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Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System

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Accelerated bone remodeling in patients with poststroke hemiplegia.

Y Sato¹, Y Fujimatsu, Y Honda

¹Department of Neurology, Futase Social Insurance Hospital, Iizuka, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|September 27, 2007

Summary

Stroke patients experience bone loss on the hemiplegic side due to vitamin D deficiency. This leads to accelerated bone remodeling and osteopenia, potentially treatable with vitamin D and bone resorption inhibitors.

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Area of Science:

Orthopedics
Endocrinology
Neurology

Background:

Stroke-induced hemiplegia causes disuse and vitamin D deficiency, leading to bone-mass reduction.
Osteopenia in hemiplegic limbs increases hip fracture risk, predominantly on the affected side.

Purpose of the Study:

To evaluate bone mineral density (BMD) and related biochemical markers in stroke patients with hemiplegia.
To understand the mechanisms of osteopenia in hemiplegic limbs.

Main Methods:

Assessed BMD of the second metacarpals in 61 stroke patients and 28 controls.
Measured serum levels of intact parathyroid hormone (PTH), osteocalcin (OC), tartrate-resistant acid phosphatase (TRAP), 25-hydroxyvitamin D (25-OHD), and calcium.

Main Results:

BMD was higher on the hemiplegic side compared to the nonhemiplegic side.
Hemiplegic BMD correlated positively with PTH, OC, and TRAP, and negatively with 25-OHD.
Serum 25-OHD was low, while PTH, OC, and TRAP were elevated in patients compared to controls.

Conclusions:

Accelerated skeletal remodeling with predominant resorption occurs in hemiplegic limbs.
Vitamin D deficiency and secondary hyperparathyroidism contribute to osteopenia in stroke patients.
Treatment with etidronate and vitamin D may correct hemiplegic limb osteopenia.