Longitudinal Changes in Bone Density in Children and Adolescents with Moderate to Severe Cerebral Palsy - 15/08/11
, John A. Kairalla, BSPH, John W. Barrington, MD, Almas Abbas, BS, Richard D. Stevenson, MD
Reprint requests: Richard C. Henderson, MD, PhD, University of North Carolina, Campus Box #7055, Chapel Hill, NC 27599.See related articles, p 726, p 764, and p 776.
Abstract |
Objective |
To assess the natural history of “growth” in bone mineral density (BMD) in children and adolescents with moderate to severe cerebral palsy (CP).
Study design |
A prospective, longitudinal, observational study of BMD in 69 subjects with moderate to severe spastic CP ages 2.0 to 17.7 years. Fifty-five subjects were observed for more than 2 years and 40 subjects for more than 3 years. Each evaluation also included assessments of growth, nutritional status, Tanner stage, general health, and various clinical features of CP.
Results |
Lower BMD z-scores at the initial evaluation were associated with greater severity of CP as judged by gross motor function and feeding difficulty, and with poorer growth and nutrition as judged by weight z-scores. BMD increased an average of 2% to 5%/y in the distal femur and lumbar spine, but ranged widely from +42%/y to −31%. In spite of increases in BMD, distal femur BMD z-scores decrease with age in this population.
Conclusions |
Children with severe CP develop over the course of their lives clinically significant osteopenia. Unlike elderly adults, this is not primarily from true losses in bone mineral, but from a rate of growth in bone mineral that is diminished relative to healthy children. The efficacy of interventions to increase BMD can truly be assessed only with a clear understanding of the expected changes in BMD without intervention.
Le texte complet de cet article est disponible en PDF.Mots-clés : BMD, CP, DXA, NAGCeP, GMFC
Plan
| The core NAGCeP Project was supported by the Genentech Foundation for Growth and Development and the National Center for Medical Rehabilitation Research, National Institutes of Health (R01 HD35739). Longitudinal continuation of the NAGCeP Project was supported by a center grant from the National Center for Medical Rehabilitation Research, Enhancing Rehabilitation Research in the South (ERRIS), National Institutes of Health (R24 HD39631). Work at the University of North Carolina site was also made possible by additional support from the General Clinical Research Centers program of the Division of Research Resources, National Institutes of Health (RR00046) and a career award from the National Institute of Arthritis, Musculoskeletal, and Skin Diseases (K24 AR02132). |
Vol 146 - N° 6
P. 769-775 - juin 2005 Retour au numéro
Article précédent
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- Oliver Fricke, Baerbel Tutlewski, Bernd Schwahn, Eckhard Schoenau
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