Article

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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS