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Updated: May 30, 2025
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Development of bone mineral density and content in children with cerebral palsy: a retrospective, longitudinal study
Philipp Koebke1, Leonie Schafmeyer2, Bruno Lentzen1
1Center of Prevention and Rehabilitation, UniReha, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.
Insights
Children with cerebral palsy (CP) show bone development near the third percentile of healthy peers. Early interventions are crucial for improving bone health and quality of life in children with CP.
Area of Science:
- Pediatric Orthopedics
- Bone Metabolism
- Child Development
Background:
- Children with cerebral palsy (CP) often experience impaired bone development.
- Longitudinal data on bone mineral content and density in this population is crucial for understanding growth patterns.
Purpose of the Study:
- To investigate long-term bone development in children with CP.
- To analyze bone mineral content (TBLH-BMC) and bone mineral density (TBLH-BMD) trajectories.
Main Methods:
- Retrospective longitudinal analysis of 109 children with CP.
- Dual-energy X-ray absorptiometry (DXA) scans used for measurements.
- SITAR growth curve and GAMLSS models applied to generate developmental trajectories.
Main Results:
- Bone development trajectories for TBLH-BMC and TBLH-BMD in children with CP approximate the third percentile of healthy children.
- Median annual bone mineral density increase was similar across GMFCS levels.
- Girls reached age at peak velocity earlier than boys; intensive exercise may boost bone growth in severe CP.
Conclusions:
- Children with CP exhibit bone growth near the third percentile, with stable age-adjusted z-scores.
- Early interventions targeting muscle strength, mobility, nutrition, and hormonal status are vital for bone health.
Objectives:
The aim of this study was to investigate long-term bone development in children with cerebral palsy (CP) using longitudinal measurements of total body less head bone mineral content (TBLH-BMC) and bone mineral density (TBLH-BMD).
Methods:
A retrospective longitudinal analysis was performed on 109 children with CP who participated in a rehabilitation programme from 2006 to 2018. Dual-energy X-ray absorptiometry (DXA) scans were performed at the beginning of the programme and repeated as clinically indicated. The study used SITAR growth curve analysis and the LMS method within the GAMLSS model to generate developmental trajectories for TBLH-BMC and TBLH-BMD.
Results:
The findings suggest that the expected developmental trajectories of TBLH-BMC and TBLH-BMD in children with CP approximately follow the third percentile of healthy children. The median annual increase in bone mineral density was similar between GMFCS I-II and III-V groups at 5.12 and 5.79 %, respectively. Girls with CP reached age at peak velocity (APV) earlier than boys. The intensive exercise programme may have contributed to greater annual bone growth in children with more severe CP.
Conclusions:
Children with CP have bone growth trajectories close to the third percentile of their healthy peers, suggesting that age-adjusted z-scores for TBLH-BMC and BMD remain relatively stable throughout childhood and adolescence. Early and targeted interventions, including improving muscle strength and mobility and optimising nutritional and hormonal status, are essential to promote better bone health and quality of life in children with CP.
