Gannotti Mary E, Fuchs Robyn Kimberly, Roberts Dawn E, Hobbs Nedda, Cannon Ian M
Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA.
Department of Physical Therapy, Indiana University, Indianapolis, IN, USA.
J Pediatr Rehabil Med. 2015;8(3):251-7. doi: 10.3233/PRM-150336.
Children with moderate to severe cerebral palsy are at risk for low bone mass for chronological age, which compounds risk in adulthood for progressive deformity and chronic pain. Physical activity and exercise can be a key component to optimizing bone health. In this case report we present a young adult male with non-ambulatory, spastic quadriplegia CP whom began a seated speed, resistance, and power training exercise program at age 14.5 years. Exercise program continued into adulthood as part of an active lifestyle. The individual had a history of failure to thrive, bowel and bladder incontinence, reduced bone mineral density (BMD) for age, and spinal deformity at the time exercise was initiated. Participation in the exercise program began once a week for 1.5-2 hours/session, and progressed to 3-5 times per week after two years. This exercise program is now a component of his habitual lifestyle. Over the 6 years he was followed, lumbar spine and total hip BMD Z-scores did not worsen, which may be viewed as a positive outcome given his level of gross motor impairment. Additionally, the individual reported less back pain, improved bowel and bladder control, increased energy level, and never sustained an exercise related injury. Findings from this case report suggest a regular program of seated speed, resistance, power training may promote overall well-being, are safe, and should be considered as a mechanism for optimizing bone health.
中度至重度脑瘫儿童按实际年龄计算存在低骨量风险，这会增加成年后患渐进性畸形和慢性疼痛的风险。身体活动和锻炼可能是优化骨骼健康的关键组成部分。在本病例报告中，我们介绍了一名患有非行走性痉挛性四肢瘫脑瘫的年轻成年男性，他在14.5岁时开始了一项坐姿速度、阻力和力量训练锻炼计划。该锻炼计划作为积极生活方式的一部分持续到成年。该个体有发育不良、大小便失禁、按年龄计算骨矿物质密度（BMD）降低以及在开始锻炼时脊柱畸形的病史。锻炼计划开始时每周进行一次，每次1.5 - 2小时，两年后增加到每周3 - 5次。这个锻炼计划现在是他习惯性生活方式的一部分。在对他进行随访的6年中，腰椎和全髋BMD的Z评分没有恶化，鉴于他的总体运动障碍程度，这可被视为一个积极的结果。此外，该个体报告背部疼痛减轻、大小便控制改善、精力水平提高，并且从未遭受与锻炼相关的损伤。本病例报告的结果表明，定期的坐姿速度、阻力、力量训练计划可能促进整体健康，是安全的，应被视为优化骨骼健康的一种方式。
