Abstract
We evaluated the bone mineral density (BMD) of the bilateral femurs in 112 patients with hemiplegia using dual-energy X-ray absorptiometry in order to elucidate the effect of disuse and immobilization. BMD of the paretic side was significantly reduced compared with that of the nonparetic side in hemiplegic patients (femoral neck 0.582±0.014 g/cm2 versus 0.623±0.014 g/cm2 and total femur 0.645±0.02 g/cm2 versus 0.702±0.017 g/cm2; mean±SEM, P<0.01, respectively). Femoral BMD in both the paretic and nonparetic limb had significantly (P<0.01) lower values than in age- and sex-matched controls, but the paretic side had a more significant reduction of BMD; femoral neck-20% versus -14% and total femur -24% versus -18%. In addition, patients with impaired activities of daily living (ADL), evaluated by a mobility score, had significantly decreased BMD ratios of paretic/nonparetic side than patients with improved ADL (femoral neck 91% versus 97%, P<0.01 and total femur 89% versus 94%, P<0.05). Our results indicated that BMD of both femurs of patients with hemiplegia was reduced, although the paretic side showed a greater BMD decrease. This decrease might be prevented or reduced by improvement of ADL.
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References
Jerkins DP, Cochran TH (1969) Osteoporosis: the dramatic effect of disuse of an extremity. Clin Orthop 64:128–134
Kazarian LE, Von Gierke HE (1969) Bone loss as a result of immobilization and chelation. Preliminary results in Macaca mulatta. Clin Orthop 65:67–75
Issekutz B Jr, Blizzard JJ, Birkhead NC, Rodahl K (1966) Effect of prolonged bedrest on urinary calcium output. J Appl Physiol 21:1013–1020
Stewart AF, Adler M, Byers CM, Segre GV, Broadus AE (1982) Calcium homeostasis in immobilization: an example of absorptive hypercalciuria. N Engl J Med 306:1136–1140
Denham MJ (1973) Progressive osteoporosis in hemiplegia. Gerontol Clin 15:361–365
Van Ouwenaller C, Uebelhart D, Chantraine A (1989) Bone metabolism in hemiplegic patients. Scand J Rehab Med 21:165–170
Panin N, Gorday WJ, Paul B (1971) Osteoporosis in hemiplegia. Stroke 2:41–47
Naftchi NE, Viau AT, Marshall CH, Davis WS, Lowman EW (1975) Bone mineralization in the distal forearm of hemiplegic patients. Arch Phys Med Rehabil 56:487–492
Peszczynski M (1957) The fractured hip in hemiplegic patients. Geriatrics 12:687–690
Mulley G, Espley AJ (1979) Hip fracture after hemiplegia. Postgrad Med J 55:264–265
Lips P, van Ginkel FC, Netelenbos JC, Wiersinga A, van der Vijgh WJF (1990) Lower mobility and markers of bone resorption in the elderly. Bone Miner 9:49–57
Kushida K, Inoue T, Sumi Y, Denda M, Yamazaki K, Ooya K, Okamoto S, Hujiwara T, Kinn K, Taniguti M, Ooishi T (1990) Osteoporosis: bone mineral measurement using DXA. Nihon Rinsho 48:121–126 (in Japanese)
Payne RB, Little AJ, Williams RB, Milner JR (1973) Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J 4:643–646
Prince RL, Price RI, Ho S (1988) Forearm bone loss in hemiplegia: a model for the study of immobilization osteoporosis. J Bone Miner Res 3:305–310
Iversen E, Hassager C, Christiansen C (1989) The effect of hemiplegia on bone mass and soft tissue body composition. Acta Neurol Scand 79:155–159
Wolff J (1892) Das Gesetz der Transformation der Knochen. Berlin, Hirschwald
Krolner B, Toft B, Pors-Nielsen S, Tondevold E (1983) Physical exercise as prophylaxis against involutional vertebral bone loss: a controlled trial. Clin Sci 64:541–546
Aloia JF, Cohn SH, Ostuni JA, Cane R, Ellis K (1978) Prevention of involutional bone loss by exercise. Ann Intern Med 89: 356–358
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Takamoto, S., Masuyama, T., Nakajima, M. et al. Alterations of bone mineral density of the femurs in hemiplegia. Calcif Tissue Int 56, 259–262 (1995). https://doi.org/10.1007/BF00318043
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DOI: https://doi.org/10.1007/BF00318043