Ouyang Huixi, Miller Tiev, Qin Ling, Ying Michael T C, Hung Vivian W Y, Leung Thomas W H, Pang Marco Y C
School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
Arch Osteoporos. 2025 Aug 6;20(1):108. doi: 10.1007/s11657-025-01541-4.
Post-stroke fracture risk necessitates investigation of bone properties and contributing factors. The decline in paretic tibia failure load post-stroke was attributed to decreased trabecular bone density and thickness at 2-year follow-up. Less decline in bone strength was associated with better leg blood flow, walking speed, strength, and activity at baseline.
To delineate long-term changes in distal tibia bone properties after stroke and identify their associated factors.
High-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the bilateral distal tibia were performed in 46 chronic stroke participants (age, 60.4 ± 7.8 years; post-stroke onset, 6.3 ± 4.2 years) and 45 controls (age, 57.7 ± 6.3 years) at baseline and 2 years later. We measured the change in the estimated failure load (indicator of bone strength), volumetric bone mineral density (vBMD), geometry, and microstructure. Blood flow volume of the popliteal artery, muscle strength, sensory function, and gait speed were also assessed.
In the paretic leg of stroke participants, a significant decline in estimated failure load was observed (- 3.39%, p < 0.01), which was greater than that of the non-paretic side (- 1.93%, p < 0.01) and controls (- 1.89 to - 2.18%, p < 0.05). The deterioration in estimated failure load was accompanied by a decline in trabecular vBMD and thickness. Greater arterial blood flow, higher walking velocity, better muscle strength, and higher physical activity level at baseline at 2-year follow-up portended less decline in estimated failure load.
During the 2-year follow-up, there was a decline in estimated failure load of the paretic distal tibia among people with chronic stroke, attributed to a decreased trabecular density and thickness. Greater decline in estimated tibial bone strength was associated with lower arterial blood flow volume and motor function on the paretic side.
中风后骨折风险需要对骨骼特性及相关因素进行研究。在中风后2年的随访中，患侧胫骨破坏载荷的下降归因于小梁骨密度和厚度的降低。骨强度下降较少与基线时较好的腿部血流、步行速度、力量及活动能力相关。
描绘中风后胫骨远端骨骼特性的长期变化并确定其相关因素。
对46名慢性中风参与者（年龄60.4±7.8岁；中风发病后6.3±4.2年）和45名对照者（年龄57.7±6.3岁）在基线及2年后进行双侧胫骨远端的高分辨率外周定量计算机断层扫描（HR-pQCT）。我们测量了估计破坏载荷（骨强度指标）、骨体积密度（vBMD）、几何结构和微观结构的变化。还评估了腘动脉血流量、肌肉力量、感觉功能和步态速度。
在中风参与者的患侧腿部，观察到估计破坏载荷显著下降（-3.39%，p<0.01），大于非患侧（-1.93%，p<0.01）和对照者（-1.89%至-2.18%，p<0.05）。估计破坏载荷的恶化伴随着小梁vBMD和厚度的下降。在2年随访中，基线时动脉血流量更大、步行速度更高、肌肉力量更好以及身体活动水平更高预示着估计破坏载荷下降较少。
在2年随访期间，慢性中风患者患侧胫骨远端的估计破坏载荷下降，这归因于小梁密度和厚度降低。患侧胫骨骨强度下降更大与动脉血流量较低和运动功能较差相关。
