title: Differences in tibia morphology between the sound and affected sides in ankle-foot orthosis-using survivors of stroke.
abstract: OBJECTIVE
  To examine differences in tibia and proximal femur morphology between the affected and sound limbs in ankle-foot orthosis (AFO)-using survivors of stroke.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  A university bone density laboratory.
  
  
  METHODS
  Ambulatory, AFO-using survivors of stroke (N=9; age range, 55-74y; poststroke duration, 13.5±4.4y; AFO use, 6.5±1.4y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Total body and hip areal bone mineral density (aBMD) and bone mineral content (BMC) were assessed by dual-energy x-ray absorptiometry. The 4%, 38%, and 66% sites of both tibias were measured with peripheral quantitative computed tomography for total, cortical, and trabecular volumetric BMD (vBMD) and BMC. Bone geometry, bone strength index (BSI), strength strain index (SSI), and minimum and maximum rotated moments of inertia (Imin, Imax) were determined.
  
  
  RESULTS
  Total hip and trochanter BMC and aBMD were 7% to 19% greater on the sound side (P<.05). Total BMC and vBMD were 2% to 21% greater (P<.05) on the sound limb, depending on site. Trabecular BMC and vBMD and BSI values were 19%, 21%, and 31% higher (P<.05) on the sound limb at the 4% site. Cortical BMC and vBMD (P<.05), and cortical thickness (P<.01) were greater on the sound side at the 38% and 66% sites. Cortical area and bone strength (SSI, Imin) were greater (P<.05) at the 66% site. Endosteal circumferences were greater on the affected side (P<.01).
  
  
  CONCLUSIONS
  Interlimb differences in bone characteristics after a stroke persist despite returning to ambulatory status with AFO use.
authors.affiliation: Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA. kylesherk@hotmail.com
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Sherk
authors.forename: Vanessa D
authors.initials: VD
authors.lastname: Sherk
authors.forename: Mark A
authors.initials: MA
authors.lastname: Anderson
authors.forename: Debra A
authors.initials: DA
authors.lastname: Bemben
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bemben
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D016009:Chi-Square Distribution; D005260:Female; D061826:Foot Orthoses; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000473:pathology*; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed