The Relationship of Bone Strength and Fitness Training in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      In the first year, all subjects received clinical assessments include subjective assessment,
      basic data, nutritional status and fitness assessments. Laboratory assessments include body
      composition, bone density(lumbar spine and femur by dual energy X-ray absorptiometry ), bone
      strength (by calcaneal ultrasound) and bone metabolism.

      In the 2nd year, were randomized into three groups. The high level training group (20
      children) will receive high frequency fitness training program(Frequency: three times one
      week, Duration: thirty minutes). The low level training group (20 children) will receive low
      frequency fitness training program(Frequency: two times one week, Duration: thirty
      minutes).The control group (20 children) will not receive fitness training program but
      maintain the usual life style.

      In the 3rd year, all subjects received post-training clinical assessments include subjective
      assessment, basic data, nutritional status and fitness assessments. Laboratory assessments
      include body composition, bone density(lumbar spine and femur by dual energy X-ray
      absorptiometry ), bone strength (by calcaneal ultrasound) and bone metabolism.

      These data provided in this study could establish the bone quality and fitness data of
      children with diplegic CP, and provide us to plan treatment strategies in the management of
      bone and fitness problems in the future.
    

Detailed description: 
      Malnutrition and motor impairment are common in children with cerebral palsy. Poor nutrition
      and motor impairment may further contribute to fitness impairment, low bone mineralization
      density (BMD), low bone strength, and even fractures in children with CP. To management of
      bone problems is based on the understanding the pathophysiology of bone mineralization or
      bone strength in CP.

      Multiple factors, including nutritional factors (eg. nutritional status, body composition)
      and non-nutritional factors (eg. fitness, immobility, use of anticonvulsants) that may
      potentially have an impact on bone density/strength in children with CP However, there were
      few studies to investigate the relationship of bone strength and fitness in children with
      cerebral palsy in Taiwan. We hypothesized that fitness training may potentially have an
      impact on bone density/strength in children with CP. The purpose of this study is to further
      find out the relationship of bone quality and fitness training in children with CP.

      We will collect 60 children with diplegic CP. The inclusion criteria include good cognition
      to comprehend the command and cooperation during examination and fitness training. The
      exclusion criteria were following as chromosomal abnormalities, active medical conditions
      such as pneumonia or others, poor tolerance during assessment and fitness training.

      In the first year, all subjects received clinical assessments include subjective assessment,
      basic data, nutritional status and fitness assessments. Laboratory assessments include body
      composition, bone density(lumbar spine and femur by dual energy X-ray absorptiometry ), bone
      strength (by calcaneal ultrasound) and bone metabolism.

      In the 2nd year, were randomized into three groups. The high level training group (20
      children) will receive high frequency fitness training program(Frequency:three times one
      week, Duration: 40 minutes).The low level training group (20 children) will receive low
      frequency fitness training program(Frequency: 1-2 times one week, Duration: 40 minutes). The
      control group (20 children) will not receive fitness training program but maintain the usual
      life style.

      In the 3rd year, all subjects received post-training clinical assessments include subjective
      assessment, basic data, nutritional status and fitness assessments. Laboratory assessments
      include body composition, bone density(lumbar spine and femur by dual energy X-ray
      absorptiometry ), bone strength (by calcaneal ultrasound) and bone metabolism.

      These data provided in this study could establish the bone quality and fitness data of
      children with diplegic CP, and provide us to plan treatment strategies in the management of
      bone and fitness problems in the future.
    

Intervention name(s): fitness training program
Intervention type(s): Other
Intervention description(s): Experimental: high level training group. The experimental group received training for 40 min per day 3 times a week for 12 weeks. The hVCT program consisted of a 5-min warm-up exercise, twenty repetitions of sitting-to-standing movements, cycling for 20 min, and a cool-down exercise for 5 min.
Experimental: low level training group. The experimental group received training for 40 min per day 1-2 times a week for 12 weeks. The program consisted of a 5-min warm-up exercise, twenty repetitions of sitting-to-standing movements, fitness training for 20 min, and a cool-down exercise for 5 min.
Control:The control group will not receive fitness training program but maintain the usual life style.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cerebral palsy; bone density; bone strength