Unilateral Osteoporosis in Longstanding Hemiplegia in the Elderly

Hodkinson, H. M.; Brain, A. T.

doi:10.1111/j.1532-5415.1967.tb05337.x

Cited by 30 publications

(8 citation statements)

References 4 publications

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“…While bone loss has been recognized as a possible complication of hemiplegia since the sixties [10, 11], it is only during the last two decades that several studies demonstrated a significant reduction in BMD and bone mass following stroke [2,12,13,14,15,16,17,18,19]. …”

Section: Clinical Evidencementioning

confidence: 99%

Osteoporosis after Stroke: A Review of the Causes and Potential Treatments

Carda¹,

Cisari

Invernizzi

et al. 2009

Cerebrovasc Dis

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Osteoporosis is a known consequence of stroke, associated with an increased incidence of fractures, mainly of the hip, leading to further disability. The pattern of bone loss seen in stroke patients is different from that usually encountered with postmenopausal osteoporosis, since it is limited to the paretic side and more evident in the upper extremities. Several factors appear to have an influence on bone mass in stroke patients, such as the degree of paresis, gait disability and the duration of immobilization. The pathogenesis of osteoporosis after stroke remains unclear. Paresis, reduced mobility and reduced bone load seem to play a major role. Other factors such as nutritional and iatrogenic ones may also play an important part. In this paper, the clinical evidence, pathophysiology and possible treatments of poststroke osteoporosis will be reviewed.

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Section: Clinical Evidencementioning

confidence: 99%

Osteoporosis after Stroke: A Review of the Causes and Potential Treatments

Carda¹,

Cisari

Invernizzi

et al. 2009

Cerebrovasc Dis

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show abstract

“…This hypothesis is based on the longaccepted concept of laws affecting bone formation and the literature which emphasizes the role of stress in maintaining bone integrity. 3 ' "• 15 We were also interested in demonstrating the applicability of the technique of measuring the CCT to the study of this problem.…”

Section: Discuss/onmentioning

confidence: 99%

“…15 However, since many hemiplegic patients, with or without significant spasticity or return of voluntary motor function, may be able to ambulate with weight bearing by means of bracing the affected lower extremity, we chose to study the upper extremity in order to eliminate the factor of weight bearing, the role of which, in the prevention of osteoporosis, remains unclear.…”

Section: Discuss/onmentioning

confidence: 99%

Osteoporosis in Hemiplegia

Panin

Gorday

Paul

1971

Stroke

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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

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“…(21) Generalized bone loss, developed in the course of disuse, is a well recognized complication after para or tetraplegia in human. (22) A localized loss of bone is also documented in patients with regional disuse after fracture (23) , unilateral amputation (24) , stroke or poliomyelitis (25) and reduced physical activity (26,27) . However, in men, other risk factors are commonly observed and intricated in the pathogenesis of osteoporosis (smoking, alcohol abuse, previous gastric surgery, glucocorticosteroid therapy…).…”

Section: Introductionmentioning

confidence: 99%