ABSTRACT
The hemiplegia accelerates hone loss and is associated with an increased bone turnover. To study any difference of bone mineral density [BMD] between the affected and the unaffected sides of chronic stroke patients and the effect of rehabilitation program on bone mass and on the markers of bone resorption: urinary excretion of pyridinohine and deoxypyridinoline. Cohort correlational study. Prince Abdullah Bin Abdul Aziz hospital, Bisha, Saudi Kingdom Patients: 33 males, with mean age 59.6 +/- 4.1 yr [range, 54-67 yr] at the time of ad mission. On the paretic and nonparetic sides and biochemical markers of bone turnover were measured at the time of admission and after completing a 3 months rehabilitation program. BMI] was measured by dual energy X-ray absorptiometry [l]EXA] at the lumbar spine, femoral neck, and distal radius. Urinary f-pyr and f-Dpyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography [HPLC] and corrected for creatinine excretion. The baseline values of UMD were lower than normal in all selected regions and a significant difference of BMD was found between the paretic and nonparetic limbs. A significant increase in the BMD was observed only in the femoral neck after 3 months of rehabilitation program [<0.05]. The baseline values of bone resorption markers f-Pyr and f-Dpyr, were higher than normal and a significant improvement in the levels of these markers was observed after the rehabilitation program [p<0.001 and<0.05 respectively]. Patients with hemiplegia have increased bone resorption. Additionally, the results suggest that the early weight-bearing and electrically stimulated muscle contraction can have a beneficial effect on the preservation of hone mass and reduces the progression of osteoporosis found in those patients. BMD in our patients showed no significant difference before and after rehabilitation program while bone markers increased significantly reflecting a decrease in the bone resorption rate. The bone markers are therefore more useful than DEXA for therapeutic monitoring of patients with osteoporosis