BMDBone mineral density Individuals with a physical disability such as cerebral palsy (CP), are at risk for low bone mineral density (BMD) and associated osteoporosis and fragility fractures. 1 Risk factors for this are multifactorial, and include decreased weightbearing, inadequate calcium and vitamin D intake, and exposure to medications such as anticonvulsants that adversely affect BMD. Low BMD is asymptomatic; however, fragility fractures, commonly in the shaft of longbones such as the distal femur, are painful and are 20% more common in non-ambulatory individuals with CP.