Article

AIM: To investigate the impact of new evidence for weight-bearing,
bisphosphonates, and vitamin D and calcium interventions, towards updating the
systematic review and clinical practice guidelines for osteoporosis in children
with cerebral palsy (CP) published in 2011. METHOD: Computer-assisted literature
searches were conducted for articles published from 2010 to 2016. Searches
focused on children with CP functioning at Gross Motor Function Classification
System levels III to V and limited to weight-bearing activities, bisphosphonates,
and vitamin D and/or calcium supplementation. Articles were classified according
to the American Academy of Neurology guidelines to update the grading of the
evidence for improving bone mineral density (BMD) and decreasing fragility
fractures. RESULTS: Six new articles underwent full-text review and data
abstraction. These included one weight-bearing, three bisphosphonate, and two
mixed intervention studies (bisphosphonate and vitamin D/calcium
supplementation). Overall, there continues to be 'probable' evidence for
bisphosphonates, 'possible' evidence for vitamin D/calcium, and 'insufficient'
evidence for weight-bearing activities as effective interventions to improve low
BMD in children with CP. There is 'possible' evidence for bisphosphonates in
reducing fragility fractures. INTERPRETATION: The grading of evidence to support
the use of weight-bearing activities, bisphosphonates, and vitamin D and calcium
supplementation in pediatric CP osteoporosis clinical practice guidelines
remained the same.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS