Skeletal and functional status in patients with long-standing stroke

Abstract

Introduction: Skeletal and functional status can be affected after stroke, mainly due to subjects’ immobilisation. The aim of our study was to assess the functional and bone status in post-stroke patients with hemiplegia. Quantitative ultrasound at hand phalanges and bone mineral density (BMD) in the wrist and the calcaneal bone were compared between the paralysed and the non-paralysed side. The study was performed at the Department of Rehabilitation in Nowa Sol.
Material and methods: The study included a group of 71 subjects (29 females and 42 males) who had suffered a stroke. Skeletal status was assessed by densitometry (Pixi, Lunar Corp., USA, forearm, calcaneus) and ultrasound (DBM Sonic 1200, IGEA, Italy, hand phalanges). Functional status was evaluated by the Barthel index.
Results: The mean values of forearm BMD and ultrasound measurements were significantly lower in the affected limbs versus the opposite site. The mean Barthel index value was 73 ± 21.5. Reduction of the time interval between stroke and standing up positively influenced the difference between wrist BMD in the affected versus the opposite limb, both in the whole group of patients (r = 0.3, p < 0.05) and females (r = 0.41, p < 0.05). Forearm BMD in males in the affected limb correlated with the Barthel index (r = 0.35, p < 0.05).
Conclusion: Fracture risk in post-stroke subjects may be increased due to disturbed skeletal and functional status. Reduction of the time interval between stroke and standing up improved wrist densitometric results. (Pol J Endocrinol 2011; 62 (1): 2-7)