Effects of passive versus dynamic loading interventions on bone health in children who are nonambulatory

Pediatr Phys Ther. Fall 2013;25(3):248-55. doi: 10.1097/PEP.0b013e318299127d.


Purpose: To investigate the effectiveness of a novel dynamic standing intervention compared with a conventional passive standing intervention on bone health in children with cerebral palsy who are nonambulatory.

Methods: Four children in passive standers and 5 in dynamic standers were followed for 15 months (standing 30 min/d, 5 d/wk). Dual-energy x-ray absorptiometry scans of the distal femur were obtained at 3-month intervals to measure changes in bone mineral density (BMD), bone mineral content, and area.

Results: Increases in BMD were observed during dynamic standing (P < .001), whereas passive standing appeared to maintain the baseline BMD. Increases in bone mineral content were observed in each standing intervention (P < .001), with dynamic standing inducing greater increases. Increases in area were comparable between interventions (P = .315).

Conclusions: Dynamic standing demonstrated the potential of moderate-magnitude, low-frequency loading to increase cortical BMD. Further investigations could provide insight into the mechanisms of bone health induced through loading interventions.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Absorptiometry, Photon
  • Bone Density*
  • Cerebral Palsy / rehabilitation*
  • Child
  • Disabled Children / rehabilitation
  • Exercise Therapy / methods*
  • Femur / physiology*
  • Humans
  • Longitudinal Studies
  • Posture*
  • Weight-Bearing