Bone quality in adults with severe motor and intellectual disabilities.
Tomoko Sakai, Tokumitsu Shirai, Tsutomu Oishi
PMID 33469670WHAT IT FOUND
In adults with severe motor and intellectual disabilities, the ability to walk was the strongest predictor of better bone quality.
Older age and anti-epileptic drug use were linked to lower bone quality. Tube feeding and sex were not significant factors.
Key findings
01Current physical ability was the strongest predictor of T-scores, with walking associated with significantly higher values than sitting or being bedridden.
02All participants had low bone quality, with T-scores below the threshold for osteoporosis.
03Anti-epileptic drug use and older age were significant negative predictors of bone quality, while sex and tube-feeding status were not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used heel ultrasound instead of the standard dual-energy X-ray absorptiometry (DXA) because DXA equipment was not available. It was a single-centre study, which may introduce selection bias. The number of tube-fed patients was small (9 out of 60), limiting the ability to draw conclusions about feeding status. The term 'severe motor and intellectual disabilities' is a social welfare concept in Japan, which may not translate directly to medical classifications elsewhere. The study design cannot prove that physical activity causes better bone quality, only that they are associated.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that walking causes better bone quality; this observational study shows an association, not a direct causal link. Also, do not generalise the findings to all people with disabilities, as the participants were adults in a specific Japanese long-term care facility.