Characteristics of calcium, phosphorus and bone metabolism in children with cerebral palsy and measures to improve them

  Cerebral palsy is a group of persistent central motor and postural developmental disorders and activity limitation syndromes that result from non-progressive brain injury in the developing fetal or infant brain. The motor deficits of cerebral palsy are often accompanied by sensory, perceptual, cognitive, communication, and behavioral deficits, as well as epilepsy and secondary muscular and skeletal problems. Most children present with reduced activity, hypermobility, and even prolonged bed rest. A combination of reduced bone density, osteoporosis, and pathological fractures is often reported.  Some studies have shown that blood calcium and phosphorus are relatively stable in children with cerebral palsy. Under the mutual regulation and strict control of parathyroid hormone, calcitonin and 1,25-(OH) 2D3, blood calcium and phosphorus are stable within a certain range, and there are no clinical manifestations of blood calcium and phosphorus abnormalities through their own regulation when the body is not obviously deficient in calcium.  However, children with cerebral palsy have reduced activity, low motor activity, or even prolonged bed rest or wheelchair living or immobilization after surgery (due to fracture or hip dislocation), etc. The weakening of muscle tension on bones reduces bone stress, enhances bone resorption, and the daily calcium deposition is significantly lower than that of normal children, and the bone mineralization is insufficient relative to children in the growth period, and the bone density of children with cerebral palsy in all age groups is lower than that of normal children of the same age.  It has been found that the bone quality of children is determined by the amount of calcium deposited in the bone at a specific age during the early growth period, i.e., the calcium intake after birth is related to the subsequent bone mass. Therefore, increasing the calcium intake of children with cerebral palsy, i.e., increasing the amount of calcium and phosphorus deposited, has a significant effect on preventing osteoporosis and pathological fractures.  Strengthening exercise, especially various weight-bearing exercises, standing training and increasing the amount of exercise can make the bone resorption of children with cerebral palsy weaken and bone formation flourish, which is conducive to the rehabilitation of children with cerebral palsy and prevention of bone damage.  Therefore, measures to improve the disorders of calcium, phosphorus and bone metabolism in children with cerebral palsy: 1. Increase the amount of exercise for children with cerebral palsy, reduce fixation as much as possible, and emphasize the necessity of starting exercise therapy for children with cerebral palsy from early infancy; 2. Increase the intake of calcium and phosphorus for children with cerebral palsy to promote the deposition of calcium and phosphorus in bone and improve bone density, which is a powerful measure to prevent fractures due to osteoporosis.