Children with intestinal failure, both on enteral nutrition and parenteral nutrition, are weaker than healthy literature controls, and decreased strength was associated with lower fat-free mass, with this relationship stronger in males than in females.
Key Findings
Results
Children with intestinal failure had significantly lower handgrip strength compared to published norms.
31 children aged 4-18 years with intestinal failure were included (71% male, mean age 9.9 years)
Handgrip strength was significantly lower compared to published norms (p = 0.004)
80.6% of children with IF scored below the mean for handgrip strength
Handgrip strength was measured using a dynamometer
Results
Children with intestinal failure had significantly lower knee flexion and extension strength compared to published norms.
Knee flexion was significantly lower compared to published norms (p = 0.002)
Knee extension was significantly lower compared to published norms (p < 0.001)
71.0% of children scored below the mean for knee flexion and 74.2% for knee extension
Knee flexion and extension were measured using a dynamometer
Results
A substantial proportion of children with intestinal failure demonstrated impaired functional strength as measured by the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2).
26.9% of children had BOT-2 scores less than -1 SD from the norm
Functional strength was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2)
31 children were included in the study, with 12 (39%) receiving parenteral nutrition
Results
No significant differences in strength were found between children with intestinal failure receiving enteral nutrition versus parenteral nutrition.
12 of 31 children (39%) received parenteral nutrition
The remaining children received enteral nutrition
No significant differences in handgrip strength, knee flexion, or knee extension were found between the two nutrition groups
Results
A significant positive relationship was found between functional strength and body composition, with increased fat-free mass and decreased fat mass associated with greater strength.
Linear regression revealed a significant positive relationship between functional strength and fat-free mass and fat mass (r2 = 0.36, p = 0.002)
Body composition was assessed using dual-energy X-ray absorptiometry (DXA)
Male sex strengthened this relationship (r2 = 0.62, p < 0.001)
The relationship between body composition and strength was stronger in males than in females
Yanchis D, So S, Patterson C, Belza C, Garofalo E, Wong-Sterling S, et al.. (2026). Reduced strength is associated with abnormal body composition in children with a history of intestinal failure.. Journal of pediatric gastroenterology and nutrition. https://doi.org/10.1002/jpn3.70307