Research
  • Feeding Methods
  • Fundoplication
  • Gastrostomy
  • Jejunostomy
  • United States
  • United States
http://bibfra.me/vocab/relation/supportingbody
RzTDSdffmEM
Label
Interventions for feeding and nutrition in cerebral palsy, prepared for Agency for Healthcare Research and Quality ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Elizabeth D. Ferluga, Kristin R. Archer, Nila A. Sathe, Shanthi Krishnaswami, Andrea Klint, Mary Lou Lindegren, Melissa L. McPheeters
Instantiates
Publication
Note
"March 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
840646236
Extent
1 online resource (175 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)840646236
Label
Interventions for feeding and nutrition in cerebral palsy, prepared for Agency for Healthcare Research and Quality ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Elizabeth D. Ferluga, Kristin R. Archer, Nila A. Sathe, Shanthi Krishnaswami, Andrea Klint, Mary Lou Lindegren, Melissa L. McPheeters
Publication
Note
"March 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
840646236
Extent
1 online resource (175 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)840646236

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