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 .
Fractures After Stroke: Frequency, Types, and Associations
Background and Purpose — Stroke patients may have an increased risk of fractures because of weak bones or an increased risk of falling . Our goal was to estimate the frequency of fracture after stroke and to identify those at greatest risk . Methods — This study incorporated 2 complementary strategies : a prospect i ve , single-center , cohort study and an analysis of Scottish routine hospital discharge data  . Results — Eighty-eight fractures ( 30 % hip ) occurred in 2696 hospital-referred stroke patients . The proportions sustaining any fracture or hip fracture within 2 years were 4 % and 1.1 % , respectively , 1.4 ( 95 % CI , 0.92 to 2.07 ) times the rate of hip fracture in the general population ( ie , observed number divided by expected number or st and ardized morbidity ratio ) . Female sex , older age , low abbreviated mental test score , and prestroke dependence were associated with an increased hip fracture rate . Routine data identified 129 935 acute stroke patients admitted to Scottish hospitals . During 363 447 patient-years , 4528 patients had hip fractures  , 2.0 % had fractures by 1 year , and 10.6 % had fractures by 10 years . This is 1.7 times the rate of hip fracture in the general population and 2.3 times that in patients with myocardial infa rct ion . Older patients predictably had the highest rate of poststroke hip fractures but a lower st and ardized morbidity ratio than younger patients . Conclusions — Fractures after stroke are probably frequent and serious enough to justify the development of preventive strategies , but the modest event rate would mean that r and omized , controlled trials to test these strategies specifically in stroke patients would need to enroll thous and s of patients
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 .