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Year : 2019  |  Volume : 32  |  Issue : 4  |  Page : 1479-1484

Assessment of osteoporosis in hemiplegic patients with stroke

1 Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Dina S Fotoh
Shebein El Kom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_137_16

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Objective The aim of this work was to find out the proportion of patients with stroke who are at risk of osteoporosis (OP) and to examine the relationships between bone mineral densities (BMDs) and severity of stroke and functional assessment. Background Loss of BMDs and fractures in patients after stroke are among the most serious health complications. Neurogenic OP is explained by the neural connection between brain and bone, which is mediated centrally by classic neurotransmitters and several neuropeptides. Moreover, mechanical stress on bone is one of the determinants of bone morphology, BMD, and bone strength. So reduction of mechanical stress on bone in patients with stroke inhibits osteoblast-mediated bone formation and accelerates osteoclast-mediated bone resorption, leading to what has been called disuse OP. Patients and methods A total of 100 patients with stroke diagnosed on clinical evaluation, including the mode of onset, the neurologic examination, and brain computed tomography scans, were included in this study. All patients were subjected to laboratory investigations, including the measurement of complete blood count, total and ionized serum calcium, and parathyroid hormone, and radiological investigations, including assessment of BMD of the lumbar spine (L2–L4), total hip, and distal forearm by dual-energy radiographic absorptiometry on both paretic and nonparetic sides. Results There were significant differences between BMDs at the spine and hip on the paretic side and duration of stroke, Lawton instrumental activity of daily living, and Scandinavian stroke scale (P < 0.001). There was a statistically significant increase in BMD regarding Barthel index (P < 0.001). There was also significant decrease in BMD on the paretic side in comparison with the nonparetic side (P < 0.001). Conclusion OP was more severe on the paretic side in patients with stroke compared with the nonaffected side. There was a significant negative correlation between BMD and age and duration of stroke.

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