Bone mineral density in patients with stroke

Objective: Stroke is an acute neurologic dysfunction of vascular origin, ch aracterized by loss of voluntary movement, sensory disturbances, and neurol ogic findings in the contralateral half of the body. Acute and long-term co mplications because of immobilization are seen in all organ systems. The ai m of this study was to determine any differences between the affected and u naffected sides' bone mineral densities of acute and chronic stroke patient s. 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. U pper and lower limb BMDs were measured by dual-energy x-ray absorptiometry. Additionally, patients were evaluated for the degree of spasticity, the ph ases of motor improvement, and the activities of daily living. Results: In acute-phase stroke patients, BMD of the affected side was not s ignificantly 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, aff ected and unaffected side lower limb BMDs (femur total BMD scores) were not significantly different. However, in chronic stroke patients, affected sid e BMD of Ward's region was significantly higher compared with the normal si de. There is no correlation between BMD and Brunnstrom phases, Ashworth sca les, and the degree of activities of daily living. Conclusions: Higher BMD of the affected side Ward's region in chronic cereb rovascular accident patients may be related to spasticity and changes in wa lking pattern, which increase the mechanical stress loading of the Ward's r egion.