Change of Bone Mineral Density and Relationship to Clinical Parameters in Male Stroke Patients
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Objective To investigate the clinical characteristics that significantly contribute to a decreased bone mineral density (BMD), the BMD changes and clinical characteristics of men who experienced a stroke between the ages of 50 years and 65 years were studied between 3 months and 4 months after the stroke.Methods Subjects had a brain hemorrhage or a cerebral infarction. Only men aged 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis. All subjects underwent a BMD test between 3 months and 4 months after their strokes. Also, patients with a medication history that might have caused a secondary osteoporosis before a stroke were excluded. Results The BMD for the lumbar spine and hemiplegic side of the femoral neck correlated significantly with the results of the manual muscle test (MMT) of the hemiplegic lower extremity and the Modified Barthel Index (MBI) score. This result suggests that the immobility from the decreased muscle strength and the weakened daily functionality might have reduced the BMD. According to a multiple linear regression analysis, the MBI score is significantly correlated with the lumbar BMD. The BMD of the hemiplegic femoral neck is significantly correlated with the MMT and the MBI score.Conclusion This study showed that BMD monitoring should be considered in male stroke patients, especially for patients with a high dependency in daily functions and a decreased muscle strength in the hemiplegic lower extremity.
Abstract
Objective To investigate the clinical characteristics that significantly contribute to a decreased bone mineral density (BMD), the BMD changes and clinical characteristics of men who experienced a stroke between the ages of 50 years and 65 years were studied between 3 months and 4 months after the stroke.Methods Subjects had a brain hemorrhage or a cerebral infarction. Only men aged 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis. All subjects underwent a BMD test between 3 months and 4 months after their strokes. Also, patients with a medication history that might have caused a secondary osteoporosis before a stroke were excluded. Results The BMD for the lumbar spine and hemiplegic side of the femoral neck correlated significantly with the results of the manual muscle test (MMT) of the hemiplegic lower extremity and the Modified Barthel Index (MBI) score. This result suggests that the immobility from the decreased muscle strength and the weakened daily functionality might have reduced the BMD. According to a multiple linear regression analysis, the MBI score is significantly correlated with the lumbar BMD. The BMD of the hemiplegic femoral neck is significantly correlated with the MMT and the MBI score.Conclusion This study showed that BMD monitoring should be considered in male stroke patients, especially for patients with a high dependency in daily functions and a decreased muscle strength in the hemiplegic lower extremity.
참고문헌 (27)
- NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, "Osteoporosis prevention, diagnosis, and therapy", JAMA, 285, pp.785~795 (2001)
- Lane JM, "Osteoporosis: diagnosis and treatment", Instr Course Lect, 46, pp.445~458 (1997)
- Kanis JA, "An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation", Osteoporos Int, 11, pp.192~202 (2000)
- Paker N, "Relationship between bone turnover and bone density at the proximal femur in stroke patients", J Stroke Cerebrovasc Dis, 18, pp.139~143 (2009)
- Iwamoto J, "Bone mineral density of metatarsus in hemiplegic subjects", Am J Phys Med Rehabil, 78, pp.202~207 (1999)
- Yavuzer G, "Bone mineral density in patients with stroke", Int J Rehabil Res, 25, pp.235~239 (2002)
- Sato Y, "Increased bone resorption during the first year after stroke", Stroke, 29, pp.1373~1377 (1998)
- Sato Y, "Influence of immobilization on bone mass and bone metabolism in hemiplegic elderly patients with a long-standing stroke", J Neurol Sci, 156, pp.205~210 (1998)
- 고명환, "편마비 환자에서 마비측 상지의 골밀도 감소 양상", Annals of Rehabilitation Medicine, 28(3), pp.214~219 (2004), 대한재활의학회
- Poplingher AR, "Hip fracture in stroke patients:epidemiology and rehabilitation", Acta Orthop Scand, 56, pp.226~227 (1985)
- Hamdy RC, "Long-term effects of strokes on bone mass", Am J Phys Med Rehabil, 74, pp.351~356 (1995)
- Takamoto S, "Alterations of bone mineral density of the femurs in hemiplegia", Calcif Tissue Int, 56, pp.259~262 (1995)
- Ramnemark A, "Progressive hemiosteoporosis on the paretic side and increased bone mineral density in the nonparetic arm the first year after severe stroke", Osteoporos Int, 9, pp.269~275 (1999)
- del Puente A, "Determinants of bone mineral density in immobilization: a study on hemiplegic patients", Osteoporos Int, 6, pp.50~54 (1996)
- Sahin L, "Bone mineral density in patients with stroke", Am J Phys Med Rehabil, 80, pp.592~596 (2001)
- 김기찬, "폐경 및 호르몬 대체요법 기간에 따른 골밀도, 골대사 표지자, 지질의 변화", Annals of Rehabilitation Medicine, 25(3), pp.491~497 (2001), 대한재활의학회
- Kim GC, "Relationship among estradiol, lipid profile, biochemical markers, and bone mineral density according to postmenopausal period", J Korean Acad Rehabil Med, 24, pp.318~325 (2000)
- 김기찬, "골다공증에서 알렌드로네이트 투여 시 에스트로젠 용량에 따른 치료 효과", Annals of Rehabilitation Medicine, 30(3), pp.247~543 (2006), 대한재활의학회
- 정석모, "폐경 후 골다공증에서 랄록시펜과 저용량 불소의 2년간 병합요법의 효과", Annals of Rehabilitation Medicine, 31(2), pp.207~212 (2007), 대한재활의학회
- Sato Y., "Abnormal bone and calcium metabolism in patients after stroke", Arch Phys Med Rehabil, 81, pp.117~121 (2000)
- 박은정, "Prevalence of Osteoporosis in the Korean Population Based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008--2011", Yonsei Medical Journal, 55(4), pp.1049~1057 (2014), 연세대학교의과대학[DOI]
- Kim HW, "Prevalence of pre-stroke low bone mineral density and vertebral fracture in first stroke patients", Bone, 43, pp.183~186 (2008)
- 권진욱, "첫 발병 뇌졸중 환자에서의 병전 골밀도", Annals of Rehabilitation Medicine, 34(3), pp.285~289 (2010), 대한재활의학회
- 김기찬, "Immobilization Osteoporosis", OSTEOPOROSIS, 9(1), pp.1~17 (2011), 대한골다공증학회
- Panday K, "Medication-induced osteoporosis: screening and treatment strategies", Ther Adv Musculoskelet Dis, 6, pp.185~202 (2014)
- Mazziotti G, "Drug-induced osteoporosis: mechanisms and clinical implications", Am J Med, 123, pp.877~884 (2010)
- Hamdy RC, "Changes in bone mineral content and density after stroke", Am J Phys Med Rehabil, 72, pp.188~191 (1993)