Abstract
Celebral palsy (CP), unlike many other neurodevelopmental disorders, is associated with abnormalities of pregnancy and birth, particularly “birth asphyxia” and low birthweight.
The aim of this research was to define and evaluate the degree up to which the physiotherapeutic treatment after puberty, when the musculoskeletal system is almost developed, can have a positive influence on bone mineral density (BMD).
In the research 26 individuals having different forms of CP, 13 males and 13 females, participated. The percentage according to the form of the disease gender was tetraplegic 50% women, average age 25.4 years, diplegic 26.9% and 6 women, average age 27.2 years, hemiplegic 23.1% individuals), 3 men and 3 women, average age 27.2 years. Before the measurements there were clinical tests and EEG's.
The program was conducted 3 times per week for twenty six (26) weeks and included energetic, energopathetic and energetic with resistance exercises. Each session consisted of a one-on-one program of exercise with the upper, lower extremities and lumbar region.
Dual energy X-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) of the lumbar spine and femoral neck. To minimize operator-related variability, all scans were performed and analyzed by the same trained technologist. For the control of the statistical importance of the value changes the ANOVA test was used from the statistical package SPSS.
After intervention, the physiotherapy group had a significantly greater increase in bone mineral density in femoral neck, compared with control subjects, but not in the lumbar region (L2–L4), where the physiotherapy program was not intense.
The results of this investigation show that a 6-month physiotherapeutic program enhances bone mineral density in individuals with cerebral palsy. This supports the concept that a minimal period of exercise is successful in eliciting an osteogenic response in these groups. The therapeutic goal of physiotherapists and orthopaedics is to promote exercise, especially weight-bearing activity, to decrease fragility and susceptibility to fractures in patients with decreased activity.