Bone Mineral Density among Children with Cerebral Palsy

Abstract

Background: Reduction in bone mineral density (BMD) is one of the problems among children with cerebral palsy (CP). The pathophysiology is a complex field in which various factors are involved. The present study was conducted with the aim to evaluate BMD among children with CP.

Methods: In this descriptive-analytical cross-sectional study, 85 children with CP were studied in the Children's Hospital of Tabriz, Iran, for 12 months. BMD was measured in the patients in three vertebrae (L2-L4) and the pelvis using the dual-energy X-ray absorptiometry (DXA) method. The variables of age, sex, types and subclasses of CP, previous physiotherapy, standing and walking status, nutritional status, history of receiving anticonvulsant drugs, and functional status were investigated based on the Gross Motor Function Classification System (GMFCS).

Results: In the present study, 85 children including 44 boys and 41 girls with a mean age of 5.79 ± 2.39 (3 to 11) years were studied. Osteopenia and osteoporosis were present among 48.2% and 30.6% of the participants, respectively. The ability to walk and duration of standing during the day were directly related to the increase in BMD in the vertebrae. In addition, there was an inverse relationship between BMD and GMFCS score; however, this relationship was not statistically significant.

Conclusion: Reduced BMD, osteopenia, and osteoporosis are common among children with CP. The relevant pathophysiology is multifactorial and complex.