Changes in bone density and geometry of the upper extremities after stroke: a case report

Area of Science:

• Neurorehabilitation
• Bone Metabolism
• Stroke Recovery

Background:

• Stroke often leads to upper extremity impairment and disuse.
• Bone health in the affected limb is a critical but often overlooked aspect of stroke recovery.

Purpose of the Study:

• To investigate changes in bone density and geometry in the forearm of a stroke survivor.
• To assess motor function of the paretic upper extremity during subacute and chronic recovery phases.

Main Methods:

• A single case study of a 48-year-old male with right hemiparesis post-stroke.
• Dual-energy X-ray absorptiometry and peripheral quantitative computed tomography were used for bone assessment at 3 and 12 months post-stroke.
• Upper extremity motor function was evaluated concurrently.

Main Results:

• The paretic forearm showed significant reductions in areal bone mineral density (aBMD) at the ultradistal (7.9%) and mid-regions (5.9%) by 12 months.
• The non-paretic forearm exhibited increased aBMD (mid: 4.0%, total: 2.8%).
• Peripheral quantitative computed tomography revealed decreased bone mineral density and strength in the distal radius of the paretic arm, contrasting with increased bone strength in the non-paretic radius diaphysis.

Conclusions:

• Stroke survivors with moderate to severe upper extremity impairment experience significant forearm bone density decline.
• These findings underscore the potential need for early rehabilitative interventions to mitigate adverse bone changes in the paretic limb.