Bone Abstracts

The aim of this study was to investigate BMD of affected femur in patients with hemiplegic stroke.

Medical records of 153 patients with stroke who admitted a rehabilitation clinic from January 2011 to March 2013 were retrospectively reviewed. We excluded the patients with non-hemiplegia, diseases which can affect the BMD such as diabetes mellitus, thyroid disease and anti-epileptic drugs. We also excluded the patients who did not check both femur BMD. Total 68 subjects were finally enrolled in the study (38 males, 30 postmenopausal females). We measured BMD at affected and unaffected femur using dual energy X-ray absorptiometry, bone turn-over markers and activity levels. The influences of factors on affected femur neck BMD were investigated by linear regression test.

31 subjects showed decreased BMD of affected femur neck (45%). In 16 males (61.9±10.5 years), the mean duration after stroke was 51.3±31.5 days, BMI was 22.4±3.5 (kg/m²) and wheel chair ambulators were 12. The BMD ratio of affected and unaffected femur neck was 0.915±0.07. The 25-hydroxy vitamin D was 8.2±12.3 (ng/ml), serum osteocalcin was 5.25±6.67 (ng/ml) and serum CTX was 0.315±0.42 (ng/ml). In 15 postmenopausal females (68.3±10.4 years), the mean duration after stroke was 31.1±19.7 days, BMI was 22.6±3.0 and wheel chair ambulators were eight. The BMD ratio of affected and unaffected femur neck was 0.926±0.083. The 25-hydroxy vitamin D was 10.6±10.5, serum osteocalcin was 7.81±8.23 and serum CTX was 0.44±0.56. In linear regression test, ambulation classification was a only effect factor on the BMD ratio of affected and unaffected femur neck (β=0.38, P=0.034).

The femur neck BMD of hemiplegic side were not decreased in all stroke patients. This study showed BMD changes in affected femur neck were link to ambulation classification than bone turnover marker.