Article

Children with severe cerebral palsy (CP) are at risk for developing low bone
mineral density (BMD) and low-impact fractures. The aim of this study was to
provide a systematic literature review of the epidemiology of fractures and low
BMD in children with severe CP, with an emphasis on risk factors. Gross Motor
Function Classification System (GMFCS) levels IV and V were criteria for severe
cerebral palsy. METHOD: The literature (PubMed) was searched and eligible studies
were given a level of evidence score using the Scottish Intercollegiate
Guidelines Network criteria. RESULTS: Seven studies were found concerning
epidemiology of fractures, 11 studies described epidemiology of low BMD, and 14
studies concerned risk factors. The methodological quality of most of these
studies was poor. Five studies were considered well-conducted with low risk of
confounding and bias. In these studies, the incidence of fractures in children
with moderate to severe CP approached 4% per year, whereas the prevalence of low
BMD in the femur was 77%. Limited ambulation, feeding difficulties, previous
fractures, anticonvulsant use, and lower body fat mass were associated with low
BMD z-scores. INTERPRETATION: There is only a limited amount of high-quality
evidence on low BMD and fractures in children with severe CP.

Langue : ANGLAIS