Bone Mineral Density in Stroke Survivors: An Observational Study

Abstract

Introduction: Stroke is frequently followed by bone loss, causing increased fracture risk in patients. Bone loss starts within days of vascular brain injury, progresses till fourth month and then lowers until the end of first year after stroke. Aim: To assess the Bone Mineral Density (BMD) in hip, spine and wrist and its difference between paretic and nonparetic side in ambulatory stroke survivors. Materials and Methods: This hospital-based observational cross-sectional study was conducted on 40 subjects, from January 2015 to June 2016 in the Department of Physical Medicine and Rehabilitation, VMMC and Safdarjung Hospital, New Delhi. Biochemical markers, x-rays and BMD were recorded in all patients along with demographic profile in a pre-structured proforma after taking informed consent. Statistical analysis was done using SPSS Software version 14.0. Results: Out of 40 subjects (mean age: 53.9±10.9 years), 82.5% were males with nearly equal distribution in 41-50, 51-60 and 61-70 years age groups. Around 65% stroke survivors presented within 1-3 years of stroke with 68% having right sided involvement. Bone mineral densities over hip with a mean of -2.14±1.57 and lower end of radius with a mean of -4.85±2.01 were less on paretic side as compared to the nonparetic side. DEXA scanning of spine showed 52.5% subjects were osteopenic and 37.5% were osteoporotic. Conclusion: BMD over hip and lower end of radius was less on paretic side as compared to the nonparetic side but it was insignificant statistically.