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Effect of standing frames used in real life on bone remodeling in non-walking children with cerebral palsy

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Abstract

Summary

Children with severe cerebral palsy are prone to low bone mineral density. No clear recommendation exists for an optimal use of standing frame to enhance bone health in this context. Used in real life, this study suggests for the first time that standing practice improved bone mineralization by limiting bone resorption.

Introduction

To compare the bone health of children with severe cerebral palsy who use a static standing frame in real life to that of children who do not.

Methods

A total of 24 children with severe cerebral palsy GMFCS IV & V were included in the study and were divided into two groups: 13 were using a passive standing frame and 11 were not. We performed a single center retrospective cross-sectional study comparing the two groups using dual X-ray absorptiometry data and tests on biological samples, including bone remodeling factors.

Results

Total body (less head) bone mineral content was significantly higher in children who used a standing frame for an average of 30 min/day. This was confirmed in the lumbar spine. Although the total body bone mineral density (less head and proximal femur) densitometric data were not significantly higher, a positive trend favored the use of a standing frame in the children. Bone resorptive factors (CTX) were higher in the non-standing-frame group, whereas there was no difference among osteoformation factors. No difference in fracture history was found.

Conclusions

We show that non-ambulant children with cerebral palsy who use a static standing frame in real life have better bone health, with lower bone resorption, than children who do not. Further studies are needed to determine how standing practice could impact bone mineralization over time in real life and to explore more bone remodeling factors.

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Authors and Affiliations

  1. Pediatric Physical Medicine and Rehabilitation Center, Amiens University Hospital, 80000, Amiens, France

    V. Barbier & S. Fritot

  2. MP3CV‑EA7517, CURS, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France

    V. Barbier, C. Klein & R. Mentaverri

  3. Department of Rheumatology, Amiens University Hospital, 80000, Amiens, France

    V. Goëb, J. Sobhy Danial, P. Fardellone & L. Le Monnier

  4. Department of Biochemistry and Endocrine Biology, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France

    R. Mentaverri

Authors
  1. V. Barbier
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  2. V. Goëb
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  3. C. Klein
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  4. S. Fritot
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  5. R. Mentaverri
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  6. J. Sobhy Danial
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  7. P. Fardellone
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  8. L. Le Monnier
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Corresponding author

Correspondence to V. Barbier.

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Ethics approval

This study has been declared to the National Commission for Freedom of Information Technology Act, number PI2021_843_0036.

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Oral consent was obtained from all children’s parents and an information sheet was sent to them.

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Barbier, V., Goëb, V., Klein, C. et al. Effect of standing frames used in real life on bone remodeling in non-walking children with cerebral palsy. Osteoporos Int 33, 2019–2025 (2022). https://doi.org/10.1007/s00198-022-06436-5

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  • DOI: https://doi.org/10.1007/s00198-022-06436-5

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