title: Motor impairment and skeletal mineralization in children with cerebral palsy.
abstract: OBJECTIVE
  To evaluate the bone mineral density and the effect of motor impairment on bone mineral density in children with cerebral palsy.
  
  
  METHODS
  The cross-sectional study was conducted at the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan, from January 2013 to January 2015. Children diagnosed with cerebral palsy were sampled by non-probability purposive sampling from the Cerebral Palsy clinic. On the basis of Gross Motor Function Classification level of motor impairment, the children were divided into mild Cerebral Palsy (level 1 & 2) and moderate to severe Cerebral Palsy (level 3-5) groups. Bone mineral density z-score was measured at lumbar spine with Dual Energy X-Ray Absorptiometry at L1-L4 lumbar vertebra. Data was analysed using SPSS 20.
  
  
  RESULTS
  Of the total 108 children selected, 18(16.6%) had to be excluded due to poor nutrition status or deranged serum chemistry, while in 4(3.7%) children Dual Energy X-ray Absorptiometry scan was not done on technical grounds. Of the remaining 86(79.6%) children, 39(45.3%) were males and 47(54.7%) were females. The overall mean age was 6.08±2.89 years and mean bone mineral density z-score was -2.16±0.62. Statistically significant difference was found in bone mineral density z-scores of moderate to severe compared to mild Cerebral Palsy group (p<0.05). Significant difference in bone mineral density z-scores was also found among different levels of Gross Motor Function Classification system of motor impairment (p<0.05).
  
  
  CONCLUSIONS
  Cerebral Palsy children had low bone mineral density z-score, especially those who were non-ambulatory.
authors.affiliation: Combined Military Hospital, Abbottabad.
authors.forename: Noreen
authors.initials: N
authors.lastname: Akhter
authors.affiliation: Combined Military Hospital, Kohat.
authors.forename: Atif Ahmed
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Kohat Institute of Medical Sciences, Khyber Medical University (KMU).
authors.forename: Aisha
authors.initials: A
authors.lastname: Ayyub
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density / Q000502:physiology; D002547:Cerebral Palsy / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D010024:Osteoporosis; D010154:Pakistan / Q000453:epidemiology
keywords:  Cerebral Palsy, CP, Bone mineral density, BMD, Dual energy X-ray absorptiometry, DEXA, Lumber vertebra. 