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Archives of Osteoporosis

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Open Access 01-12-2018 | Original Article

Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study

Authors: Karen Borschmann, Sandra Iuliano, Ali Ghasem-Zadeh, Leonid Churilov, Marco Y. C. Pang, Julie Bernhardt

Published in: Archives of Osteoporosis | Issue 1/2018

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

Better motor control and walking recovery were associated with reduced bone loss. Interventions targeting these impairments from early post-stroke are warranted.

Clinical trial registration

URL: http://www.anzctr.org.au. Unique identifier: ACTRN12612000123842.

Available only for authorised users

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Title: Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study
Authors: Karen Borschmann
Sandra Iuliano
Ali Ghasem-Zadeh
Leonid Churilov
Marco Y. C. Pang
Julie Bernhardt
Publication date: 01-12-2018
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0414-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

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