I look at this totally differently; what do I do to strengthen my bones so they won't fracture. Boxers microfracturing their hands so they recover stronger than they were. Of course your doctor will never approve of you falling to stress your bones. I have fallen numerous times on my left hip, including at least six times from my bicycle. I look at that as probably preventing much worse outcomes as I get older. Don't listen to me, I'm not medically trained; Is your doctor?
Fracture Risk Among Stroke Survivors According to Poststroke Disability Status and Stroke Type
Abstract
BACKGROUND:
Stroke survivors face physical and cognitive challenges, leading to an increased dependency and a higher fall risk. We aimed to investigate the impact of poststroke disability and stroke type on fracture risk at various sites compared with matched controls.
METHODS:
This retrospective cohort study used data from the Korean National Health Insurance System database (2010–2018), including patients with stroke and 1:1 matched controls. Stroke survivors were grouped based on the presence and severity of their poststroke disability and stroke type. The primary outcome was a newly diagnosed fracture, analyzed by Cox proportional hazard regression analyses adjusting for potential confounders.
RESULTS:
Among 223 358 stroke survivors (mean age, 64.8±10.9 years; 61.2% men), 16 344 fractures occurred during a mean follow-up of 3.7±2.5 years. In matched controls (n=322 161; mean age, 65.4±11.2 years; 61.3% men), 20 398 fractures were identified. Stroke survivors had increased overall fracture risk compared with matched controls (adjusted hazard ratio [aHR], 1.40 [95% CI, 1.37–1.43]). Specifically, hip fracture risk was even greater in stroke survivors (incidence rate per 1000 person-years, 4.7 [95% CI, 4.5–4.8]; aHR, 2.42 [95% CI, 2.30–2.55]) than controls (incidence rate, 2.2 [95% CI, 2.1–2.3]). The risk of vertebral fractures (aHR, 1.29 [95% CI, 1.25–1.34]) and other fractures (aHR, 1.19 [95% CI, 1.15–1.23]) was also higher than that of the control group. Hip fracture risk was the highest among stroke survivors with severe poststroke disability (aHR, 4.82 [95% CI, 4.28–5.42]), although vertebral or other fracture risk was the highest among those with mild poststroke disability. No significant difference in fracture risk was found between hemorrhagic and ischemic stroke survivors when stratified by disability status.
CONCLUSIONS:
Our findings showed increased subsequent fracture risk among stroke survivors, particularly those with poststroke disability and for hip fracture. Bone health assessment and treatment should be emphasized as an essential part of stroke management.
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