{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:23:22Z","timestamp":1788269002378,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordination for the Improvement of Higher Education Personnel\u2014Brazil","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Ci\u00eancia e Tecnologia do Estado de Pernambuco (FACEPE) awarded a master scholarship to Tatielle de Lima Vieira","award":["IBPG-0350-4.09\/25"],"award-info":[{"award-number":["IBPG-0350-4.09\/25"]}]},{"name":"National Council for Scientific and Technological Development (CNPq) awarded Paulo Adriano Schwingel a Research Productivity Grant","award":["306628\/2025-2"],"award-info":[{"award-number":["306628\/2025-2"]}]},{"award":["306628\/2025-2"],"award-info":[{"award-number":["306628\/2025-2"]}],"id":[{"id":"https:\/\/ror.org\/03swz6y49","id-type":"ROR","asserted-by":"publisher"}]},{"name":"FACEPE previously provided a Research Productivity Grant","award":["BPP-0003-4.01\/24"],"award-info":[{"award-number":["BPP-0003-4.01\/24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NeuroSci"],"abstract":"<jats:p>Purpose: To examine the association between diaphragmatic thickness and upper arm muscle area (AMA), as a surrogate of nutritional status, in children and adolescents with cerebral palsy (CP) stratified by gross motor function severity. Methods: In this cross-sectional study, participants were stratified into ambulatory (Gross Motor Function Classification System [GMFCS] I\u2013III) and non-ambulatory (GMFCS IV\u2013V) groups. AMA was estimated from anthropometric measurements, and diaphragmatic thickness was assessed by B- and M-mode ultrasonography; between-group comparisons used the Mann\u2013Whitney U test and associations were examined using Spearman\u2019s rank correlation coefficient (\u03c1). Results: Fifty children aged 2\u201312 years with a confirmed CP diagnosis were evaluated (14 ambulatory, 36 non-ambulatory). In the non-ambulatory group, diaphragmatic thickness showed significant positive correlations with AMA during inspiration (\u03c1 = 0.50; p = 0.002) and expiration (\u03c1 = 0.67; p &lt; 0.001). These subgroup-specific associations should be interpreted as exploratory, as the AMA \u00d7 GMFCS interaction did not reach statistical significance. No significant correlations were observed in ambulatory participants. Moderate muscle mass deficits were prevalent among non-ambulatory children, and approximately 63% of the total sample presented adipose tissue deficit or risk thereof. Conclusions: In children with severe CP, a significant association between peripheral muscle reserve and diaphragmatic thickness suggests a possible functional link between nutritional status and respiratory muscle morphology. These preliminary findings support further investigation of diaphragmatic ultrasonography as a non-invasive tool for combined nutritional and respiratory monitoring in pediatric neurorehabilitation.<\/jats:p>","DOI":"10.3390\/neurosci7050096","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:41:18Z","timestamp":1788266478000},"page":"96","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diaphragmatic Thickness as a Marker of Systemic Muscle Depletion in Non-Ambulatory Children with Cerebral Palsy: Implications for Integrated Neurorehabilitation Assessment"],"prefix":"10.3390","volume":"7","author":[{"given":"Maracy Balbino Morgado","family":"Sobreira","sequence":"first","affiliation":[{"name":"Graduate Program in Rehabilitation and Functional Performance (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Research Group in Neonatology and Pediatrics (Baby GrUPE), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2339-8141","authenticated-orcid":false,"given":"Tatielle de Lima","family":"Vieira","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation and Functional Performance (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Research Group in Neonatology and Pediatrics (Baby GrUPE), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Laborat\u00f3rio de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3538-5687","authenticated-orcid":false,"given":"Helga Cec\u00edlia Muniz","family":"de Souza","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Federal University of Pernambuco (HC-UFPE), Recife 50670-901, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4949-6268","authenticated-orcid":false,"given":"B\u00e1rbara Bernardo","family":"Figueir\u00eado","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation and Functional Performance (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Research Group in Neonatology and Pediatrics (Baby GrUPE), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-3403","authenticated-orcid":false,"given":"Paulo Adriano","family":"Schwingel","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation and Functional Performance (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Laborat\u00f3rio de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-9291","authenticated-orcid":false,"given":"Paulo Andr\u00e9 Freire","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation and Functional Performance (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"},{"name":"Research Group in Neonatology and Pediatrics (Baby GrUPE), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1469-8749.2007.tb12610.x","article-title":"A Report: The Definition and Classification of Cerebral Palsy April 2006","volume":"49","author":"Rosenbaum","year":"2007","journal-title":"Dev. 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