Low bone mass in patients with motor disability: prevalence and risk factors in 59 Finnish children

Dev Med Child Neurol. 2010 Mar;52(3):276-82. doi: 10.1111/j.1469-8749.2009.03464.x. Epub 2010 Aug 26.


Aim: Children with motor disabilities are at increased risk of compromised bone health. This study evaluated prevalence and risk factors of low bone mass and fractures in these children.

Method: This cross-sectional cohort study evaluated bone health in 59 children (38 males, 21 females; median age 10 y 11 mo) with motor disability (Gross Motor Function Classification System levels II-V). Bone mineral density (BMD) in the lumbar spine was measured with dual-energy X-ray absorptiometry; BMD values were corrected for bone size (bone mineral apparent density [BMAD]) and skeletal maturity, and compared with normative data. Spinal radiographs were obtained to assess vertebral morphology. Blood biochemistry included vitamin D concentration and other parameters of calcium homeostasis.

Results: Ten children (17%) had sustained in total 14 peripheral fractures; lower-limb fractures predominated. Compression fractures were present in 25%. The median spinal BMAD z-score was -1.0 (range -5.0 to 2.0); it was -0.6 in those without fractures and -1.7 in those with fractures (p=0.004). Vitamin D insufficiency was present in 59% of participants (serum 25-hydroxyvitamin D <50 nmol/l) and hypercalciuria in 27%. Low BMAD z-score and hypercalciuria were independent predictors for fractures.

Interpretation: Children with motor disability are at high risk of peripheral and vertebral fractures and low BMD. Evaluation of bone health and prevention of osteoporosis should be included in the follow-up.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon / instrumentation
  • Bone Density / physiology*
  • Bone Diseases / diagnostic imaging*
  • Bone Diseases / epidemiology
  • Bone Diseases / physiopathology*
  • Child
  • Cohort Studies
  • Cross-Sectional Studies
  • Disability Evaluation*
  • Female
  • Finland / epidemiology
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / epidemiology
  • Humans
  • Hypercalciuria / epidemiology
  • Male
  • Movement Disorders / diagnosis*
  • Movement Disorders / epidemiology
  • Movement Disorders / physiopathology*
  • Osteoporosis / diagnosis
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Vitamin D Deficiency / epidemiology