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Bone Mineral Density in Patients with Stroke

Şahin, Levent MD; Özoran, Kürşat MD; Hakan Gündüz, Osman MD; Uçan, Halil MD; Yücel, Metin MD

American Journal of Physical Medicine & Rehabilitation: August 2001 - Volume 80 - Issue 8 - p 592-596
Research Article: Osteoporosis
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Şahin L, Özoran K, Gündüz OH, Uçan H, Yücel M: Bone mineral density in patients with stroke. Am J Phys Med Rehabil 2001;80:592–596.

Objective Stroke is an acute neurologic dysfunction of vascular origin, characterized by loss of voluntary movement, sensory disturbances, and neurologic findings in the contralateral half of the body. Acute and long-term complications because of immobilization are seen in all organ systems. The aim of this study was to determine any differences between the affected and unaffected sides’ bone mineral densities of acute and chronic stroke patients.

Design In this study, we determined the bone mineral densities (BMD) of 30 male patients with acute (0-20 days) and 30 male patients with chronic (6 months or longer) stroke and compared the densities with the normal side. Upper and lower limb BMDs were measured by dual-energy x-ray absorptiometry. Additionally, patients were evaluated for the degree of spasticity, the phases of motor improvement, and the activities of daily living.

Results In acute-phase stroke patients, BMD of the affected side was not significantly different from BMD of the normal side. BMD of both upper limbs of acute stroke patients was not different from normal side upper limb BMD of chronic stroke patients. In both acute and chronic stroke patients, affected and unaffected side lower limb BMDs (femur total BMD scores) were not significantly different. However, in chronic stroke patients, affected side BMD of Ward’s region was significantly higher compared with the normal side. There is no correlation between BMD and Brunnstrom phases, Ashworth scales, and the degree of activities of daily living.

Conclusions Higher BMD of the affected side Ward’s region in chronic cerebrovascular accident patients may be related to spasticity and changes in walking pattern, which increase the mechanical stress loading of the Ward’s region.

From the Clinic of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey.

All correspondence and requests for reprints should be addressed to: Kürşat Özoran, Umurbey sok. 5/6 G.O.P., 06700 Ankara, Turkey.

© 2001 Lippincott Williams & Wilkins, Inc.