title: Vascular elasticity and grip strength are associated with bone health of the hemiparetic radius in people with chronic stroke: implications for rehabilitation.
abstract: BACKGROUND
  People with stroke often have increased bone loss and fracture rate. Increasing evidence has demonstrated a link between cardiovascular health and bone loss in other patient populations.
  
  
  OBJECTIVE
  The study objectives were: (1) to compare the bone density and geometry of the radius diaphysis on the left and right sides in people with chronic stroke and people who were matched for age (control participants) and (2) to examine the relationship between the bone strength index at the hemiparetic radius diaphysis and vascular health in people with chronic stroke.
  
  
  METHODS
  This was a case-control study.
  
  
  METHODS
  The radius diaphysis on both sides was scanned with peripheral quantitative computed tomography in 65 participants with chronic stroke and 34 control participants. Large-artery and small-artery elasticity indexes were evaluated with a cardiovascular profiling system.
  
  
  RESULTS
  The paretic radius diaphysis had significantly lower values for cortical bone mineral density, cortical thickness, cortical area, and the bone strength index but a larger marrow cavity area than the nonparetic radius diaphysis in participants with chronic stroke, whereas no bone measurement showed a significant side-to-side difference in control participants. Multiple regression analyses showed that the large-artery elasticity index and grip strength remained significantly associated with the bone strength index at the hemiparetic radius diaphysis after controlling for age, sex, time since stroke diagnosis, body mass index, and physical activity (R(2)=.790).
  
  
  CONCLUSIONS
  This study was cross-sectional and could not establish causality. The radius diaphysis is not the most common site of fracture after stroke.
  
  
  CONCLUSIONS
  Both the integrity of the vasculature and muscle strength were significantly associated with the bone strength index at the hemiparetic radius diaphysis in participants with chronic stroke. The results may be useful in guiding rehabilitative programs for enhancing bone health in the paretic arm after stroke.
authors: Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong. marco.pang@polyu.edu.hk
authors: Marco Y C
authors: MY
authors: Pang
authors: Feigo Z H
authors: FZ
authors: Yang
authors: Alice Y M
authors: AY
authors: Jones
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018483:Diaphyses / Q000000981:diagnostic imaging; D004548:Elasticity / Q000502:physiology*; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology; D017534:Radial Artery / Q000502:physiology*; D011884:Radius / Q000000981:diagnostic imaging*; D012044:Regression Analysis; D012737:Sex Factors; D020521:Stroke / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed