In subacute and chronic stroke studies , the skeletal sites in the paretic limbs sustained a more pronounced decline in bone quality than did their counterparts in the non-paretic limbs .
The rate of changes showed a decelerating trend as post-stroke duration increased , but the timing of achieving the steady rate differed across skeletal sites .
The magnitude of bone changes in the paretic upper limb was more pronounced than the paretic lower limb .
There was a strong relationship between muscle strength/mass and bone density/strength index .
Muscle spasticity seemed to have a negative impact on bone integrity in the paretic upper limb , but its influence on bone properties in the paretic lower limb was uncertain .
Substantial bone changes in the paretic limbs occurred particularly in the first few months after stroke onset .
Early intervention , muscle strength training , and long-term management strategies may be important to enhance bone health post-stroke .
To systematic ally review available evidence related to the characteristics of bone changes  post-stroke and the relationship between various aspects of muscle function ( e.g. , strength , spasticity ) and bone properties after stroke onset .
Bone Mineral Density in Patients with Stroke
Şahin L , Özoran K , Gündüz OH , Uçan H , Yücel M : Bone mineral density in patients with stroke . Am J Phys Med Rehabil 2001;80:592–596 . ObjectiveS troke is an acute neurologic dysfunction of vascular origin , characterized by loss of voluntary movement , sensory disturbances , and neurologic findings in the contralateral half of the body . Acute and long-term complications because of immobilization are seen in all organ systems . The aim of this study was to determine any differences between the affected and unaffected sides ’ bone mineral densities of acute and chronic stroke patients . Design In this study , we determined the bone mineral densities ( BMD ) of 30 male patients with acute ( 0 - 20 days ) and 30 male patients with chronic ( 6 months or longer ) stroke and compared the densities with the normal side . Upper and lower limb BMDs were measured by dual-energy x-ray absorptiometry . Additionally , patients were evaluated for the degree of spasticity , the phases of motor improvement , and the activities of daily living . Results In acute-phase stroke patients , BMD of the affected side was not significantly different from BMD of the normal side . BMD of both upper limbs of acute stroke patients was not different from normal side upper limb BMD of chronic stroke patients . In both acute and chronic stroke patients , affected and unaffected side lower limb BMDs ( femur total BMD scores ) were not significantly different . However , in chronic stroke patients , affected side BMD of Ward ’s region was significantly higher compared with the normal side . There is no correlation between BMD and Brunnstrom phases , Ashworth scales , and the degree of activities of daily living . Conclusions Higher BMD of the affected side Ward ’s region in chronic cerebrovascular accident patients may be related to spasticity and changes in walking pattern , which increase the mechanical stress loading of the Ward ’s region
In subacute and chronic stroke studies , the skeletal sites in the paretic limbs sustained a more pronounced decline in bone quality than did their counterparts in the non-paretic limbs .
The rate of changes showed a decelerating trend as post-stroke duration increased , but the timing of achieving the steady rate differed across skeletal sites .
The magnitude of bone changes in the paretic upper limb was more pronounced than the paretic lower limb .
There was a strong relationship between muscle strength/mass and bone density/strength index .
Muscle spasticity seemed to have a negative impact on bone integrity in the paretic upper limb , but its influence on bone properties in the paretic lower limb was uncertain .
Substantial bone changes in the paretic limbs occurred particularly in the first few months after stroke onset .
Early intervention , muscle strength training , and long-term management strategies may be important to enhance bone health post-stroke .
To systematic ally review available evidence related to the characteristics of bone changes  post-stroke and the relationship between various aspects of muscle function ( e.g. , strength , spasticity ) and bone properties after stroke onset .