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  • Vascular Elasticity and Grip Strength Are Associated With Bone Health of the Hemiparetic Radius in People With Chronic Stroke: Implications for Rehabilitation

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    Author(s)
    Y.C. Pang, Marco
    Z.H. Yang, Feigo
    Jones, Alice
    Griffith University Author(s)
    Jones, Alice
    Year published
    2013
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    Abstract
    Background People with stroke often have increased bone loss and fracture rate. Increasing evidence has demonstrated a link between cardiovascular health and bone loss in other patient populations. Objective The study objectives were: (1) to compare the bone density and geometry of the radius diaphysis on the left and right sides in people with chronic stroke and people who were matched for age (control participants) and (2) to examine the relationship between the bone strength index at the hemiparetic radius diaphysis and vascular health in people with chronic stroke. Design This was a case-control study. Methods The radius ...
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    Background People with stroke often have increased bone loss and fracture rate. Increasing evidence has demonstrated a link between cardiovascular health and bone loss in other patient populations. Objective The study objectives were: (1) to compare the bone density and geometry of the radius diaphysis on the left and right sides in people with chronic stroke and people who were matched for age (control participants) and (2) to examine the relationship between the bone strength index at the hemiparetic radius diaphysis and vascular health in people with chronic stroke. Design This was a case-control study. Methods The radius diaphysis on both sides was scanned with peripheral quantitative computed tomography in 65 participants with chronic stroke and 34 control participants. Large-artery and small-artery elasticity indexes were evaluated with a cardiovascular profiling system. Results The paretic radius diaphysis had significantly lower values for cortical bone mineral density, cortical thickness, cortical area, and the bone strength index but a larger marrow cavity area than the nonparetic radius diaphysis in participants with chronic stroke, whereas no bone measurement showed a significant side-to-side difference in control participants. Multiple regression analyses showed that the large-artery elasticity index and grip strength remained significantly associated with the bone strength index at the hemiparetic radius diaphysis after controlling for age, sex, time since stroke diagnosis, body mass index, and physical activity (R2=.790). Limitations This study was cross-sectional and could not establish causality. The radius diaphysis is not the most common site of fracture after stroke. Conclusions Both the integrity of the vasculature and muscle strength were significantly associated with the bone strength index at the hemiparetic radius diaphysis in participants with chronic stroke. The results may be useful in guiding rehabilitative programs for enhancing bone health in the paretic arm after stroke. 頲013 American Physical Therapy Association.
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    Journal Title
    Physical Therapy
    Volume
    93
    Issue
    6
    DOI
    https://doi.org/10.2522/ptj.20120378
    Copyright Statement
    © 2013 American Physical Therapy Association. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
    Subject
    Physiotherapy
    Clinical Sciences
    Human Movement and Sports Sciences
    Publication URI
    http://hdl.handle.net/10072/56049
    Collection
    • Journal articles

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