Use of segmental measures to estimate stature in children with cerebral palsy
R. D. Stevenson
Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, USA.
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.
