Abstract:Osteoporosis in Hemiplegia • Localized osteoporosis in 25 long-term stroke patients was evaluated by means of measuring the combined cortical thickness in the humerus, radius and third metacarpal bones of both involved and noninvolved upper extremities. The combined cortical thickness was found to be consistently smaller on the involved side. Since the factors of weight bearing and calcium homeostasis were eliminated or controlled in this study, the authors were able to focus on the role of muscle pull as manifested by voluntary muscle function and spasticity in relation to the degree of cortical thinning. A smaller degree of cortical thinning was associated with better voluntary muscle function, but the relationship of spasticity to preservation of cortical thickness was not clear cut. The applicability of these techniques to the study of factors affecting localized osteoporosis is discussed. ADDITIONAL KEY WORDS cerebral infarctioncombined cortical thickness hemiparesis physical therapy• Considering the rapidly growing population of elderly individuals, the osteoporotic process takes on increasing significance for the clinician. The decreased bone density and increased fragility associated with osteoporosis leads to a corresponding increase in the incidence of fractures, skeletal pain and interference with mobility. These sequelae have obvious psychological, sociological and economical implications.Difficulty in dealing with this problem prophylactically or therapeutically arises because (1) the etiological factors and their interrelationship are not clearly understood, and (2) simple, readily accessible and universally applicable techniques of assessment are not available or widely known. Osteoporosis has been described as a decrease in a total