Factors Affecting Bone Mineral Density in Adults with Cerebral Palsy

Abstract

ObjectiveTo clarify factors affecting bone mineral density (BMD) in adults with cerebral palsy (CP).MethodThirty-five patients with CP participated in this study. Demographic data including gender, age, body mass index (BMI), subtype according to neuromotor type and topographical distribution, ambulatory function, and functional independence measure (FIM) were investigated. The BMD of the lumbar spine and femur were measured using Dual-energy X-ray absorptiometry, and the factors affecting BMD were analyzed.ResultsThe BMD had no significant association with factors such as gender, age, and subtype in adults with CP. However, BMI was significantly correlated with the BMD of lumbar spine and femur (p<0.05). The FIM score was also positively correlated with the BMD of femur (p<0.05). Moreover, CP patients with higher ambulatory function had significantly higher BMD of femur (p<0.05).ConclusionThese findings suggest that BMI and functional levels such as FIM and ambulatory function can affect BMD in adults with CP. The results might be used as basic data, suggesting the importance of treatment including weight bearing exercise and gait training in adults with CP.

Cardiovascular disease and related risk factors in adults with cerebral palsy: a systematic review

“…In regard to risk factors of CVD, hypertension was noted within the literature pertaining to adults with CP. However, other risk factors of CVD such as overweight and obesity were addressed most frequently and may be of concern in this population . Of the limited evidence gathered from this review, inconsistent results and inconsistent use of outcome measures make it challenging to discern whether or not the prevalence of overweight/obesity is greater in adults with CP in comparison to the general population.…”

“…Many of the studies included data on risk factors of CVD, particularly overweight/obesity. Twelve studies reported percentages of individuals with CP that were either overweight or obese based on BMI within their respective sample size . One study reported sex differences for percent body fat in adults with CP and included percentages of those who were above clinical cut‐offs (i.e.…”

“…Of the 19 studies included in the systematic review, no randomized controlled trials or longitudinal experimental studies were identified. Fifteen of the 19 studies were cross-sectional, 8,9,[24][25][26][27][28][29][30][31][32][33][34][35][36] three were cohort studies, [37][38][39] and one was a case-control study. 40 Characteristics of the studies that were included in the systematic review can be found in Table I.…”

“…Twelve studies reported percentages of individuals with CP that were either overweight or obese based on BMI within their respective sample size. 8,25,27,28,30,[32][33][34][35][36]38,40 One study reported sex differences for percent body fat in adults with CP and included percentages of those who were above clinical cut-offs (i.e. at risk).…”

Adults with spastic cerebral palsy have lower bone mass than those with dyskinetic cerebral palsy

“…Femoral neck bone mineral content and volumetric BMD in children with CP increases significantly after physical intervention [24]. More recently, Yoon et al [25] suggested that BMI and functional level, as defined by FIM and ambulatory function, could be important factors affecting bone metabolism in adults with CP. In accordance with bone strength-muscular force dynamics, mechanical pressure increases bone strength, so weight bearing has also been found to be an important factor affecting BMD [26].…”