Fracture rate in children with cerebral palsy.
OBJECTIVES: To determine the prevalence of previous fracture, the rate of fracture over time and associated risk factors for fracture in children with moderate or severe cerebral palsy (CP). STUDY DESIGN: Three hundred and sixty-four children with moderate-to-severe motor impairment (Gross Motor Fun...
| Published in: | Pediatric Rehabilitation Vol. 9; no. 4; pp. 396 - 404 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Taylor & Francis Ltd
Oct-Dec2006
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106286053&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106286053 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13638491 BC5 jtl: Pediatric Rehabilitation issn: 13638491 maglogo: Y pubinfo: dt: Oct-Dec2006 vid: 9 iid: 4 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 106286053 106286053 2009520961 10.1080/13638490600668061 NLM17111566 106286053 ppf: 396 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Fracture rate in children with cerebral palsy. aug: au: Stevenson RD Conaway M Barrington JW Cuthill SL Worley G Henderson RC affil: Department of Pediatrics, University of Virginia, Charlottesville, VA 22903, USA. rds8z@virginia.edu sug: subj: Cerebral Palsy Complications Fractures Epidemiology Fractures Risk Factors Adipose Tissue Adolescence Adult Child Child, Preschool Confidence Intervals Descriptive Research Funding Source Gastrostomy Multicenter Studies North America Prospective Studies Questionnaires Relative Risk Severity of Illness Severity of Illness Indices Human Adolescent: 13-18 years Adult: 19-44 years Child: 6-12 years Child, Preschool: 2-5 years ab: OBJECTIVES: To determine the prevalence of previous fracture, the rate of fracture over time and associated risk factors for fracture in children with moderate or severe cerebral palsy (CP). STUDY DESIGN: Three hundred and sixty-four children with moderate-to-severe motor impairment (Gross Motor Function Classification System III, IV and V) enrolled in a multi-centre, region-based longitudinal study of growth, nutrition and health. Of these, 297 had baseline fracture information and 261 children had at least one follow-up assessment. Median duration of follow-up was 1.6 years, for over 600 person-years of follow-up. RESULTS: Forty-six (15.5%) children reported 62 previous fractures at baseline assessment. Children with a history of fractures at baseline were older (mean age 11.9 vs. 8.9 years, p<0.0001) and had greater body fat (triceps z-score -0.01 vs. -0.68, p=0.0003) than children with no previous fracture. Twenty children (6.7%) reported 24 fractures during the follow-up period. Factors associated with risk of fracture during the follow-up period were higher body fat (p=0.03), gastrostomy use (p=0.05) and previous fracture (p=0.10). Based on 24 fractures in 604.5 person-years of follow-up, the rate of fracture was 4.0 per hundred children (4.0%) per year. For children with a history of fracture at baseline, the fracture rate was 7.0% per year; for children with gastrostomy, 6.8% per year; and for children with high triceps skinfold, 9.7% per year. CONCLUSIONS: Children with moderate or severe CP are at high risk for fracture. Children with greater body fat, feeding gastrostomy and prior history of fracture are at highest risk and may benefit most from intervention. Further longitudinal study and clinical trials in children with CP are needed to better understand the factors contributing to fracture risk in this population and the best methods of prevention and treatment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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