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Statistical Models to Assess Leg Muscle Mass in Ambulatory Children With Spastic Cerebral Palsy Using Dual-Energy X-Ray Absorptiometry

Published on Jul 1, 2019in Journal of Clinical Densitometry2.184
· DOI :10.1016/j.jocd.2018.12.004
Chuan Zhang2
Estimated H-index: 2
(UGA: University of Georgia),
Daniel G. Whitney9
Estimated H-index: 9
(UM: University of Michigan)
+ 4 AuthorsChristopher M. Modlesky24
Estimated H-index: 24
(UGA: University of Georgia)
Abstract
Abstract Cerebral palsy (CP) is a movement disorder associated with small and weak muscles. Methods that accurately assess muscle mass in children with CP are scarce. The purpose of this study was to determine whether dual-energy X-ray absorptiometry (DXA) accurately estimates midleg muscle mass in ambulatory children with spastic CP. Ambulatory children with spastic CP and typically developing children 5-11 y were studied (n = 15/group). Fat-free soft tissue mass (FFST) and fat mass at the middle third of the tibia (i.e., midleg) were estimated using DXA. Muscle mass (muscle MRI ) and muscle mass corrected for intramuscular fat (muscle MRIfc ) in the midleg were estimated using magnetic resonance imaging (MRI). Statistical models were created to predict muscle MRI and muscle MRIfc using DXA. Children with CP compared to typically developing children had lower FFST (38%), muscle MRI (40%) and muscle MRIfc (47%) (all p MRIfc to FFST (17%, p MRI (13%) and muscle MRIfc (22%) (both p MRI and 90% of the variance in muscle MRIfc in children with CP (both p MRI and muscle MRIfc (both p > 0.99). We conclude that DXA-based statistical models accurately estimate midleg muscle mass in children with CP when the models are composed using data from children with CP rather than typically developing children.
  • References (33)
  • Citations (2)
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References33
Newest
#1Daniel G. Whitney (UM: University of Michigan)H-Index: 9
#2Edward A. Hurvitz (UM: University of Michigan)H-Index: 28
Last. Mark D. Peterson (UM: University of Michigan)H-Index: 33
view all 7 authors...
Abstract Background Individuals with cerebral palsy (CP) are at an increased risk for age-related morbidities due to functional impairments, maladapted growth, and altered body composition. While musculoskeletal (MSK) deficits are present in children, little is understood about MSK morbidity throughout the lifespan in those with CP. The purpose of this study was to examine the age-related trajectories of MSK morbidity and multimorbidity throughout adulthood in those with CP. Methods A clinic-bas...
14 CitationsSource
#1Daniel G. WhitneyH-Index: 9
#2Edward A. HurvitzH-Index: 28
Last. PetersonH-Index: 1
view all 8 authors...
National Institutes of Health (NIH) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)
21 CitationsSource
#1Taishi Midorikawa (J. F. Oberlin University)H-Index: 12
#2Megumi Ohta (Chukyo University)H-Index: 7
Last. Shizuo Sakamoto (Waseda University)H-Index: 12
view all 5 authors...
We aimed to develop regression-based prediction equations for estimating total and regional skeletal muscle mass (SMM) from measurements of lean soft tissue mass (LSTM) using dual-energy X-ray absorptiometry (DXA) and investigate the validity of these equations. In total, 144 healthy Japanese prepubertal children aged 6–12 years were divided into 2 groups: the model development group (62 boys and 38 girls) and the validation group (26 boys and 18 girls). Contiguous MRI images with a 1-cm slice t...
4 CitationsSource
#1Daniel G. Whitney (UD: University of Delaware)H-Index: 9
#2Harshvardhan Singh (UD: University of Delaware)H-Index: 7
Last. Christopher M. Modlesky (UD: University of Delaware)H-Index: 24
view all 7 authors...
Abstract Introduction Nonambulatory children with severe cerebral palsy (CP) have underdeveloped bone architecture, low bone strength and a high degree of fat infiltration in the lower extremity musculature. The present study aims to determine if such a profile exists in ambulatory children with mild CP and if excess fat infiltration extends into the bone marrow. Materials and methods Ambulatory children with mild spastic CP and typically developing children (4 to 11 years; 12/group) were compar...
