Results of a specialized rehabilitation approach in osteogenesis imperfecta

Oliver Semler; Heike Hoyer-Kuhn; Christina Stark; Eckhard Schoenau

doi:10.1530/boneabs.4.P65

Introduction: Osteogenesis imperfecta is a rare disease leading to immobility by recurrent fractures, immobilization, short stature and muscular weakness. Beside drug treatment and surgical procedures physiotherapy is the most important treatment approaches to increase mobility. The objective of our analysis was to evaluate the effect of a new standardized 12 months physiotherapy concept including whole body vibration over 6 months on motor function and bone mineral density in children with Osteogenesis imperfecta.

Methods: In a retrospective data analysis 53 children (32 male; mean age: 9.1 years, bisphosphonate treatment n=46; OI type 1 n=8; OI type 3 n=17; OI type 4 n=26, OI type 5 n=2) were analyzed. The 12 months concept included a period of 6 months of whole body vibration and concomitant physiotherapy, resistance training and treadmill training. The concept is structured in two in-patient stays and two periods of three months home-based vibration training. Primary outcome parameter was the gross motor function measure before and after 12 months. iDXA (GE) was used to analyze muscle and bone parameters.

Results: Results of the training period and the follow-up are presented in Table 1:

Table 1
	Change during training	Change during follow up	Change over all
GMFM 66 (score) (mean and P-value)	3.62	−0.42	3.20
	<0.001	0.60	<0.001
1-min walking (m) (mean and P-value)	20.25	−3.93	16.3
	0.002	0.733	0.01
BMD L2-L4 (z-score) (mean and P-value)	Not measured do to radiation reduction		0.13
			0.43
BMD TBLH (z-score) (mean and p-value)			−0.03 0.66
Height (cm) (mean and P-value)	2.3	1.8	4.1
	<0.001	<0.001	<0.001
Height (S.D.) (mean and P-value)	−0.07	−0.06	−0.13
	0.445	0.729	0.305
BMI (SD) (mean and P-value)	0.04	−0.06	−0.02
	0.893	0.275	0.429

Conclusions: The physiotherapy concept including whole body vibration leads to a significant improvement on gross motor function, lean mass and bone mineral content in children with Osteogenesis imperfecta. Additional the height of the children increased comparable to their age group and they showed no increase of their dwarfism. Therefore this therapeutic approach should be considered as part of an integrated treatment concept in children with OI.

Disclosure: OS and ES are employed by the rehabilitation center.

Bone Abstracts

P65