Preventing hip fracture after stroke.
Hip fracture after stroke is a frequently occurring and costly complication. The bone quality of stroke survivors is affected by decreased mobility, asymmetric weight bearing, and impaired vitamin D stores. Simultaneously, the risk of falling after stroke is often increased by various impairments. Yet, attempts to limit falls are not enough to prevent fractures. Closer attention to bone health is also needed. Bone markers, which reflect the dynamics of bone remodeling, are becoming more available. Activity is necessary for bone health, but there are no clear guidelines for the type and amount of therapeutic exercise. New metrics for studying bone mineral density and exercise are on the horizon. Finally, there appears to be a role for bisphosphonate prophylaxis in a yet-to-be-defined at-risk population of stroke survivors. The purpose of this review is to discuss the setting for hip fracture after stroke and assess emerging treatments and technologies that may be used to combat the problem.
Bast
Brian A
BA
Department of Orthopaedics, Sports and Spine Rehabilitation, Beth Israel Medical Center, New York, USA.
Greenwald
Brian D
BD
D000058:Accidental Falls / Q000517:prevention & control; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000627:therapeutic use; D005081:Exercise Therapy; D006620:Hip Fractures / Q000517:prevention & control*; D006801:Humans; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D014807:Vitamin D / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium