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Relative impact of neuromuscular and cardiovascular factors on bone strength index of the hemiparetic distal radius epiphysis among individuals with chronic stroke.
- Source :
-
Osteoporosis International . Sep2012, Vol. 23 Issue 9, p2369-2379. 11p. 1 Color Photograph, 4 Charts. - Publication Year :
- 2012
-
Abstract
- Summary: The objective of this study was to examine the associations of neuromuscular and cardiovascular impairments with the bone strength index of the hemiparetic distal radius epiphysis in chronic stroke survivors. The results showed that grip strength is the most predominant predictor of the bone strength index. Introduction: The pupose of the study was to examine the associations of neuromuscular and cardiovascular impairments with the bone strength index of the hemiparetic distal radius epiphysis in chronic stroke survivors. Methods: Sixty-five chronic stroke survivors and 34 healthy control subjects underwent scanning of the distal radius epiphyseal site on both sides using peripheral quantitative computed tomography to measure trabecular volumetric bone mineral density (vBMD) (mg/cm), total vBMD (mg/cm), total area (mm), and compressive bone strength index (cBSI) (g/cm). Various indicators of neuromuscular (grip strength, spasticity) and cardiovascular function (vascular elasticity, oxygen consumption during 6-min walk test) were evaluated. Results: Analysis of variance revealed a significant main effect of side ( p < 0.001) and group × side interaction ( p < 0.05) for total BMC, total vBMD, trabecular vBMD, and cBSI ( p < 0.05), with the stroke group showing greater side-to-side difference in these variables. However, no significant side-to-side difference in total area was detected in either group ( p > 0.05). Sex-specific analysis yielded similar results. Multiple regression analyses revealed that the cBSI of the hemiparetic distal radius epiphysis had a stronger association with neuromuscular factors than cardiovascular factors. Overall, grip strength was the strongest determinant of the cBSI of the hemiparetic distal radius epiphysis ( p < 0.01). Conclusions: Muscle weakness is the most predominant determinant of cBSI in the hemiparetic distal radius epiphysis among chronic stroke patients. Future studies should investigate the efficacy of different muscle-strengthening strategies in enhancing bone strength of this skeletal site in the chronic stroke population. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TOMOGRAPHY
*ANALYSIS of variance
*CARDIOVASCULAR system
*CONFIDENCE intervals
*STATISTICAL correlation
*HEMIPLEGIA
*INTERVIEWING
*MEDICAL records
*MULTIVARIATE analysis
*NEUROMUSCULAR manifestations of general diseases
*OSTEOPOROSIS
*RADIAL bone
*REGRESSION analysis
*REHABILITATION
*RESEARCH funding
*SCALES (Weighing instruments)
*STATISTICS
*STROKE
*T-test (Statistics)
*X-ray densitometry in medicine
*DATA analysis
*EQUIPMENT & supplies
*BONE density
*CASE-control method
*DATA analysis software
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 0937941X
- Volume :
- 23
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Osteoporosis International
- Publication Type :
- Academic Journal
- Accession number :
- 78911491
- Full Text :
- https://doi.org/10.1007/s00198-012-1899-8