{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:18:39Z","timestamp":1783491519128,"version":"3.55.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with neurological impairment are at high risk of malnutrition and require regular nutritional monitoring. Telemedicine has been increasingly used to support follow-up visits, but its impact on nutritional outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a longitudinal observational study including 152 children with neurological impairment. Patients received either standard in-person follow-up or a combination of in-person and telemedicine visits. Nutritional status was assessed using body mass index (BMI) z-score at baseline and follow-up. Nutritional outcome was classified as improved, stable, or worsened based on changes in BMI z-score. The aim of this study was to evaluate the association between telemedicine follow-up and nutritional outcomes and to identify clinical factors associated with nutritional worsening. Multivariable logistic regression was performed to identify predictors of nutritional deterioration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, children in the telemedicine group were younger and had a higher prevalence of percutaneous endoscopic gastrostomy (PEG) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), while no differences were observed in gross motor function classification system (GMFCS) severity or baseline nutritional status. No significant differences were observed between groups in BMI z-score at follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.877), change in BMI z-score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.458), nutritional status at follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.356), or nutritional outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.329). In multivariable analysis, baseline BMI z-score was associated with nutritional worsening (OR 1.23, 95% CI 1.04-1.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), whereas telemedicine follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.166), age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.767), PEG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.869), GMFCS severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.704), and follow-up duration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.352) were not associated with worsening.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline BMI z-score was the only variable independently associated with nutritional worsening during follow-up. No statistically significant differences in nutritional outcomes were observed between telemedicine and standard care groups; however, differences in baseline characteristics limit direct comparability. Telemedicine may represent a feasible and complementary approach to support follow-up in nutritionally vulnerable pediatric patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1868448","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:56:37Z","timestamp":1783490197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Telemedicine follow-up and nutritional outcomes in children with neurological impairment: a longitudinal study"],"prefix":"10.3389","volume":"14","author":[{"given":"Francesca","family":"Eletti","sequence":"first","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Perico","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Visioli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Montanari","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Metabolic Diseases Unit, Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica Maria","family":"Tagi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Metabolic Diseases Unit, Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Vizzuso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Calcaterra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]},{"name":"Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Borsani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianvincenzo","family":"Zuccotti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"630365","DOI":"10.3389\/fped.2021.630365","article-title":"Barriers and facilitators for implementing paediatric telemedicine: rapid review of user perspectives","volume":"9","author":"Tully","year":"2021","journal-title":"Front Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e1257","DOI":"10.1212\/WNL.0000000000010010","article-title":"Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic","volume":"95","author":"Rametta","year":"2020","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13052-023-01408-9","article-title":"Present and future of telemedicine for pediatric care: an Italian regional experience","volume":"49","author":"Zuccotti","year":"2023","journal-title":"Ital J Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1452880","DOI":"10.3389\/fnut.2024.1452880","article-title":"Telemedicine in nutritional management of children with severe neurological impairment: implication for quality of life","volume":"11","author":"Tagi","year":"2024","journal-title":"Front Nutr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"455","DOI":"10.3390\/nu17030455","article-title":"Telemedicine for personalized nutritional intervention of rare diseases: a narrative review on approaches, impact, and future perspectives","volume":"17","author":"Eletti","year":"2025","journal-title":". 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