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 alterations in upper and lower extremities 12 months after stroke measured by peripheral quantitative computed tomography and DXA.
To evaluate the loss of trabecular and cortical bone mineral density ( BMD ) and geometric parameters of bone strength expressed by stress-strain index ( SSI ) in the proximal and distal forearm and the alterations of BMD in the hip of hemiplegic patient and 12 mo after stroke . Sixty-seven hemiplegic patients ( 43 men and 24 women ) with a history of single completed strokes associated with unilateral weakness were enrolled in this prospect i ve study . All patients underwent bone densitometry measurements at 3 , 6 , and 12 mo after the initial episode of stroke . Both paretic and normal forearms were examined by peripheral quantitative computed tomography ( pQCT ) at the 4 % and 20 % sites of the forearm length and both hips were examined by dual-energy X-ray absorptiometry ( DXA ) including the area of femoral neck and greater trochanter . The diagnosis of stroke was confirmed by cranial computed tomography . Motor function was assessed by the functional ambulation category ( FAC ) and spasticity by the modified Ashworth scale ( MAS ) . We found statistically significant trabecular and cortical bone density reductions during the course of our study in the forearm , which was more profound on the paretic side . Trabecular bone loss and SSI measured at 4 % of the paretic forearm in the male group represented a 12-mo decrease of 14.01 % and 28.61 % , respectively , and in the female group 9.29 % and 19.17 % , respectively . Cortical bone and SSI measured at the 20 % site of paretic forearm in the male group corresponded to a 12-mo decrease of 4.02 % and 7.43 % , respectively , and in the female group 2.59 % and 6.97 % , respectively . Paretic femoral neck and trochanter measurements in males showed a reduction of 11.76 % and 10.38 % , respectively , and in females 13.04 % and 12.6 % , respectively . A significant loss of BMD and bone strength was found during the first year after stroke in both trabecular and cortical bone at the forearm and at the neck and great trochanter on the paretic hip . Most prominent BMD reduction was evident in men compared with perimenopausal women in the same age
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 .