Richard Grossberg1,2,3, Martha G Blackford4,5,6, Heidi H Kecskemethy7,8, Richard Henderson9, Michael D Reed1,4,5,6. 1. Hattie Larlham Center for Children with Disabilities, Mantua, OH, USA. 2. Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 3. Rainbow Babies & Children's Hospital, Cleveland, OH, USA. 4. Department of Pediatrics, Northeast Ohio Medical University, Rootstown, OH, USA. 5. Division of Clinical Pharmacology & Toxicology, Akron Children's Hospital, Akron, OH, USA. 6. Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA. 7. Department of Biomedical Research, Nemours/A.I. duPont Hospital for Children, Wilmington, DE, USA. 8. Department of Medical Imaging, Nemours/A.I. duPont Hospital for Children, Wilmington, DE, USA. 9. Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA.
Abstract
AIM: Osteoporosis is a significant clinical problem in persons with moderate to severe cerebral palsy (CP), causing fractures with minimal trauma. Over the past decade, most studies examining osteoporosis and CP have been cross-sectional in nature, focused exclusively on children and adolescents and only involving one evaluation of bone mineral density (BMD). The purpose of this study was to assess BMD in a group including adults with CP, and changes in each individual's BMD over a 5- to 6-year period. METHOD: The study group included 40 residents of a long-term care facility aged 6 to 26 years at the time of their initial evaluation. Twenty-one patients (52.5%) were male, 35 (88%) were white, and 38 (95%) were in Gross Motor Function Classification System level V. BMD was assessed by dual-energy X-ray absorptiometry on the right and left distal femurs for three distinct regions of interest. RESULTS: Five residents had a fracture that occurred during the study period; this represented a fracture rate of 2.1% per year in the study group. Longitudinally, annualized change in the median BMD was 0.7% to 1.0% per year in the different regions of the distal femur, but ranged widely among the study group, with both increases and decreases in BMD. Increase in BMD over time was negatively correlated with age and positively correlated with change in weight. INTERPRETATION: Changes in BMD over time in profoundly involved persons with CP can range widely, which is important to recognize when evaluating potential interventions to improve BMD. Age and changes in body weight appear the most relevant factors.
AIM: Osteoporosis is a significant clinical problem in persons with moderate to severe cerebral palsy (CP), causing fractures with minimal trauma. Over the past decade, most studies examining osteoporosis and CP have been cross-sectional in nature, focused exclusively on children and adolescents and only involving one evaluation of bone mineral density (BMD). The purpose of this study was to assess BMD in a group including adults with CP, and changes in each individual's BMD over a 5- to 6-year period. METHOD: The study group included 40 residents of a long-term care facility aged 6 to 26 years at the time of their initial evaluation. Twenty-one patients (52.5%) were male, 35 (88%) were white, and 38 (95%) were in Gross Motor Function Classification System level V. BMD was assessed by dual-energy X-ray absorptiometry on the right and left distal femurs for three distinct regions of interest. RESULTS: Five residents had a fracture that occurred during the study period; this represented a fracture rate of 2.1% per year in the study group. Longitudinally, annualized change in the median BMD was 0.7% to 1.0% per year in the different regions of the distal femur, but ranged widely among the study group, with both increases and decreases in BMD. Increase in BMD over time was negatively correlated with age and positively correlated with change in weight. INTERPRETATION: Changes in BMD over time in profoundly involved persons with CP can range widely, which is important to recognize when evaluating potential interventions to improve BMD. Age and changes in body weight appear the most relevant factors.
Authors: David R Weber; Alison Boyce; Catherine Gordon; Wolfgang Högler; Heidi H Kecskemethy; Madhusmita Misra; Diana Swolin-Eide; Peter Tebben; Leanne M Ward; Halley Wasserman; Christopher Shuhart; Babette S Zemel Journal: J Clin Densitom Date: 2019-07-10 Impact factor: 2.617
Authors: Cheri A Blauwet; Emily M Brook; Adam S Tenforde; Elizabeth Broad; Caroline H Hu; Eliza Abdu-Glass; Elizabeth G Matzkin Journal: Sports Med Date: 2017-09 Impact factor: 11.136