Methods: Forty-seven chronic stroke patients, and 26 healthy individuals participated in the study. We used peripheral quantitative computed tomography (pQCT) to evaluate the BMD and geometry of the distal radius epiphysis on both sides. Compressive bone strength index (cBSI) was computed based on the densitometric and geometric data derived from pQCT. Each subject was also evaluated for grip strength, spasticity, motor function, and sensation of the upper extremity. Indicators of cardiovascular health including the stroke volume, cardiac output, large and small artery elasticity indices (C1 and C2) were measured using impedance cardiography and pulse wave analysis. Results: The side-to-side differences in total BMD, trabecular BMD, and cBSI were significant in the stroke group only (by 7-16%, p<0.001). Multiple regression analysis showed that grip strength (p<0.001) and C2 (p<0.01) were significant predictors of the cBSI of the hemiparetic distal radius. Conclusion: The hemiparetic distal radius has compromised bone strength index, which is related to poorer cardiovascular health and muscle strength. Whether cardiovascular training and upper limb muscle strengthening can improve bone strength of the radius in stroke survivors awaits further research.
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