Description of Bone Health Changes in a Cohort of Children With Acute Flaccid Myelitis (AFM)

Author:

Curley Natalie1,Yang Yilin2,Dean Janet34,Salorio Cynthia45,Sadowsky Cristina34

Affiliation:

1. 1 Arizona College of Osteopathic Medicine, Glendale, Arizona

2. 2 Johns Hopkins School of Medicine, Baltimore, Maryland

3. 3 International Center for Spinal Cord Injury at Kennedy Krieger Institute, Baltimore, Maryland

4. 4 Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland

5. 5 Rehabilitation Outcomes and Related Research at Kennedy Krieger Institute, Baltimore, Maryland

Abstract

Objectives: To qualitatively describe bone health changes in children with acute flaccid myelitis (AFM) and assess relationships with muscle mass and strength and functional performance. Methods: Retrospective analysis of a cohort of 79 children with AFM seen consecutively in one specialized academic center between January 1, 2007, and December 31, 2019. Results: Of the 79 participants who were aged 4 months to 21 years old, 41 (52%) had bone density measured by dual energy absorptiometry (DXA) and 32 of them (78%) were diagnosed with low bone mass (LBM). We recorded 25 fractures that occurred after onset of neurologic deficit in 14 of the children in the cohort (18%). Lean muscle mass correlated with bone mass and functional performance as assessed by Physical Abilities and Mobility Scale (PAMS) but not with muscle strength as assessed by manual muscle testing (MMT). Bone density in the lower limbs was associated with ambulatory status. Conclusion: Children with AFM have a high likelihood of muscle and bone loss and frequently sustain pathologic fractures. Bone health in children with AFM should be carefully monitored, and efforts should be made to preserve bone mass and maximize muscle mass.

Publisher

American Spinal Injury Association

Subject

Neurology (clinical),Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation

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