The effect of weight bearing on bone mineral density and bone growth in children with cerebral palsy: A randomized controlled preliminary trial

BACKGROUND: The present study aims to explore the effect of weight bearing exercise on bone mineral density (BMD) and bone growth in children with cerebral palsy (CP). METHODS: Twelve children with CP of functional level of gross motor functional classification scale (GMFCS) V and 6 healthy children (control group) were included in the study. Participants underwent a dual-energy X-ray absorptiometry scan to measure the BMD of the femur and full-length anteroposterior radiography to measure the bone length of the femur and tibia at baseline and after 6 months. Patients were randomly divided into 2 groups: group A with programmed standing exercises and assisted standing for more than 2 hours a day, more than 5 days a week; and group B with conventional physiotherapy with a standing program for 20 minutes a day, 2 to 3 days a week. RESULTS: A 6-month follow-up showed significantly increased BMD on the femur neck in the control group. Although the changes in BMD were not significant in both groups, group A demonstrated an increased trend of BMD, whereas group B showed a decreased trend. Bone length was significantly increased in all 3 groups at the 6-month follow-up. Although this increase was not significant, the change in bone length was greatest in the control group. The smallest changes were observed in group B. CONCLUSIONS: Weight bearing exercise may play an important role in increasing or maintaining BMD in children with CP and is also expected to promote bone growth. Programmed standing may be used as an effective treatment method to increase BMD in children with CP. However, further studies with a larger cohort and longer follow-up period are required to reveal further information on the benefit of weight bearing exercise and to develop a detailed program.