Differences in Tibia Morphology Between the Sound and Affected Sides in Ankle-foot Orthosis-using Survivors of Stroke

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2012 Nov 6

PMID 23123505

Citations 2

Authors

Kyle A Sherk

Vanessa D Sherk

Mark A Anderson

Debra A Bemben

Michael G Bemben

Affiliations

Soon will be listed here.

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.

Design: Observational study.

Setting: A university bone density laboratory.

Participants: Ambulatory, AFO-using survivors of stroke (N=9; age range, 55-74y; poststroke duration, 13.5±4.4y; AFO use, 6.5±1.4y).

Interventions: Not applicable.

Main Outcome Measures: 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.

Citing Articles

Gait speed and spasticity are independently associated with estimated failure load in the distal tibia after stroke: an HR-pQCT study.

Miller T, Qin L, Hung V, Ying M, Tsang C, Ouyang H Osteoporos Int. 2021; 33(3):713-724.

PMID: 34636938 DOI: 10.1007/s00198-021-06191-z.

The impact of stroke on bone properties and muscle-bone relationship: a systematic review and meta-analysis.

Yang F, Jehu D, Ouyang H, Lam F, Pang M Osteoporos Int. 2019; 31(2):211-224.

PMID: 31720713 DOI: 10.1007/s00198-019-05175-4.

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