An assessment of the osteogenic index of therapeutic exercises for stroke patients: relationship to severity of leg motor impairment.

SUMMARY

Exercise may be a viable way to promote bone health in stroke survivors. This study used the osteogenic index to evaluate the osteogenic potential of selected exercises for stroke survivors. The results show that brisk walking and stepping may be good skeletal loading exercises for this population.

INTRODUCTION

Exercise may induce positive effects on bone health in stroke patients. The purpose of this study was to evaluate the osteogenic potential of selected exercises for stroke survivors.

METHODS

Sixty stroke patients were categorized into group 1 (moderate to severe leg motor impairment) and group 2 (mild to moderate impairment). Each subject performed five exercises in random order: walking at self-selected speed, walking at maximal speed, stepping onto a 6-in. riser, sit-to-stand, and jumping. The peak ground reaction force (GRF) on the hemiparetic side and the number of loading cycles achieved in 1 min were determined. The osteogenic index (OI) was computed for each exercise, based on the formula: OI = Peak GRF (in body weight) x In (number of loading cycles + 1). Two-way analysis of variance was used to compare the OI among the five exercises between the two groups.

RESULTS

For group 1, stepping had significantly higher OI than other exercises (p < 0.001). For group 2, both walking at maximal speed and stepping had significantly higher OI than other exercises (p < 0.001).

CONCLUSIONS

Stepping had the highest OI for those with more severe leg motor impairment. Both stepping and brisk walking had superior OI for those with mild leg motor impairment.