Clinical Characteristics and Bone Mineral Density Score in Post-Stroke Neuromuscular Deficit

Abstract

Background: Disuse osteoporosis in hemiparetic patients often results in significant morbidity, decreased quality of life, and different clinical characteristics. The study aimed to investigate the effect of these clinical factors on bone mineral density (BMD).

Methods: This was an analytical observational study with a cross-sectional method evaluating hemiparetic patients at Cipto Mangunkusumo Hospital from 2018 to 2019. BMD (g/cm²) was assessed using dual energy X-ray absorptiometry (DXA) on the spine and both sides of the body. The relationship and correlation between BMD and delta BMD scores with clinical characteristics were analyzed. A linear regression test was used to assess the correlation between variables.

Results: A total of 34 participants were recruited for this study. There was a difference between the healthy and paretic side of BMD of both hip and wrist (P < 0.001), strong positive correlation between the onset of hemiparesis and wrist and hip delta BMD (r = 0.779, P = 0.001 and r = 0.791, P = 0.001), and significant association between delta BMD and age and motor strength. Multivariate analysis shows that the onset of hemiparesis was a strong predictor of delta BMD (aR² wrist = 0.486, aR² hip = 0.614). There was a 7.36% decrease in the mean BMD score of the paretic side compared to the non-paretic side.

Conclusion: A low BMD score is prevalent in seven out of 10 patients with post-stroke neuromuscular deficit. Age, limb strength, the onset of hemiparesis, and rehabilitation compliance are associated with decreased BMD among patients with post-stroke neuromuscular deficit.