School of Health Science, Latrobe University, Melbourne, Victoria, Australia; Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
Int J Stroke. 2015 Apr;10(3):396-9. doi: 10.1111/ijs.12228. Epub 2013 Dec 23.
Stroke survivors experience accelerated bone loss and increased fracture risk, particularly in paretic weight bearing limbs. Understanding how these changes unfold and their relationship to stroke severity and physical activity could help in the development of targeted interventions to prevent or reduce the severity of these outcomes. The primary aim of this study is to investigate the time course and magnitude of changes in volumetric bone mineral density within the first year after stroke, and to examine relationships with physical activity and motor recovery.
This is a prospective, observational study of 43 nondiabetic, nonambulant adults with first ever hemispheric stroke.
The primary outcome was the difference in six-month change of total volumetric bone mineral density between paretic and nonparetic distal tibiae, measured at 7% of bone length site using high-resolution peripheral quantitative computed tomography.
The secondary outcomes are cortical and trabecular volumetric bone mineral density, cortical thickness, and total and cross-sectional areas of distal tibiae and radii of paretic and nonparetic limbs. Also included are total body and regional bone mineral density derived using dual-energy X-ray absorptiometry, physical activity measured using accelerometry, and motor recovery (Chedoke McMaster Stroke Assessment).
Measuring the timing and magnitude of changes to volumetric bone mineral density and bone structure from immediately after stroke, and relationships between these changes with physical activity and motor recovery will provide the basis for targeted interventions to reduce fracture risk in stroke survivors.
中风幸存者经历骨量加速丢失和骨折风险增加，尤其是在瘫痪的承重肢体中。了解这些变化的发生方式及其与中风严重程度和身体活动的关系，有助于制定针对这些结局的干预措施，以预防或减轻其严重程度。本研究的主要目的是探究中风后一年内骨容积密度的变化时间进程和幅度，并探讨其与身体活动和运动功能恢复的关系。
这是一项前瞻性、观察性研究，纳入了 43 名无糖尿病、非卧床的首次半球性中风的成年患者。
主要结局为使用高分辨率外周定量计算机断层扫描，在距骨 7%骨长处测量的患侧和非患侧远胫骨的 6 个月总容积骨密度变化差异。
次要结局包括皮质和小梁容积骨密度、皮质厚度、以及远胫骨和瘫痪肢体和非瘫痪肢体的总横截面积。还包括使用双能 X 射线吸收法测定的全身和局部骨密度、使用加速度计测定的身体活动以及运动功能恢复（Chedoke McMaster 中风评估）。
从中风后立即开始测量容积骨密度和骨结构的变化时间和幅度，以及这些变化与身体活动和运动功能恢复之间的关系，为针对中风幸存者的骨折风险降低的干预措施提供了基础。
