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Title: Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study.
Austin Authors: Borschmann, Karen ;Iuliano, Sandra ;Ghasem-Zadeh, Ali ;Churilov, Leonid ;Pang, Marco Y C;Bernhardt, Julie
Affiliation: School of Health Science, La Trobe University, Bundoora, Australia
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Endocrinology, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
Issue Date: 8-Jan-2018 2018-01-08
Publication information: Archives of osteoporosis 2018; 13(1): 5
Abstract: Bone fragility contributes to increased fracture risk, but little is known about the emergence of post-stroke bone loss. We investigated skeletal changes and relationships with physical activity, stroke severity, motor control and lean mass within 6 months of stroke. This is a prospective observational study. Participants were non-diabetic but unable to walk within 2 weeks of first stroke. Distal tibial volumetric bone mineral density (vBMD, primary outcome), bone geometry and microstructure (high-resolution peripheral quantitative computed tomography) were assessed at baseline and 6 months, as were secondary outcomes total body bone mineral content and lean mass (dual energy X-ray absorptiometry), bone metabolism (serum osteocalcin, N-terminal propeptide of type 1 procollagen (P1NP), C-terminal telopeptide of type 1 collagen (CTX)), physical activity (PAL2 accelerometer) and motor control (Chedoke McMaster) which were also measured at 1 and 3 months. Thirty-seven participants (69.7 years (SD 11.6), 37.8% females, NIHSS 12.6 (SD 4.7)) were included. The magnitude of difference in vBMD between paretic and non-paretic legs increased within 6 months, with a greater reduction observed in paretic legs (mean difference = 1.5% (95% CI 0.5, 2.6), p = 0.007). At 6 months, better motor control was associated with less bone loss since stroke (r = 0.46, p = 0.02). A trend towards less bone loss was observed in people who regained independent walking compared to those who did not (p = 0.053). Higher baseline daily count of standing up was associated with less change in bone turnover over 6 months: osteocalcin (r = -0.51, p = 0.01), P1NP (r = -0.47, p = 0.01), CTX (r = -0.53, p = 0.01). Better motor control and walking recovery were associated with reduced bone loss. Interventions targeting these impairments from early post-stroke are warranted. URL: . Unique identifier: ACTRN12612000123842.
DOI: 10.1007/s11657-017-0414-4
ORCID: 0000-0002-9807-6606
Journal: Archives of osteoporosis
PubMed URL: 29313169
Type: Journal Article
Subjects: Bone loss
Bone mineral density
Physical activity
Appears in Collections:Journal articles

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