Bone Size, Architecture, and Strength Deficits in Cerebral Palsy

Abstract

Childhood and adolescence are the most important periods of bone development. The bones experience an increase in size, an accretion of mineral, a change in architecture, and an increase in strength that accommodate greater strains on the skeleton due to the increasing weight of the growing body and the increasing muscle forces produced during physical activity. Children with cerebral palsy (CP) tend to have smaller bones, lower areal bone mineral density, and less developed bone architecture compared to typically developing children, which contributes to their much weaker bones and higher risk for fracture. In this chapter, we will review how deficits in bone that emerge during the growth and development of children with CP contribute to their high rate of fragility fractures.We will also review methods of bone assessment, factors that contribute to the poor bone development in children and adolescents with CP, bone health in adults with CP, and potential treatment strategies.