Effect of Sunlight Exposure on Vitamin D Levels in Children With Cerebral Palsy

Overview

The goal of this clinical trial is to learn the effect of sunlight exposure on serum vitamin D levels in children aged 1-5 years with cerebral palsy. This study also aims to assess the effect of sunlight exposure on the incidence of acute respiratory tract infections and to evaluate the safety of the intervention. The main questions it aims to answer are: * Does sunlight exposure increase vitamin D levels in children with cerebral palsy? * Does sunlight exposure influence the incidence of acute respiratory tract infections in children with cerebral palsy? * Does sunlight exposure cause acute adverse effects in children with cerebral palsy? Participants will: * Be randomly assigned to either the sunlight exposure group or the control group. * Undergo baseline assessments, including vitamin D levels measurement, anthropometric measurements, dietary assessment, and Fitzpatrick skin phototype assessment before randomization. * Receive sunlight exposure for 10 minutes, three times per week between 11:00 AM and 1:00 PM for 8 weeks (intervention group), while participants in the control group will continue their usual sunlight exposure habits. * Have caregivers record daily sunlight exposure (intervention group), acute respiratory tract infection episodes, adverse events, and dietary intake during the study period. * Undergo repeat vitamin D levels measurement and evaluation of dietary intake, acute respiratory tract infections incidence, and adverse events at the end of the 8-week intervention.

This study evaluates the effect of sunlight exposure for 8 weeks in increasing serum vitamin D levels among children with cerebral palsy. Children with cerebral palsy have a high risk of vitamin D deficiency due to limited mobility, inadequate nutritional intake, and the use of antiepileptic medications that may interfere with vitamin D metabolism. Sunlight exposure is a natural and accessible source of vitamin D. Eligible participants are children with clinically confirmed cerebral palsy. Children with cerebral palsy who meet the eligibility criteria will be recruited from the Pediatric Clinic and Pediatric Inpatient Unit of Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Children with chronic liver or kidney disease, contraindications to direct sunlight exposure, inability to follow the intervention schedule, severe malnutrition, or baseline vitamin D deficiency (\<20 ng/mL) will not be included in the study. Vitamin D status will be assessed by measuring serum vitamin D concentration. The assessment will be performed through blood sampling conducted by trained healthcare personnel according to standard medical procedures. During the study, parents or caregivers will be instructed to monitor the child's condition, including signs of discomfort during sunlight exposure such as overheating, skin redness, persistent crying, or other complaints. If participants are unable to complete the exposure in one session due to discomfort, the exposure may be performed gradually within the same day while maintaining the required total duration. Researchers will monitor adherence to the intervention through scheduled video calls to ensure that the sunlight exposure procedure is performed according to the study protocol. Dietary intake assessment will be performed using food recall and analyzed by the research team.