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Association of Gross Motor Function Classification System Level and School Attendance with Bone Mineral Density in
Ki Jin Jung1, Soon-Sun Kwon2, Chin Youb Chung3
1Department of Orthopedic Surgery, Soonchunhyang University Hospital, Cheonan, South Korea.
Insights
Children and adolescents with cerebral palsy (CP) have significantly lower bone mineral density (BMD). Gross Motor Function Classification System (GMFCS) level and school attendance impact BMD, crucial for osteoporosis management in CP.
Area of Science:
- Pediatrics
- Orthopedics
- Rehabilitation Medicine
Background:
- Children and adolescents with cerebral palsy (CP) often experience impaired bone health.
- Bone mineral density (BMD) is a critical indicator of skeletal integrity and fracture risk.
Purpose of the Study:
- To evaluate bone mineral density (BMD) in pediatric and adolescent populations with cerebral palsy (CP).
- To analyze the influence of Gross Motor Function Classification System (GMFCS) level and functional outcome measures on BMD.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess BMD in 50 patients with CP.
- Multiple regression analysis was performed to identify factors associated with BMD, including GMFCS level and Pediatric Outcomes Data Collection Instrument (PODCI) scores.
Main Results:
- Patients with CP exhibited significantly low mean Z-scores for BMD in the femur and lumbar spine.
- The GMFCS level and average frequency of missed school days (from PODCI) were independently associated with both femur and lumbar spine BMD.
Conclusions:
- GMFCS level and school attendance are significant independent factors affecting BMD in children and adolescents with CP.
- These factors should be considered in the prevention and management strategies for osteoporosis in the CP population.
Abstract:
The present study aimed to evaluate bone mineral density (BMD) in children and adolescents with cerebral palsy (CP) and to critically analyze the effects of a variety of factors, particularly the Gross Motor Function Classification System (GMFCS) level, the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire, and the Pediatric Outcomes Data Collection Instrument (PODCI), on BMD. Fifty patients with CP who underwent dual-energy X-ray absorptiometry were included. Collected data included the extent of involvement, muscle tone, demographic data, factors determined through chart review, and laboratory results. Factors associated with BMD in this group were analyzed by performing multiple regression analysis. The mean Z-scores in male and female patients were -3.252 ± 1.822 and -3.789 ± 1.764, respectively, in the proximal part of the femur and -2.219 ± 1.323 and -2.451 ± 1.434, respectively, in the lumbar spine. In multiple regression analysis, the GMFCS level and the average frequency of missed school in the PODCI were significant factors associated with both femur and lumbar spine BMD. Both the GMFCS level and school attendance were independently associated with BMD and should be considered for the prevention and management of osteoporosis in patients with CP.
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