Weight-Bearing Exercises in Kids with CP May Boost Bone Density and Bone Growth

Children with cerebral palsy (CP) who did weight-bearing exercises for six months increased their bone mineral density (BMD) as well as bone growth, according to a Korean study, “The effect of weight bearing on bone mineral density and bone growth in children 
with cerebral palsy:
 A randomized controlled preliminary trial,” that appeared in the journal Medicine.

CP is caused by an abnormal development or damage to the parts of the brain that control movement, balance, and posture. Kids with CP are at high risk of lifetime osteoporosis and are more prone to traumatic fractures, even during simple activities.

“The incidence of fractures in cerebral palsy (CP) children with moderate to severe motor impairment has been reported up to 9.7 percent per year,” researchers wrote. “Reduced physical activity and abnormal muscle tone can also negatively influence bone growth in length.”

In the study, children with CP who were unable to stand and were classified as group V on the gross motor functional classification scale (GMFCS – a measure of a child’s or youth’s abilities and limitations in gross motor function) were divided into groups A (seven patients) and B (five patients), with six healthy children as controls. Their average age was 3 years old.

Children in group A did programmed standing exercises and assisted standing for at least two hours per day, at least five days per week. Children in group B did a standing program of 20 minutes per day, two or three times per week. BMD and bone growth were measured at the beginning and at end of the study, six months later.

Researchers found that BMD tended to increase among children in group A, and decrease among children in group B. Bone length tended to increase in all three groups — though by the biggest margin among healthy children, followed by the kids in group A. The smallest increases were seen among children in group B.

Based on the results, the team concluded that “weight-bearing exercise may play an important role in increasing or maintaining BMD in children with CP and is expected to promote bone growth. Programmed standing exercise (at least two hours a day, more than five days a week) could be used as an effective treatment to increase BMD and to catch up in normal bone growth in children with CP.”

However, the researchers noted that “further studies with a larger patient cohort and longer follow-up periods are required to reveal the benefit of weight-bearing exercise and to establish a detailed program. Further considerations are also required on increasing BMD in children with disabilities who are unable to tolerate standing posture.”