The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy☆,☆☆,★

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Abstract

After an 8-month physical activity intervention in children with cerebral palsy, increases in femoral neck bone mineral content (BMC) (9.6%), volumetric bone mineral density (v BMD) (5.6%), and total proximal femur BMC (11.5%) were observed in the intervention group (n = 9) compared with control subjects (n = 9; femoral neck BMC, –5.8%; v BMD, –6.3%; total proximal femur BMC, 3.5%). (J Pediatr 1999;135:115-7)

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Participants

Children with spastic CP (13 girls and 5 boys) were randomly assigned to either physical activity or control groups. Groups were homogeneous for age, sex, maturation, and ambulatory status. The physical activity intervention group (6 girls and 3 boys; mean age, 9.0 ± 2.9 years) consisted of 1 independent ambulator, 3 non-ambulators, 3 ambulators with assistance, and 2 independent ambulators with an aid such as crutches or a walker. The control group (7 girls and 2 boys; mean age, 9.0 ± 2.7

RESULTS

There were no differences between groups at baseline for height (activity group, 128.3 ± 15.6 cm; control group, 127.4 ± 14.7 cm), weight (activity group, 26.2 ± 14.2 kg; control group, 25.4 ± 7.7 kg), or dietary calcium and for changes in these variables during the study (height increased 3%; weight increased 2% for both groups). Similarly, there were no significant differences in BMC or vBMD between groups at baseline (Table).After intervention, the physical activity group had a significantly

DISCUSSION

We demonstrated that an 8-month program of weight-bearing physical activity enhances bone mineral accrual in children with CP. This supports the concept that a minimal period of loading is successful in eliciting an osteogenic response in patients5 and that disuse,6 decreased activity,7 and non-weight-bearing activity8 can precipitate a loss in BMC in adults without developmental disabilities. Findings showed a reduction in bone density in children with CP when a standing program was

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Supported by Saskatchewan Health Services and Utilization Research Committee (Sask HSURC).

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Reprint requests: Karen E. Chad, College of Kinesiology, University of Saskatchewan, 105 Gymnasium Pl, Saskatoon, Saskatchewan, S7N 5C2, Canada.

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