Bone Abstracts

Objective: Investigate bone mineral density in children with cerebral palsy (CP) with special focus on severe forms of CP.

Methods: Investigation encompassed 23 children, both genders, between 6 and 17 years of age, with diagnosed cerebral palsy, who were hospitalized between January 1 and December 31, 2014. Bone mineral density (BMD) was established using Dual-energy x-ray Absorptiometry – DXA method, at L1–L4 lumbar vertebrae and at the femur neck, and BMD results were analyzed according to criteria by ISCD Pediatric Position Statement from 2008. Severity of motor function disorder was assessed using Gross Motor Function Classification Scale (GMFCS), which has five levels (I–V; level I is mild, level V is severe level of motor disorder). In statistical analysis, descriptive statistics, χ²-test and Kruskal-Wallis test were used.

Results: From total number of subjects, 56.5% were boys and 43.5% girls, with average age of 13±3.565 years. Osteoporosis had 52%, osteopenia had 21%, and normal BMD had 13% of subjects. There were 70% of subjects with a motor disorder level V according to GMFCS, 13% with level IV, 17% with level I (no subjects with motor disorder levels II and III). Comparing the categories of BMD disorders with the level of motor disorder according to GMFCS, obtained a statistically significant difference among the respondents (P=0.004): there were 83% of children with level V among the subjects who have osteoporosis and 60% of children with level V among the subjects with osteopenia. All children with a normal BMD were GMFCS level I. In children with the level I the average value of z-score of the spine was −0.3 and z-score of the hip was −0.4 while these values in children with level V were −2.0 (P<0.05).

Conclusion: Children with CP have a disorder of bone metabolism with increased susceptibility to bone fractures, especially those with severe CP (nonwalkers).

Disclosure: The authors declared no competing interests.