血管弹性和握力与慢性卒中患者轻偏瘫范围内的骨健康有关：对康复的启示

Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong

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 bonestrength index at the hemiparetic radius diaphysis and vascular health in people withchronic 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 withchronic 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-arteryelasticity index and grip strength remained significantly associated with the bone strengthindex at the hemiparetic radius diaphysis after controlling for age, sex, time since strokediagnosis, 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.