Resting metabolic rate of adults with cerebral palsy is higher than age-matched controls

Adults with cerebral palsy (CP) exhibit problems of energy balance, resulting in extremes of leanness and fatness. To examine whether resting energy needs are different between adults with CP and age-matched controls without CP, we compared resting metabolic rate and body composition between these groups. Eleven adults with CP were compared with 50 normal, healthy controls within the same age range (18–40). Resting metabolic rate (RMR) using indirect calorimetry, body composition, anthropometrics, and usual physical activity patterns were determined. There were no significant differences in height, weight, fat-free mass, percent body fat, or calories expended in physical activity between the two groups. The CP subjects had a measured RMR that was 19 percent higher (p ≤ .05) than the controls (1945 versus 1576 kcal/24 hours). After statistically adjusting for individual differences in fat-free mass, a 22 percent higher RMR remained (p ≤ .05) in the CP subjects (2011 versus 1560 kcal/24 hours). This adjustment was needed because energy needs are a function of the metabolically active cell mass, and therefore a person's RMR must be evaluated relative to their fat-free body mass; not just relative to total body weight. Thus, the higher RMR of these CP subjects was independent of any differences in fat-free mass. These results suggest that resting energy needs of adults with CP are higher for their metabolic size than normal controls. Thus, energy requirements of CP adults cannot be estimated with any degree of accuracy from the traditional methods which are based on the resting energy needs of healthy adults without disabilities.