This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ramnemark, A. Articles by Gustafson, Y. Search for Related Content PubMed PubMed Citation Articles by Ramnemark, A. Articles by Gustafson, Y. Pubmed/NCBI databases Medline Plus Health Information Osteoporosis Related Collections Rehabilitation, Stroke Risk Factors for Stroke

(Stroke. 1999;30:755-760.)
© 1999 American Heart Association, Inc.

Original Contributions

Hemiosteoporosis After Severe Stroke, Independent of Changes in Body Composition and Weight

A. Ramnemark, MD; L. Nyberg, RPT, PhD; R. Lorentzon, MD, PhD; T. Olsson, MD, PhD Y. Gustafson, MD, PhD

From the Department of Geriatric Medicine (A.R., L.N., Y.G.), Sports Medicine Unit, Department of Orthopaedics (R.L.), and Department of Medicine (T.O.) Umeå University, Umeå, Sweden.

Correspondence to Anna Ramnemark, Department of Geriatric Medicine, Umeå University, SE-901 87 Umeå, Sweden. E-mail Anna.Ramnemark{at}germed.umu.se

Background and Purpose—Fractures are a serious complication after stroke, and the risk of hip fractures among stroke patients is increased 2 to 4 times versus a reference population. Fractures after stroke are probably caused by the development of hemiosteoporosis and the high incidence of accidental falls. The aim of this study was to investigate the development of hemiosteoporosis in relation to other changes in body composition during the first year after severe stroke.

Methods—The study included 24 patients with extensive paresis after stroke. Bone mineral content (BMC) and fat and lean mass were assessed 1, 4, 7, and 12 months after stroke onset by a dual-energy x-ray absorptiometer.

Results—The loss of total body BMC was significant during the first year after stroke (–1.6%; P<0.05), but there were no significant changes in total lean or fat mass. At inclusion, there were no significant differences between sides in lean or fat mass or BMC, but during follow-up, BMC of the affected side decreased significantly compared with the same side at inclusion (–7.5%; P<0.01). Side differences in fat mass became significant between legs (9.3%; P<0.001) and whole sides (4.8%; P<0.01). There were only minor side changes in lean mass. Loss of BMC was independent of weight changes.

Conclusions—During the first year after severe stroke, patients developed pronounced hemiosteoporosis. This was not associated with general changes in lean or fat mass. The development of hemiosteoporosis was independent of weight changes after stroke.

Key Words: body composition • bone density • complications • hemiplegia • osteoporosis

This article has been cited by other articles:

				S F. Mackintosh, K Hill, K J Dodd, P Goldie, and E Culham Falls and injury prevention should be part of every stroke rehabilitation plan Clinical Rehabilitation, April 1, 2005; 19(4): 441 - 451. [Abstract] [PDF]

				L. Jorgensen, T. Engstad, and B. K. Jacobsen Higher Incidence of Falls in Long-Term Stroke Survivors Than in Population Controls: Depressive Symptoms Predict Falls After Stroke Stroke, February 1, 2002; 33(2): 542 - 547. [Abstract] [Full Text] [PDF]

				L. Jorgensen, T. Engstad, and B. K. Jacobsen Bone Mineral Density in Acute Stroke Patients : Low Bone Mineral Density May Predict First Stroke in Women Stroke, January 1, 2001; 32(1): 47 - 51. [Abstract] [Full Text] [PDF]

				Y. Sato, M. Kaji, N. Saruwatari, K. Oizumi, A. Ramnemark, L. Nyberg, Y. Gustafson, R. Lorentzon, and T. Olsson Hemiosteoporosis Following Stroke: Importance of Pathophysiologic Understanding and Histologic Evidence • Response Stroke, September 1, 1999; 30 (9): 1974d - 1981. [Full Text] [PDF]