Individuals with cerebral palsy (CP) are in a population group at increased risk for developing osteopenia and osteoporosis before old age. The relative causes for the development of osteopenia and osteoporosis are different than that for elderly individuals. Multiple factors play a causal role including poor nutritional status and decreased mobility. The development of osteoporosis and osteopenia in adolescents with CP is almost fully attributed to poor bone mineral density growth, versus loss of bone mineral density in the elderly population.
The Journal of Pediatrics published a study in June that examined the factors involved in bone mineral density status in adolescents with CP in cases with no known interventions in place. The study enrolled 69 children and adolescents age 2 thru 17 with moderate to severe spastic CP. The prospective, longitudinal study followed 55 subjects for 2 years and 40 of the original subjects for more than 3 years to observe changes.
The assessment included several measurements of growth. Bone mineral density in the distal femur and spine were assessed throughout the study. General health, nutritional status, growth, Tanner staging, and clinical features of CP were also assessed throughout the study.
The researchers found that more severe forms of CP were associated with a lower bone mineral density at initial evaluation. Severity of CP was scaled based on poor feeding, gross motor function, and poorer growth. Bone mineral density did increase in the study, but the range was wide, from +42% to -31%. Overall, bone mineral density in the distal femur decreased with age according to statistical analysis.
The authors conclude that children with moderate to severe CP are at risk for developing osteopenia and osteoporosis. This is due to a multitude of factors that cause poor bone mineral density growth. This is in contrast to the elderly population that has bone mineral density loss. Children with CP do not have proper growth and development of bone due to poor nutrition associated with poor feeding ability and decreased motor skills which decrease stimulation to the bone to lay down minerals in the bony matrix. The study provides an understanding of the processes at play in the development of osteopenia and can now give greater information in terms of which interventions may best help decrease the rate of osteopenia and improve bone mineral density.
Posted by Kristopher Foster on March 8, 2006 03:31 PM
