Turkish Journal of Physical Medicine and Rehabilitation 2004 , Vol 50 , Num 6

Erken Dönem Ambulatuar İnmeli Hastalarda Kemik Metabolizmasındaki Değişiklikler

Nihal Özaras 1 ,Meltem Esenyel 2 ,Ali Rıza Uras 3 ,Saliha Eroğlu Demir 2
1 Bezmialem Vakıf Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
2 SSK Vakıf Gureba Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul
3 SSK Vakıf Gureba Eğitim Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul

Stroke is a major cause of mortality and morbidity in elderly people. In stroke patients, hip fractures are 2 to 4 times more likely than age matched reference population. The major determinant of hip fracture is the hemiosteoporosis of the paretic side. Immobilization and disuse are the major factors, but several other factors may also play a role in the development of hemiosteoporosis. This study is planned to investigate the bone metabolism in stroke patients who were able to walk in the first year of their illness. Twenty-six patients with hemiparesia who had a stroke during the last year were included to the study. All patients were over 60 years of age and could walk with or without aids or personal support. Functional status was evaluated by Barthel Index while stroke severity was assessed by the use of Scandinavian Stroke Scale. Bilateral femur and lumbar spine bone density, parathyroid hormone, osteocalcin and deoxypyridinoline levels were determined. Thirty control subjects over 60 years of age with no known systemic illness were also included to the study to compare parathyroid hormone and bone turnover markers’ level. In this study, there was no difference between two lower extremity bone mineral densities of the stroke patients who could walk with or without support. Therefore, we recommend stroke patients to undergo a regular rehabilitation program and be ambulated as soon as possible in order to prevent the osteoporosis. 

Keywords : Stroke, osteoporosis, hemiosteoporosis