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Bone quality in adults with severe motor and intellectual disabilities
Tomoko Sakai1, Tokumitsu Shirai, Tsutomu Oishi
1Department of Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Objective:
To determine bone quality in adults with severe motor and intellectual disabilities.
Design:
A retrospective cohort study.
Patients:
Bone quality of 60 patients with severe motor and intellectual disabilities (28 men, 32 women; mean age 57 years) at a long-term care facility for adults was examined retrospectively.
Methods:
Quantitative ultrasonography was used to measure the stiffness index, T-score and Z-score of the calcaneus. A multiple linear regression model, including sex, age, anti-epileptic drug use, tube-feeding status, and current and peak physical abil-ities, was used to identify significant predictors of T-scores.
Results:
Quantitative ultrasonography revealed that all patients had lower bone quality (based on T-scores, Z-scores, and stiffness index), and all patients had T-scores with standard deviations (SD) below 1.8. Current physical ability, age, and anti-epileptic drug use were significant factors in T-score determination, while tube-feeding and peak physical ability were not. The ability to walk without assistance was the most significant predictor in quantitative ultrasonography.
Conclusion:
Severely low bone quality is observed in patients with severe motor and intellectual disabilities; and it is strongly associated with current physical activity. It is important that patients with severe motor and intellectual disabilities preserve their physical abilities to prevent osteoporosis-related fractures.
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