Tomoko Sakai, Tokumitsu Shirai, Tsutomu Oishi
Department of Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan. E-mail: t_sakai.orth@tmd.ac.jp
DOI: 10.2340/16501977-2789

Objective: To determine bone quality in adults with severe motor and intellectual disabilities.
Design: A retrospective cohort study.
Patients: Bone quality of 60 patients with severe motor and intellectual disabilities (28 men, 32 women; mean age 57 years) at a long-term care facility for adults was examined retrospectively.
Methods: Quantitative ultrasonography was used to measure the stiffness index, T-score and Z-score of the calcaneus. A multiple linear regression model, including sex, age, anti-epileptic drug use, tube-feeding status, and current and peak physical abil-ities, was used to identify significant predictors of T-scores.
Results: Quantitative ultrasonography revealed that all patients had lower bone quality (based on T-scores, Z-scores, and stiffness index), and all patients had T-scores with standard deviations (SD) below 1. 8. Current physical ability, age, and anti-epileptic drug use were significant factors in T-score determination, while tube-feeding and peak physical ability were not. The ability to walk without assistance was the most significant predictor in quantitative ultrasonography.
Conclusion: Severely low bone quality is observed in patients with severe motor and intellectual disabilities; and it is strongly associated with current physical activity. It is important that patients with severe motor and intellectual disabilities preserve their physical abilities to prevent osteoporosis-related fractures.

Fractures are common in adults with severe motor and intellectual disabilities. This study assessed the bone quality of 60 individuals from young adult to advanced age. All patients had low bone quality from a young age, and current physical ability, age, and anti-epileptic drug use were factors affecting bone quality, while tube-feeding and peak physical ability were not. Severely low bone quality in patients with severe motor and intellectual disabilities is strongly associated with current physical activity levels. It is very important for patients with severe motor and intellectual disabilities to increase and preserve their physical activities and abilities, respectively, to prevent osteoporosis-related fractures.