Effect on the Bone Mineral Density According to Weight-bearing Exercise in Children with Spastic Quadriplegic Cerebral Palsy: A Preliminary Study

다국어 초록 (Multilingual Abstract)

Objective To evaluate the effect of weight-bearing exercise on the bone mineral density (BMD) in children with spastic quadriplegic cerebral palsy (CP).
Method A heterogeneous group of 18 prepubertal children with CP (age, 8.9±2.9 years; GMFCS level, IV and V) participated. Patients underwent a dual-energy X-ray absorptiometry scan of the lumbar spine (L1-L4) and proximal femur, and the Z scores were calculated by using data obtained from the control group who were normal children (age, 8.8±2.9 years). We divided the patients into 2 groups: group A standing for 2 hours a day, 5 days a week; group B standing for 30 minutes a day, 1 or 2 days a week. We measured BMD after 1 year and compared it to baseline measurements.
Results BMD was significantly higher on L2-L4 vertebrae, femoral neck and trochanter area after exercise in group A(p 0.05). There was no significant difference in BMI after exercise in the group B (p 0.05). ＜ ＞ BMD according to static weight-bearing exercise for 1 year were significantly different between groups A and B on the L1, L4 vertebrae, femoral neck and trochanter area (p＜0.05).
Conclusion This study suggests that weight-bearing exercise may be an important part of a rehabilitation protocol to maintain and improve BMD in children with spastic quadriplegic CP.

참고문헌 (Reference)

1 Henderson RC, "levels in noninstitutionalized children with cerebral palsy" 12 : 443-447, 1997

2 Sherk HH, "Vitamin D prophylaxis and the lowered incidence of fractures in anticonvulsant rickets and osteomalacia" 129 : 251-257, 1977

3 Pritchett JW, "Treated and untreated unstable hips in severe cerebral palsy" 32 : 3-6, 1990

4 Pritchett JW, "The untreated unstable hip in severe cerebral palsy" 173 : 169-172, 1983

5 Ward KA, "Perspective: cerebral palsy as a model of bone development in the absence of postnatal mechanical factors" 6 : 154-159, 2006

6 Harke HT, "Pediatric bone densitometry: technical issues" 3 : 371-378, 1999

7 Brunner R, "Pathological fractures in patients with cerebral palsy" 5 : 232-238, 1996

8 Gudjonsdottir B, "Effects of a dynamic versus a static prone stander on bone mineral density and behavior in four children with severe cerebral palsy" 14 : 38-46, 2002

9 Lee JJ, "Disorders of bone metabolism in severely handicapped children and young adults" 245 : 297-302, 1989

10 Mukherjee S, "Cerebral palsy. In: Randall LB, editor. Physical medicine and rehabilitation" Sauders 1243-1267, 2007

11 Henderson RC, "Bone-mineral density in children and adolescents who have spastic cerebral palsy" 77 : 1671-1681, 1995

12 Lin PP, "Bone mineralization in the affected extremities of children with spastic hemiplegia" 38 : 782-786, 1996

13 Rosenthal DI, "Bone mass measurement, fracture risk, and screening for osteoporosis" 104 : 31-33, 1989

14 Henderson RC, "Bone density and metabolism in children and adolescents with moderate to severe cerebral palsy" 110 : e5-, 2002

15 Caulton JM, "A randomized controlled trial of standing programme on bone mineral density in non-ambulant children with cerebral palsy" 89 : 131-135, 2004