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 Acute Stroke Patients: Low Bone Mineral Density May Predict First Stroke in Women
Background and Purpose — Osteoporosis and stroke share several risk factors , including age , smoking , low physical activity , and hypertension . Thus , low bone mineral density ( BMD ) and high stroke risk may be related . We examined the relationship between BMD and acute stroke in noninstitutionalized men and women aged ≥60 years . Methods — Sixty-three stroke patients ( 33 women and 30 men ) and 188 control subjects from the general population were included .  BMD was measured by using dual-energy x-ray absorptiometry at both proximal femurs . The measurements of the stroke patients were performed 6 days after the onset of stroke . Results — The BMD at the femoral neck in the female stroke patients was 8 % lower than in the control subjects ( P = 0.007 ) . In men , no difference in BMD between the stroke patients and their controls was found . Women with BMD values in the lowest quartile had a higher risk of stroke than women with BMD values in the highest quartile ( OR 4.8 ) , and the probability value for linear trend over the quartiles was statistically significant ( P = 0.003 ) . The OR for stroke increased 1.9 per SD ( 0.13 g/cm2 ) reduction in BMD , and the association between low BMD and stroke in women remained significant when the analysis was adjusted for potential confounders . Conclusions — Female , but not male , stroke patients  have lower BMD than population controls . Low BMD may predict stroke 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 .