Did you know that individuals with cerebral palsy are more likely to develop osteoporosis than those without CP?
Osteoporosis is a condition characterized by weak, porous bones.
This article will explain how cerebral palsy affects bone health and how to strengthen the bones.
What Causes Osteoporosis in Individuals with Cerebral Palsy?
Many factors associated with cerebral palsy are also associated with low bone mineral density and osteoporosis.
Risk factors include immobility, poor nutrition, and adverse side effects of medications.
Cerebral palsy is a motor disability caused by damage to the developing brain.
More severe cases of cerebral palsy can make it very difficult for individuals to control their legs.
Generally, children that cannot walk spend the majority of their time in their wheelchairs.
Our bodies function on demand. Think ‘use it or lose it.’ It takes energy to conserve bone density and muscle mass. If you do not use your legs, the body doesn’t see a point in expending the energy to maintain them.
Because these children don’t get to practice bearing weight on their legs, their bones and muscles are generally very weak.
Another factor that can cause osteoporosis in children with cerebral palsy is poor nutrition.
Sometimes, children with cerebral palsy cannot control the muscles in their mouths.
This makes it very difficult for them to chew and swallow, which ultimately results in lacking nutrition.
Vitamin D and calcium are essential for maintaining bone health.
The easiest way for people to get their daily dose of vitamin D is through sunlight.
However, many children with cerebral palsy tend to not go outside as much as other children due to limited mobility.
Vitamin D and calcium deficiencies result in softened bones and impair growth.
There is increasing evidence suggesting that anticonvulsants are associated with a greater risk of osteoporosis.
One explanation is that anticonvulsants induce enzymes that reduce the availability of active vitamin D and decreases calcium absorption.
Bone loss due to the use of anticonvulsants occurs slowly but gradually and often goes unrecognized until it becomes problematic.
How to Prevent Osteoporosis in Cerebral Palsy Patients
It’s suggested that “bone mineral density achieved by the end of adolescence will determine the risk for pathological fractures and osteoporosis later in life.”
This study found that nearly 40% of middle-aged adults with cerebral palsy have lower than normal bone mineral density.
Therefore, taking preventative measures to support bone health in children with cerebral palsy is necessary.
The best way to prevent osteoporosis in individuals with cerebral palsy is to reduce the major risk factors.
1. See a Physiotherapist
A physiotherapist will assess your child’s physical abilities and guide them through weight-bearing exercises to develop leg strength and improve overall mobility.
Weight-bearing exercise is proven to significantly improve bone mineral density by placing mechanical stress on the bones.
The femur is the most commonly fractured bone in individuals with cerebral palsy. The only time the femur bears weight is during standing.
Therefore, a physiotherapist will likely have your child practice bearing weight by using a standing frame.
2. Increase Exposure to Sunshine
Another way individuals with cerebral palsy can decrease their chances of developing osteoporosis is to get some sun exposure.
As a general guideline, encourage your child to stay out in the sunshine for at least 10-15 minutes, 3 times a week.
Various factors can affect vitamin D absorption (how strong the sun is, whether your child is wearing sunscreen, etc), so use your best judgment and adjust accordingly.
3. Add More Vitamin D and Calcium Into Your Child’s Diet
To prevent osteoporosis, try to incorporate more vitamin D and calcium-rich foods into your child’s diet.
Foods that are high in vitamin D include fatty fish, egg yolks, and mushrooms.
Dairy products (cheese, yogurt, milk), dark leafy greens, and tofu are rich in calcium.
While it is ideal to get all your major nutrients from food, children with cerebral palsy may find it easier to take supplements because they require less chewing.
You can also try blending your child’s food to minimize chewing.
If your child also struggles to swallow, it may be more beneficial for your child to use a feeding tube.
4. Speak to Your Child’s Doctors About Medications
It might also be a good idea to speak to your child’s doctor about bisphosphonates.
Bisphosphonates are medications that slow down the loss of bone density.
Although they are widely used for adults, bisphosphonate use in children can be controversial due to a lack of long-term research.
Some side effects include fever, flu-like symptoms, nausea, vomiting, and abdominal pain.
Cerebral Palsy and Osteoporosis
Generally, the more severe your cerebral palsy is, the less mobility you will have. This can significantly increase chances of developing osteoporosis.
Therefore, it’s essential to focus on early management of bone health by practicing weight-bearing exercises, getting exposure to sunlight, consuming enough vitamin D and calcium, and taking the right medications.
Hopefully, this article helped you better understand why individuals with cerebral palsy are more likely to develop osteoporosis than the general population and how to prevent it. Good luck!
Featured image: ©iStock.com/belchonock