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Site-Specific Bone Mineral Density Is Unaltered Despite Differences in Fat-Free Soft Tissue Mass Between Affected and Nonaffected Sides in Hemiplegic Paralympic Athletes with Cerebral Palsy

Preliminary Findings

Runciman, Phoebe PhD; Tucker, Ross PhD; Ferreira, Suzanne PhD; Albertus-Kajee, Yumna PhD; Micklesfield, Lisa PhD; Derman, Wayne MBChB, PhD

American Journal of Physical Medicine & Rehabilitation: October 2016 - Volume 95 - Issue 10 - p 771–778
doi: 10.1097/PHM.0000000000000532
Original Research Articles

Objective This study investigated bone mineral density (BMD, g/cm2), fat mass (FM, kg), and fat-free soft tissue mass (FFSTM, kg) in Paralympic athletes with cerebral palsy (CP) using dual-energy x-ray absorptiometry.

Methods Bone mineral density, BMD Z scores (standard deviations), FM, and FFSTM were measured for the whole body and at the lumbar spine, femoral neck, and total hip sites on both nonaffected and affected sides of 6 athletes with hemiplegic CP.

Results There were no differences between nonaffected and affected sides with respect to site-specific BMD and BMD Z scores and FM. Fat-free soft tissue mass was significantly lower on the affected side in both upper and lower limbs (15% lower; P < 0.05).

Conclusion The present study is the first to describe similar BMD between sides, symmetry in FM, and asymmetry in FFSTM in Paralympic athletes with CP. These findings have important consequences for rehabilitation, as they indicate the potential for positive physiological adaptation as a result of exercise training over long periods of time.

From the Division for Exercise Science and Sports Medicine, University of Cape Town, South Africa (PR, YA-K, LM, WD); Department of Sport Science, Stellenbosch University, Stellenbosch, South Africa (SF); International Olympic Committee Research Centre, Cape Town, South Africa (WD); MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (LM); Division of Orthopaedic Surgery, Institute of Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa (PR, WD); and Department of Medicine, University of the Free State, Bloemfontein, South Africa (RT).

All correspondence and requests for reprints should be addressed to: Phoebe Runciman, PhD, Institute of Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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