Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 1

The Relationship of Bone Mineral Density with Demographic and Clinical Variables in Patients with Stroke

Sibel Özbudak Demir 1 ,Nebahat Sezer 2 ,Serap Tomruk 3 ,Belma Füsun Köseoğlu 4
1 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
2 Department of Physical Medicine and Rehabilitation, Ankara Yıldırım Beyazıt University, Ankara, Turkey
3 Ankara Fizik Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara
4 Clinic of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey

Objective: This study was designed to evaluate lower extremity bone mineral density (BMD) at paretic and non-paretic side in patients with stroke and to investigate association between BMD and demographic variables, motor level, functional status.

Materials and Methods: Fourthy-six patients with stroke (26 female, 20 male) and fourthy healthy control subject (23 female, 17 male) were involved in the study. Demographic and clinical characteristics were documented. The BMD of femur were measured bilaterally. Ashworth scale was used in evaluation of spasticity and the Brunnstrom recovery staging was used in motor evaluation. Functional status was assessed using the Functional Independence Measure (FIM), ambulatory level was assessed by Functional Ambulatory Category (FAC).

Results: The mean age was 61.2±24.6 years. There was significant bone loss in paretic side compared with nonparetic side in all patients. A significant decline was observed BMD of nonparetic side compared to control subject. Higher age, being female and lower body weight were highly related to BMD loss. There was a statistically significant correlation between BMD loss and Brunnstrom stage, FIM score, FAC.

Conclusion: Patients with stroke are at increased risk of developing osteoporosis both paretic and non-paretic sides. BMD loss appear to be related to age, sex, body-weight, motor impairment, functional status and ambulatory category. We suggest that controlled clinical trials are needed which demonstrate early mobilization with focus on exercises in a weight bearing position may decrease bone loss in patient with stroke.

Keywords : Stroke, bone mineral density, osteoporosis