C-L Chen1, K-C Lin, C-Y Wu, J-Y Ke, C-J Wang, C-Y Chen. 1. Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, 5 Fu-Hsing St. Kwei-Shan, Tao-Yuan 333, Taiwan.
Abstract
SUMMARY: This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. INTRODUCTION: Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. METHODS: Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. RESULTS: The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p < 0.05). Children with level I had greater knee flexor strength and GMFM-66 scores than those with level II (p < 0.001). However, the knee extensor strength and distal femur and lumbar aBMD did not differ between two groups. Regression analysis revealed the weight and knee extensor strength, but not GMFM-66 scores, were related positively to the distal femur and lumbar aBMD (adjusted r (2) = 0.56-0.65, p < 0.001). CONCLUSIONS: These results suggest the muscle strength, especially antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.
SUMMARY: This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. INTRODUCTION: Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. METHODS: Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. RESULTS: The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p < 0.05). Children with level I had greater knee flexor strength and GMFM-66 scores than those with level II (p < 0.001). However, the knee extensor strength and distal femur and lumbar aBMD did not differ between two groups. Regression analysis revealed the weight and knee extensor strength, but not GMFM-66 scores, were related positively to the distal femur and lumbar aBMD (adjusted r (2) = 0.56-0.65, p < 0.001). CONCLUSIONS: These results suggest the muscle strength, especially antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.
Authors: Chia-Ling Chen; Jyh-Yuh Ke; Chao-Jan Wang; Katie P Wu; Ching-Yi Wu; Alice May-Kuen Wong Journal: Dev Med Child Neurol Date: 2010-10-11 Impact factor: 5.449
Authors: Richard C Henderson; Robert K Lark; Matthew J Gurka; Gordon Worley; Ellen B Fung; Mark Conaway; Virginia A Stallings; Richard D Stevenson Journal: Pediatrics Date: 2002-07 Impact factor: 7.124
Authors: I Duran; F Schütz; S Hamacher; O Semler; C Stark; J Schulze; J Rittweger; E Schoenau Journal: Osteoporos Int Date: 2017-04-01 Impact factor: 4.507
Authors: Joan Jasien; Caitlin M Daimon; Stuart Maudsley; Bruce K Shapiro; Bronwen Martin Journal: Int J Endocrinol Date: 2012-07-22 Impact factor: 3.257