Multifactorial influences on constipation in children with cerebral palsy: a cross-sectional study of diet, motor function, and spasticity

Objective: Constipation is an important problem in cerebral palsy (CP) and its exact cause is not known. The aim of this study was to investigate constipation and related factors in children with cerebral palsy. Material and Methods: This cross-sectional study was conducted with 68 children with CP between October 2024 and January 2025. Socio-demographic data, Gross Motor Function Classification System (GMFCS) scores, Functional Independence Measure for Children (WeeFIM), Modified Ashworth Scale (MAS), 24-hour food intake records, anthropometric measurements, and Bristol Stool Scale evaluations were collected. Results: It was found that constipation complaints increased with higher GMFCS scores, while constipation complaints decreased with improved WeeFIM scores and increased carbohydrate intake (p=0.013; p=0.040; p=0.031, respectively). Additionally, constipation severity worsened as spasticity in the right and left adductor muscles increased (p=0.001; p=0.002, respectively). Malnutrition, as indicated by the upper mid-arm circumference z-score and Body Mass Index z-scores, was associated with increased constipation (p=0.019; p=0.040, respectively). Sixty-four point seven percent (64.7%) of the mothers reported using dried apricots to alleviate constipation in their children. Conclusion: Managing constipation in CP requires a multidisciplinary approach, integrating nutritional counseling, motor rehabilitation, and spasticity control. This study highlights the need for comprehensive interventions, moving beyond diet modifications to include physical therapy and functional independence strategies for effective constipation management in CP.