Abstract

Diminished bone mineral density (BMD) is a frequent finding in cerebral palsied children. The underlying pathophysiology is complex in CP and variable risk factors such as immobility, nutritional deficiency and anticonvulsant use have been proposed. This study aimed at assessing BMD in children with CP.

In this analytic-descriptive cross-sectional study, 85 children with CP were recruited in Tabriz Children Teaching Centre. Patients’ BMD of three lumbar vertebrae (L2–L4) and hip was determined by Dual energy X-ray Absorptiometry (DXA). Functional status was assessed by the Gross Motor Functional Classification (GMFC) scale. Eighty five patients, 44 males and 41 females with a mean age of 5.79±2.39 (3–11) years were enrolled in the study. Reduced BMD, –2< Z score< –1 and Z score≤-2 were present in 48.2% and 30.6% of the patients, respectively. Standing ability and its duration was directly associated with increased lumbar vertebral BMD. The mean hip BMD was significantly lower in the cases with positive history of receiving anti-convulsant medications. The mean lumbar vertebral and hip BMDs were higher in cases with hypotonic CP and in the patients with hemiplegic involvement in a nonsignificant manner. There was also nonsignificant inverse correlation between the BMD and GMFC.

Diminished BMD, –2< Z score< –1 and Z score≤-2 are frequent in children with CP. The relating pathophysiology is multifactorial and complex.