Duran Ibrahim, Martakis Kyriakos, Stark Christina, Schafmeyer Leonie, Rehberg Mirko, Schoenau Eckhard
University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, Cologne, Germany.
University of Cologne, Medical Faculty and University Hospital, Department of Pediatrics, Cologne, Germany.
J Pediatr Endocrinol Metab. 2020 Jul 13. doi: 10.1515/jpem-2020-0080.
Objectives In children with cerebral palsy (CP), the most common cause of physical impairment in childhood, less muscle and bone growth has been reported, when compared with typically developing children. The aim of this study was to evaluate the effect of an intensive rehabilitation program including physiotherapy in combination with 6 months of home-based, vibration-assisted training on muscle and bone growth in children with CP. Methods We included children with CP, who participated in a rehabilitation program utilizing whole-body vibration (WBV). Muscle mass was quantified by appendicular lean mass index (App-LMI) and bone mass by total-body-less-head bone mineral content (TBLH-BMC) assessed by Dual-energy X-ray absorptiometry (DXA) at the beginning of rehabilitation and one year later. To assess the functional muscle-bone unit, the relation of TBLH-BMC to TBLH lean body mass (TBLH-LBM) was used. Results The study population included 128 children (52 females, mean age 11.9 ± 2.7). App-LMI assessed in kg/m2 increased significantly after rehabilitation. The age-adjusted Z-score for App-LMI showed no significant change. TBLH-BMC assessed in gram increased significantly. The Z-scores for TBLH-BMC decreased lesser than expected by the evaluation of the cross-sectional data at the beginning of rehabilitation. The parameter T B L H - B M C T B L H - L B M $\frac{TBLH-BMC}{TBLH-LBM}$ did not change relevantly after 12 months. Conclusions Muscle growth and to a lesser extent bone growth could be increased in children with CP. The intensive rehabilitation program including WBV seemed to have no direct effect on the bone, but the observed anabolic effect on the bone, may only been mediated through the muscle.
在脑性瘫痪(CP)儿童中,这是儿童期身体损伤的最常见原因,与正常发育儿童相比,已有报道称其肌肉和骨骼生长较少。本研究的目的是评估一项强化康复计划的效果,该计划包括物理治疗以及为期6个月的家庭振动辅助训练对CP儿童肌肉和骨骼生长的影响。方法:我们纳入了参与利用全身振动(WBV)的康复计划的CP儿童。在康复开始时和一年后,通过双能X线吸收法(DXA)评估肌肉质量,采用附属瘦体重指数(App-LMI)进行量化,骨骼质量采用无头全身骨矿物质含量(TBLH-BMC)进行评估。为了评估功能性肌肉-骨骼单元,使用TBLH-BMC与TBLH瘦体重(TBLH-LBM)的关系。结果:研究人群包括128名儿童(52名女性,平均年龄11.9±2.7岁)。康复后,以kg/m²评估的App-LMI显著增加。App-LMI的年龄校正Z评分无显著变化。以克评估的TBLH-BMC显著增加。TBLH-BMC的Z评分下降幅度小于康复开始时横断面数据评估的预期。参数TBLH - BMC/TBLH - LBM在12个月后没有明显变化。结论:CP儿童的肌肉生长以及程度较轻的骨骼生长可以增加。包括WBV的强化康复计划似乎对骨骼没有直接影响,但观察到的对骨骼的合成代谢作用可能仅通过肌肉介导。