Secondary Condition Prevention: Osteoporosis Risk and Low Bone Mineral Density in Children with Disabilities
|Jennifer Rowland, Ph.D.|
Osteoporosis has traditionally affected adults. However, it is now considered to be a problem for children with mobility disabilities (Apkon, 2002).*
Osteoporosis and risk for falls are secondary conditions for people with disabilities that can be lessened or prevented through early treatment (U.S. Surgeon General's Report, 2005), which makes early detection in children especially important. Over the past decade, researchers have begun paying more attention to the threat of osteoporosis in this new at-risk population.
An important determinant of osteoporosis later in life is accumulation of peak bone mass until the individual reaches his or her mid-20s (Boot et al., 1997). Children with mobility disabilities are at risk for osteoporosis later in life because they have difficulty achieving peak bone mass early in life (Apkon, 2002). Contributors to increased bone mass during childhood include nutritional factors such as calcium and vitamin D intake, and weight-bearing physical activity.
Evidence that an 8-month weight-bearing physical activity program increases bone mineral content in children with cerebral palsy (Chad et al., 1999)
To determine the effects of weight-bearing physical activity on bone mineral content (BMC) and volumetric bone mineral density in children with cerebral palsy (CP), 18 children with CP were randomly assigned to a weight-bearing physical activity group or a control group that was instructed to maintain "usual lifestyle habits" (Chad et al., 1999). Children in the physical activity group performed a physical therapist-led program involving facilitation of normal movement while promoting weight-bearing activities twice per week for the first 2 months and 3 times per week for the last 6 months. Researchers did not describe the specific exercises used in this program; however, they indicated that each session included individualized exercises lasting 20 minutes for the arms, 20 minutes for the legs, and 20 minutes for the trunk. Results indicated participants in the weight-bearing activity program demonstrated increased bone mineral content and volumetric bone mineral density compared to control participants who did not participate in a weight-bearing physical activity program. However, it was noted that when the weight-bearing program was discontinued for 2 to 3 months, bone density once again decreased.
Osteoporosis is a preventable secondary condition, and children with mobility disabilities can decrease their risk for osteoporosis by incorporating proper nutrition and a regular weight-bearing physical activity program into their weekly routines.
*NOTE: For more information on osteoporosis and disabilities, refer to the following NCHPAD publications and previous Secondary Conditions columns:
- Osteoporosis and Nutrition
- Focus on Secondary Condition Prevention: Osteoporosis Risk and Low Bone Mineral Density for People with Disabilities, May 2006
- Osteoporosis Risk and Low Bone Mineral Density in People with Spinal Cord Injury, June 2006
- Osteoporosis Risk and Low Bone Mineral Density in People with Developmental Disabilities, July 2006
Apkon, S. (2002). Osteoporosis in children who have disabilities. Physical Medicine & Rehabilitation Clinics of North America, 13, 839-855.
Boot, A. M., de Ridder, M. A., Pols, H. A., Krenning, E. P., de Muinck Keizer-Schrama, S. M. (1997). Bone mineral density in children and adolescents: Relation to puberty, calcium intake, and physical activity. Journal of Clinical Endocrinology & Metabolism, 82, 57-62.
Chad, K. E., Bailey, D. A., McKay, H. A., Zello, G. A., & Snyder, R. E. (1999). The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy. Journal of Pediatrics, 135(1), 115-117.
U.S. Department of Health and Human Services. (2005). The 2005 Surgeon General's call to action to improve the health and wellness of persons with disabilities: Calling you to action. U.S. Department of Health and Human Services, Office of the Surgeon General.
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