Deans' stroke musings: Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 16, 2018

Upright activity and higher motor function may preserve bone mineral density within 6 months of stroke: a longitudinal study

You do realize that standing is one of the causes of falling and that falling after 65 results in death lots of time? Will your patients sign a waiver absolving you of killing them?
https://link.springer.com/epdf/10.1007/s11657-017-0414-4?author_access_token=llxbJoqMAwbJR_-wSasLove4RwlQNchNByi7wbcMAY5Yc2JLyKIO9HuvO8n_m0d9g6X67dQIlftqkWNr1ccluDEouY0oDjLLG90erJn5jg22kDJNXKRySBJhFYdfYJU6QZ2RCBKtJPtQgz-bZyDb4g%3D%3D

Karen Borschmann

1,2

Sandra Iuliano

3,4

Ali Ghasem-Zadeh

3,4

Leonid Churilov

Marco Y. C. Pang

Julie Bernhardt

1,2

Received: 24 May 2017 /Accepted: 18 December 2017

The Author(s) 2018. This article is an open access publication

Abstract

Purpose: Bone fragility contributes to increased fracture risk, but little is known about the emergence of post-stroke bone loss. We investigated skeletal changes and relationships with physical activity, stroke severity, motor control and lean mass within 6 months of stroke.

Methods

This is a prospective observational study. Participants were non-diabetic but unable to walk within 2 weeks of first stroke. Distal tibial volumetric bone mineral density (vBMD, primary outcome), bone geometry and microstructure (high-resolution peripheral quantitative computed tomography) were assessed at baseline and 6 months, as were secondary outcomes total body bone mineral content and lean mass (dual energy X-ray absorptiometry), bone metabolism (serum osteocalcin, N-terminal propeptide of type 1 procollagen (P1NP), C-terminal telopeptide of type 1 collagen (CTX)), physical activity (PAL2 accelerometer) and motor control (Chedoke McMaster) which were also measured at 1 and 3 months.

Results

Thirty-seven participants (69.7 years (SD 11.6), 37.8% females, NIHSS 12.6 (SD 4.7)) were included. The magnitude of difference in vBMD between paretic and non-paretic legs increased within 6 months, with a greater reduction observed in paretic legs (mean difference = 1.5% (95% CI 0.5, 2.6), p= 0.007). At 6 months, better motor control was associated with less bone loss

since stroke (r=0.46, p= 0.02). A trend towards less bone loss was observed in people who regained independent walking compared to those who did not (p= 0.053). Higher baseline daily count of standing up was associated with less change in bone turnover over 6 months: osteocalcin (r=−0.51,

p=0.01),P1NP(r=−0.47, p = 0.01), CTX (r=−0.53, p = 0.01).

Conclusion

Better motor control and walking recovery were associated with reduced bone loss. Interventions targeting these impairments from early post-stroke are warranted.

Clinical trial registration

URL:

http://www.anzctr.org.au

. Unique identifier: ACTRN12612000123842.