Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Top Stroke Rehabil. 2012 Sep-Oct;19(5):436-43. doi: 10.1310/tsr1905-436.
Patients with stroke have a 2- to 4-fold increased risk of hip fracture compared to the general population, because of decreased bone mineral density (BMD) on the paretic side and the high incidence of accidental falls. However, the relationship between BMD and stroke-related motor impairment and functional mobility is not known. The purpose of this study was to investigate these relationships.
A convenience sample of 87 patients with stroke was recruited from an outpatient rehabilitation clinic. Demographics and clinical history were collected, and patients answered questionnaires regarding functional status. Motor impairment was assessed using motor items of the National Institutes of Health Stroke Scale (NIHSS), and BMD was measured using dual energy X-ray absorptiometry.
Mean BMD measured at the total hip was lower on the paretic side relative to the contralateral side (0.883 ± 0.148 g/cm2 vs 0.923 ± 0.136 g/cm2;P < .001). Compared to patients without limitations in walking, those reporting limitations had lower BMD at the paretic total hip (0.808 ± 0.141 g/cm2 vs 0.917 ± 0.139 g/cm2;P = .001) and lower BMDZ scores (-0.282 ± 0.888 vs -0.028 ± 0.813;P = .035). A significant correlation was found between mean BMD and the BMDZ score at the total hip on the paretic side and motor impairment in that lower extremity (r = -0.326,P = .003;r = -0.312,P = .004, respectively).
In patients with stroke, BMD at the paretic hip correlated with motor impairment. Furthermore, ability to ambulate was shown to be a simple yet useful test to determine which individuals had increased bone loss at the paretic versus nonparetichip.
与普通人群相比，中风患者的髋部骨折风险增加了 2-4 倍，这是由于患侧骨密度（BMD）降低以及意外跌倒的发生率高所致。然而，BMD 与中风相关的运动障碍和功能移动性之间的关系尚不清楚。本研究的目的是调查这些关系。
从门诊康复诊所招募了 87 名中风患者的便利样本。收集了人口统计学和临床病史，并且患者回答了有关功能状态的问卷。使用国立卫生研究院中风量表（NIHSS）的运动项目评估运动障碍，使用双能 X 射线吸收法测量 BMD。
患侧相对于对侧的全髋关节的平均 BMD 较低（0.883 ± 0.148 g/cm2比 0.923 ± 0.136 g/cm2；P <.001）。与没有行走障碍的患者相比，报告有行走障碍的患者的患侧全髋关节的 BMD 较低（0.808 ± 0.141 g/cm2比 0.917 ± 0.139 g/cm2；P =.001），BMDZ 评分也较低（-0.282 ± 0.888 比-0.028 ± 0.813；P =.035）。在患侧髋关节的平均 BMD 与该下肢的 BMDZ 评分与运动障碍之间发现了显著的相关性（r = -0.326，P =.003；r = -0.312，P =.004）。
在中风患者中，患侧髋关节的 BMD 与运动障碍相关。此外，步行能力被证明是一种简单而有用的测试，可以确定哪些个体在患侧和非患侧髋关节有更多的骨质流失。
