Influence of Verticalization on Bone Mineral Density and Biological Parameters of Bone Remodeling in Children With Severe Cerebral Palsy

Study Overview
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Brief Summary
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Low bone mineral density affects 77% of children with severe cerebral palsy (GMFCS IV & V) with an increased fracture risk of 4%. One strategy supposed to improve bone mineral density is verticalisation with static devices. Nowadays there is no time recommendation of verticalisation however high intensity verticalisation has been shown to be effective in improving bone mineral density in childrens with cerebral palsy, but difficult to apply in real life due to lack of qualified therapists, device's complexity, and severe impairment in those children. The investigators aim to compare bone mineral density and bone remodelling factors of verticalized and non verticalized childrens with severe cerebral palsy as achieved in everyday life. The investigators conduced a retrospective study comparing bone mineral density and factors who influence bone remolling in severe cerebral palsy's according to whether they are verticalized or not.

Official Title
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Influence of Verticalization on Bone Mineral Density and Biological Parameters of Bone Remodeling in Children With Severe Cerebral Palsy

Conditions
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Cerebral Palsy, Osteoporosis, Bone Mineral Density, Bone Remodeling Disorder, Fracture

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with cerebral palsy GMFCS (gross motor functional classification scale) IV-V age of patients 3-18 years Exclusion Criteria: patients with neuro muscular disease patient age < 3 years old and > 18 years old patient with constitutionnal bone disease patient with growth hormone treatment patient with surgery < 6 months patient with fracture <3 months Refusal of the legal representative

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| static verticalization device<br>children with severe cerebral palsy (GMFCS IV & V) with static verticalization device | |
| non verticalization device<br>children with severe cerebral palsy (GMFCS IV & V) without static verticalization device | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Variation of Densitometric Z score between both groups | A Z-score compares the patient bone density to the average bone density of people your own age and gender.A Z-score is helpful in diagnosing secondary osteoporosis and is always used for children. It is most useful when the score is less than 2 standard deviations below this normal. In this setting, it is helpful to scrutinize for coexisting illnesses or treatments that may contribute to osteoporosis such as glucocorticoid therapy, hyperparathyroidism, or alcoholism. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral Palsy, Osteoporosis, bone mineral density, bone remodelling factors, Fracture, static verticalization device, weight bearing exersices