CHANGES IN BONE-MINERAL CONTENT AND DENSITY AFTER STROKE

The purpose of this study was to determine whether there are differences in bone mineral content and density between paralyzed and nonparalyzed sides of patients who had sustained strokes associated with unilateral muscle weakness, to determine the relationship between duration of stroke and degree of demineralization and to compare the degree of demineralization in upper and lower limbs. The bone mineral content and density were measured by dual photon absorptiometry (high resolution scanning mode, Lunar DP4) in ambulant patients with a history of single completed strokes associated with unilateral weakness. The bone mineral content and density of each limb was determined by the region of interest analysis program. In the 30 patients included in this study, the bone mineral content and density were significantly less on the paralyzed than on the nonparalyzed side. The degree of demineralization was more pronounced in the upper than in the lower limbs. The mean percentage differences in bone mineral content and density between paralyzed and nonparalyzed arms were 13.8% (P < 0.00001) and 7.95% (P = 0.0003), respectively, and between paralyzed and nonparalyzed legs the differences were 4.5% (P = 0.0012) and 3.42% (P = 0.0028), respectively. A better correlation was noted between the time elapsed since the stroke and the degree of demineralization in the upper limbs (r = 0.75, P < 0.0001), than in the lower limbs (r = 0.60, P = 0.0004). In conclusion, patients who have strokes associated with muscle weakness are at an increased risk of developing osteoporosis on the paralyzed side and particularly in the upper limbs.