Kim Hui Dong, Kim Sae Hyun, Kim Dong Kyu, Jeong Ho Joong, Sim Young Joo, Kim Ghi Chan
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea.
Ann Rehabil Med. 2016 Dec;40(6):981-988. doi: 10.5535/arm.2016.40.6.981. Epub 2016 Dec 30.
To investigate the clinical characteristics that significantly contribute to a decreased bone mineral density (BMD), the BMD changes and clinical characteristics of men who experienced a stroke between the ages of 50 years and 65 years were studied between 3 months and 4 months after the stroke.
Subjects had a brain hemorrhage or a cerebral infarction. Only men aged 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis. All subjects underwent a BMD test between 3 months and 4 months after their strokes. Also, patients with a medication history that might have caused a secondary osteoporosis before a stroke were excluded.
The BMD for the lumbar spine and hemiplegic side of the femoral neck correlated significantly with the results of the manual muscle test (MMT) of the hemiplegic lower extremity and the Modified Barthel Index (MBI) score. This result suggests that the immobility from the decreased muscle strength and the weakened daily functionality might have reduced the BMD. According to a multiple linear regression analysis, the MBI score is significantly correlated with the lumbar BMD. The BMD of the hemiplegic femoral neck is significantly correlated with the MMT and the MBI score.
This study showed that BMD monitoring should be considered in male stroke patients, especially for patients with a high dependency in daily functions and a decreased muscle strength in the hemiplegic lower extremity.
为了研究导致骨密度(BMD)降低的显著临床特征,对年龄在50岁至65岁之间中风的男性在中风后3个月至4个月期间的骨密度变化及临床特征进行了研究。
受试者患有脑出血或脑梗死。仅纳入年龄在50岁至65岁之间的男性,以排除绝经后骨质疏松症,并消除老年性骨质疏松症的影响。所有受试者在中风后3个月至4个月期间接受了骨密度测试。此外,排除了中风前有可能导致继发性骨质疏松症用药史的患者。
腰椎和偏瘫侧股骨颈的骨密度与偏瘫下肢的徒手肌力测试(MMT)结果和改良巴氏指数(MBI)评分显著相关。这一结果表明,肌肉力量下降和日常功能减弱导致的活动减少可能降低了骨密度。根据多元线性回归分析,MBI评分与腰椎骨密度显著相关。偏瘫侧股骨颈的骨密度与MMT和MBI评分显著相关。
本研究表明,对于男性中风患者,尤其是日常功能依赖性高且偏瘫下肢肌肉力量下降的患者,应考虑进行骨密度监测。