Effects of Passive Versus Dynamic Loading Interventions on Bone Health in Children Who Are Nonambulatory

Damcott, Megan PhD; Blochlinger, Sheila PT, ATP; Foulds, Richard PhD

Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e318299127d
Research Article
Abstract

Purpose: To investigate the effectiveness of a novel dynamic standing intervention compared with a conventional passive standing intervention on bone health in children with cerebral palsy who are nonambulatory.

Methods: Four children in passive standers and 5 in dynamic standers were followed for 15 months (standing 30 min/d, 5 d/wk). Dual-energy x-ray absorptiometry scans of the distal femur were obtained at 3-month intervals to measure changes in bone mineral density (BMD), bone mineral content, and area.

Results: Increases in BMD were observed during dynamic standing (P < .001), whereas passive standing appeared to maintain the baseline BMD. Increases in bone mineral content were observed in each standing intervention (P < .001), with dynamic standing inducing greater increases. Increases in area were comparable between interventions (P = .315).

Conclusions: Dynamic standing demonstrated the potential of moderate-magnitude, low-frequency loading to increase cortical BMD. Further investigations could provide insight into the mechanisms of bone health induced through loading interventions.

In Brief

Children&amp;#x0027;s bone health is reported to improve in those who received a dynamic standing intervention and to remain stable among those who received a passive standing intervention.

Author Information

Human Performance and Engineering Laboratory (Dr Damcott), Kessler Foundation Research Center, West Orange, New Jersey; Rehabilitation Technology Department (Ms Blochlinger), Children's Specialized Hospital, Mountainside, New Jersey; Department of Biomedical Engineering (Dr Foulds), New Jersey Institute of Technology, Newark, New Jersey.

Correspondence: Megan Damcott, PhD, Human Performance and Engineering Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, NJ 07052 (mdd7@njit.edu).

Grant support: National Institute on Disability and Rehabilitation Research, Rehabilitation Engineering Research Center, grant H133E0511-06.

The authors declare no conflicts of interest.

At the time this study was completed, Dr Megan Damcott was a student at New Jersey Institute of Technology/University of Medicine and Dentistry of New Jersey, Biomedical Engineering Department, Newark, New Jersey, completing her doctorate of philosophy.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.