Study of bone mineral density in stroke survivors

Abstract

Osteoporosis after stroke differs from age-related and other causes of osteoporosis. Stroke is frequently followed by extensive bone loss, precipitating the increased fracture risk in survivors. It is more evident on the paretic side and that too in the upper extremities. The present study is to assess the Bone Mineral Density (BMD) in hip, spine and wrist and to assess BMD difference between paretic and non-paretic side in ambulatory stroke survivors. The study design is Cross-sectional observational study. Forty individuals attending the OPD of Department of Physical Medicine and Rehabilitation, VMMC & Safdarjung hospital, New Delhi with the diagnosis of stroke, fulfilling inclusion criteria were enrolled. Tools of measurement used were: –BMD using dual energy X-ray absorptiometry (DEXA) by OSTEOSCORE-3 (Digital 2D Densitometer) at spine, forearm and hip; –Biochemical markers (S.Ca, Phosphorous, ALP); –X-ray of spine, bilateral hip and wrist. Our study involved total 40 subjects having 33 (82.5%) males and 7 (17.5%) females. Mean age of study group was found to be 53.9 ± 10.9 years. The T score for forearm was found to be significantly higher in non-paretic side (Mean = −4.11 ± 2.46) compared to paretic side (Mean = −4.85 ± 2.01) ( P = 0.04). The T score for hip on non-paretic side was found to be higher (Mean = −1.96 ± 1.74) compared to that of paretic side (Mean = −2.14 ± 1.57) ( P = 0.4). Fifteen (37.5%) subjects were found to be osteoporotic on DEXA scanning of spine. Most of the patients who presented after one year of stroke had low T-score at hip and forearm on paretic side in comparison to non-paretic side.