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 .
Prevention of Secondary Osteoporosis Postmenopause in Hemiplegia
Ikai T , Uematsu M , Eun SS , Kimura C , Hasegawa C , Miyano S : Prevention of secondary osteoporosis postmenopause in hemiplegia . Am J Phys Med Rehabil 2001;80:169–174 . Objectives To study secondary osteoporosis postmenopause in women with hemiplegia and to show the therapeutic effects of etidronate and how osteoporotic conditions relate to the activities of daily living ( ADL ) . Design Eighty-one postmenopausal women with hemiplegia were admitted within 6 mo of their first cerebrovascular accident . The bone mineral density ( BMD ) and biochemical markers of bone turnover were measured at the time of admission . Forty women ( treatment group ) received a 2-wk administration of etidronate . Forty-one women ( control group ) were not administered etidronate . Results After completing a 3-mo rehabilitation program , BMD levels were remeasured . ADL was evaluated by FIMTM . The low ADL group had a larger decrease in BMD than the high ADL group . For the control group , the BMD rate of change on the paretic side of the femoral neck was −9.6%/3 mo for the low ADL group . BMD loss was reduced significantly by the administration of etidronate for the low ADL group . Conclusions Results indicate that ADL corresponds to the progression of osteoporosis in postmenopausal women with hemiplegia and that increasing the level of ADL will reduce the progression of osteoporosis . Use of etidronate has also been proven to have a suppressive effect on the BMD decrease in women
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 .