Children with Spastic Quadriplegia Show Poor Bone Health, Nutrition Issues

Researchers in India who studied bone health in children with moderate to severe spastic quadriplegia have determined that nutrition plays a key role in bone maturation and strength. The research report, “Skeletal Maturation and Mineralisation of Children with Moderate to Severe Spastic Quadriplegia,“ appeared in the Journal of Clinical and Diagnostic Research.

Spastic quadriplegia is a common cerebral palsy (CP) subtype in which all four limbs are affected. Kids with CP may consume fewer calories and can be undernourished due to co-existing issues such as gastro-oesophageal reflux, frequent vomiting, and inability to properly chew and swallow. Children with spastic quadriplegia often have poor and abnormal skeletal growth. Osteoporosis is a common side condition.

To further understand bone health and nutrition in children with spastic quadriplegia, Indar Kumar Sharawat and Sadasivan Sitaraman of the Department of Pediatric Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, studied 42 children with spastic quadriplegia and compared their bone health to 42 healthy children. They evaluated bone mineral density (BMD) using the technique Dual Energy X-ray Absorptiometry (DEXA). The team studied the left hand and wrist of all study participants and estimated bone age.

Overall, BMD was lower in children with spastic quadriplegia than in healthy children. The children also had lower measures of minerals that contribute to bone health including calcium and alkaline phosphatase. The presence and severity of malnutrition corresponded with lower bone age (degree of bone maturation) but not chronological age. Anticonvulsant drugs and whether a child underwent physical therapy did not affect bone age.

Researchers concluded, “decreased BMD and delayed bone age is prevalent in children with spastic quadriplegia and nutritional status is an important contributing factor.”

CP is the most common childhood condition associated with poor bone health. The study emphasized the important role of nutrition in contributing to bone health in children with CP.