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

Natalie Curley, Yilin Yang, Janet Dean, Cynthia Salorio, Cristina Sadowsky

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)42-52
Number of pages11
JournalTopics in Spinal Cord Injury Rehabilitation
Issue number1
StatePublished - Dec 1 2022


  • acute flaccid myelitis
  • bone density
  • bone health
  • bone mass
  • fractures
  • functional performance
  • muscle mass
  • muscle strength
  • paralysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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