Abstract / Summary
Background/Objectives: Accurate assessment of resting energy expenditure (REE) and total energy expenditure (TEE) in children with cerebral palsy (CP) remains challenging. This review aimed to map and synthesize the existing evidence on methods used to estimate REE and TEE in children and adolescents with CP and identify their limitations and research gaps. Methods: A structured search was conducted in PubMed, Scopus, SciELO, EBSCO, and Embase for English or Spanish language articles published with no restrictions on publication date until September 2026. Studies that included children or adolescents from 0 to 19 years with a confirmed diagnosis of CP and that reported measured or estimated REE, basal metabolic rate (BMR), or TEE were included. Results: Nineteen studies met the inclusion criteria. Indirect calorimetry (IC) was the most frequently used method for measuring REE (n = 11, 57.9%), whereas doubly labeled water (DLW) was the reference method for TEE (n = 6, 31.6%). Standard predictive equations developed for TDC were used in three studies (15.8%) and frequently overestimated REE. In contrast, CP-specific predictive equations were less used and showed better estimations against reference methods. BIA-derived estimates, anthropometric approaches, and biomarker-based models remain insufficiently validated. Conclusions: IC remains the reference method for individualized assessment of REE, whereas DLW is the reference method for measuring TEE. Predictive equations for TDC are not recommended for children with CP. Further validation studies comparing BIA-derived estimates and CP-specific equations against reference methods are needed, particularly across Gross Motor Function Classification System (GMFCS) levels, nutritional status, and feeding method.