The influence of two physical activity programs on bone and muscle health in youth with cerebral palsy and other neuromotor impairments.

Weight-bearing physical activity is crucial for building strong bones, especially during childhood and adolescence when bones grow rapidly. During this time, physical activity, muscle-bone interactions, and gravity help stimulate bone development. However, in conditions that limit mobility, such as cerebral palsy (CP) and other non-progressive neuromotor impairments (CP-like), physical activity is reduced, which can lead to poor bone health. This increases the risk of fractures and may lead to osteoporosis in adults with CP. This thesis examines bone health in children and youth with CP and CP-like conditions using peripheral quantitative computed tomography (pQCT) scans of the tibiae. Bone and muscle parameters, including bone mineral content (BMC), bone mineral density (both trabecular and cortical; BMD), bone size, and muscle size, were compared to age-, sex-, and ethnicity-matched peers from a typically developing population. A total of 22 participants from all Gross Motor Function Classification System (GMFCS) levels (I-V) were included. This study found smaller, thinner and weaker bones and lower muscle strength in children and adolescents with CP and CP-like conditions across all GMFCS levels, with deficits relating to functional ability. As weaker bones increase the incidence of fragility fractures, causing pain and predisposing future comorbidities, this thesis further evaluated the effects of two physical activity programs on bone and muscle strength. Robot-assisted walking in three participants with the greatest functional limitations found upright mobility may improve bone strength. In contrast, power training in eight participants with the greatest functional abilities found no adaptations in bone or muscle. These findings suggest that while bone health is a concern across all functional abilities, adaptations appear to correlate to the loading one previously experienced, having the greatest impacts in those who do not regularly ambulate. This highlights the importance of tailored physical activity programs based on functional ability during growth and could inform strategies for improving musculoskeletal health in children and youth with CP and CP-like conditions.

Name thesis:degree_name

Master of Science (MSc)

Discipline thesis:degree_discipline

Engineering – Biomedical

Grantor dc:publisher.institution

Graduate Studies

Year dc:date.issued

2025

Author dc:creator

• Hodgson, Erin

Advisors dc:contributor.advisor

• Condliffe, Elizabeth G.
• Gabel, Leigh

Committee members dc:contributor.committeemember

• Manske, Sarah
• Kirton, Adam

• Bone Health
• Cerebral palsy
• pQCT
• Neuromotor impairments

Statement dc:rights

• University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.

Language dc:language.iso

en

DOI

https://dx.doi.org/10.11575/PRISM/47988

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:1880/120379