23 CitationsSource
#1Silmara Gusso (University of Auckland)H-Index: 9
#2Craig F. Munns (Children's Hospital at Westmead)H-Index: 34
Last. Paul Hofman (University of Auckland)H-Index: 69
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We performed a clinical trial on the effects of whole-body vibration training (WBVT) on muscle function and bone health of adolescents and young adults with cerebral palsy. Forty participants (11.3–20.8 years) with mild to moderate cerebral palsy (GMFCS II–III) underwent 20-week WBVT on a vibration plate for 9 minutes/day 4 times/week at 20 Hz (without controls). Assessments included 6-minute walk test, whole-body DXA, lower leg pQCT scans, and muscle function (force plate). Twenty weeks of WBVT...
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#1Kate E. Therkelsen (BU: Boston University)H-Index: 7
#2Alison PedleyH-Index: 18
Last. Joanne M. Murabito (BU: Boston University)H-Index: 76
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Intramuscular fat may mediate associations between obesity and physical disability. We examined the associations between muscle attenuation, a proxy for intramuscular fat, and physical function. Paraspinous muscle computed tomography attenuation was obtained on a Framingham Heart Study subgroup (n = 1152, 56 % women, mean age 66 years). Regressions modeled cross-sectional associations between muscle attenuation and mobility disability, grip strength, and walking speed with standard covariates; m...
19 CitationsSource
#1Sunyoung Kim (Kyung Hee University)H-Index: 14
#2Chang Won Won (Kyung Hee University)H-Index: 15
Last. Min Young Moon (Kyung Hee University)H-Index: 1
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The purpose of this study was to predict osteoporosis risk as decreasing muscle mass and to declare the cut-off value of low muscle mass in an elderly Korean population. This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys (KNHANES). The subjects included 1,308 men and 1,171 women over 65 yr. Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual energy X-ray absorptiometry (DXA), and appendicular skeletal musc...
29 CitationsSource
#1Sian A. Williams (UWA: University of Western Australia)H-Index: 7
#2Siobhan Reid (UWA: University of Western Australia)H-Index: 19
Last. Jane ValentineH-Index: 16
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Aim With evidence for an atrophic effect of botulinum toxin type A (BoNT-A) documented in typically developing muscles, this study investigated the immediate morphological alterations of muscles in children with cerebral palsy (CP) after BoNT-A treatment. Method Fifteen children (10 males, five females; age range 5–11y, mean age 8y 5mo, SD 1y 10mo) with spastic diplegic CP [Gross Motor Function Classification System Levels I (n=9) and II (n=6)] receiving BoNT-A injections for spasticity manageme...
35 CitationsSource
PURPOSE OF REVIEW: This review summarizes the recent articles and perspectives about the linkage between muscle and bone. Moreover, it focuses on common, clinically important signals affecting both muscle and bone. RECENT FINDINGS: The clinical significance of sarcopenia has recently been highlighted, and muscle mass and muscle strength affect osteoporosis differently. The link between muscle and bone is also important from the viewpoint of exercise therapy. The clinical evaluation of vitamin D ...
47 CitationsSource
#1Mark D. Peterson (UM: University of Michigan)H-Index: 33
#2Paul M. Gordon (UM: University of Michigan)H-Index: 20
Last. Charles F. Burant (UM: University of Michigan)H-Index: 41
view all 4 authors...
Cerebral palsy (CP) is caused by an insult to or malformation of the developing brain which affects motor control centers and causes alterations in growth, development, and overall health throughout the life span. In addition to the disruption in development caused by the primary neurological insult, CP is associated with exaggerated sedentary behaviors and a hallmark accelerated progression of muscle pathology compared with typically developing children and adults. Factors such as excess adipos...
25 CitationsSource
Cited By2
Newest
#1Chuan Zhang (UGA: University of Georgia)H-Index: 2
#2Gavin T. Colquitt (GS: Georgia Southern University)H-Index: 4
Last. Christopher M. Modlesky (UGA: University of Georgia)H-Index: 24
view all 5 authors...
Summary Background Cerebral palsy (CP) is a neurological disorder characterized by a profound skeletal muscle deficit. However, whether there is a regional-specific skeletal muscle deficit in children with CP is unknown. The purpose of this study was to determine whether fat-free soft tissue mass (FFST), a commonly used surrogate for skeletal muscle mass, is more compromised in the limbs than in the trunk in children with CP. A second purpose was to determine whether physical characteristics can...
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