Balance, falls, and bone health: Role of exercise in reducing fracture risk after stroke

Eng, Janice J.; Pang, Marco Yiu Chung; Ashe, Maureen C.

doi:10.1682/jrrd.2007.01.0014

Cited by 63 publications

(52 citation statements)

References 142 publications

(202 reference statements)

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“…242 Moreover, the decline in BMD, coupled with balance deficits resulting from stroke, increases fracture risk. 245 Changes in BMD after stroke are correlated with functional deficits in the paretic limb(s). Jørgensen et al 246 assessed 40 patients at 6 days, 7 months, and 1 year after stroke.…”

Section: Poststroke Osteoporosismentioning

confidence: 99%

“…587 If left undetected or untreated, balance impairments can result in a cascade of serious, undesirable, and expensive events. 175,245 Evaluation of balance abilities is considered part of routine clinical practice in individuals with stroke. 308,588,589 Standardized tests of balance challenge different aspects of postural control such as anticipatory postural reactions during a variety of functional behaviors.…”

Section: Balance and Ataxiamentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

Self Cite

2,169

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Poststroke Osteoporosismentioning

confidence: 99%

Section: Balance and Ataxiamentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

Self Cite

2,169

840

View full text Add to dashboard Cite

show abstract

“…Participation in regular physical activity in people with stroke has been associated with improved mobility and motor function, increased cardiovascular fitness, greater strength and bone density as well as increased quality of life (Pang et al 2006;Eng et al 2008; Saunders et al 2009). Moreover, inactivity is now recognized as a modifiable risk factor for recurrent stroke as well as for cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Exercise perceptions among people with stroke: barriers and facilitators to participation

Simpson

Eng

Tawashy

2011

International Journal of Therapy and Rehabilitation

110

106

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Background/Aims-People with stroke continue to lead sedentary lives despite the multiple benefits of exercise. Knowledge regarding stroke survivors' conception of exercise, which is essential for a thorough understanding of the barriers and facilitators to exercise, is lacking. This study aims to explore the perceptions of exercise among stroke survivors, including their concepts and definitions of exercise, as well as their perceptions of barriers and facilitators to exercise.

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“…[1][2][3][4] Post-stroke hip fractures can lead to detrimental consequences such as longer hospital stay, increased disability, and reduced survival rate. 5,6 The costs related to the treatment of fractures also impose considerable economic strain on the health care sector.…”

mentioning

confidence: 99%

“…7,8 Although accidental falls are a major cause of fractures among individuals with stroke, 2,3,9 progressive bone loss after stroke may also be an important contributing factor. 4,10 Fractures in the upper extremity account for 27%-36% of all fractures after stroke, and most of these occur on the paretic side. 1,2 Thus, studying bone health of the upper extremity in people with stroke is clinically relevant.…”

mentioning

confidence: 99%

Changes in Bone Density and Geometry of the Upper Extremities after Stroke: A Case Report

Pang

Yang

Lau

et al. 2012

Physiotherapy Canada

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Purpose: The purpose of this study was to examine changes in bone density and geometry of the forearm region and motor function of the paretic upper extremity in a person with subacute stroke. Client Description: The participant was a 48-year-old man with right hemiparesis. Intervention: Not applicable. Measures and Outcomes: The assessment of upper-extremity (UE) function and bone imaging took place at 3 months and 12 months after stroke. The participant had moderate motor impairment and severe disuse of the paretic UE 3 months after stroke. During the follow-up period, no substantial change in paretic UE function was observed. At the 12 month follow-up, the areal bone mineral density (aBMD) of the ultradistal and mid-regions of the paretic forearm, as measured by dual-energy X-ray absorptiometry, sustained a significant reduction of 7.9% and 5.9%, respectively. The non-paretic side, in contrast, had a significant 4.0% increase in aBMD of the mid-forearm and a 2.8% increase in aBMD of the total forearm. Significant findings from peripheral quantitative computed tomography were a reduction in total volumetric bone mineral density (À12.1%) and bone strength index (À20.6%) in the radius distal epiphysis on the paretic side and an increase in cortical bone mineral content (2.0%) and bone strength index (7.6%) in the radius diaphysis on the non-paretic side. Implications: After a stroke that resulted in moderate to severe UE impairment, a significant decline in bone mineral density was identified in various skeletal sites in the forearm region as the participant entered the subacute and chronic stages of recovery. The results point to the potential importance of early rehabilitative intervention in preventing unfavourable bone changes in the paretic upper limb among individuals with stroke.Key Words: bone and bones; osteoporosis; muscles; rehabilitation; stroke. RÉ SUMÉObjectif : Examiner les changements dans la densité et la gé omé trie osseuses de la ré gion de l'avant-bras et la fonction motrice d'un membre supé rieur paré tique chez une personne ayant subi un AVC subaigu (participant A). Description du client : Le participant A est â gé de 48 ans avec hé miparé sie du cô té droit. Intervention : Ne s'applique pas. Mesures et ré sultats : L'é valuation de la fonction des membres supé rieurs et une imagerie osseuse ont é té ré alisé es 3 mois, puis 12 mois suivant l'AVC. Le participant A avait une incapacité motrice modé ré e et une dysfonction grave du membre supé rieur paré tique 3 mois aprè s l'AVC. Au cours de la pé riode de suivi, aucun changement particulier de la fonction du membre paré tique supé rieur n'a é té observé . Aprè s un suivi de 12 mois, la densité miné rale osseuse surfacique (aBMD) de la ré gion mé diane et ultradistale de l'avant-bras paré tique, telle que mesuré e par absorptiomé trie aux rayons X à double intensité (DXA) affichait une ré duction considé rable de 7,9 % et de 5,9 %, respectivement. Le cô té non paré tique, au contraire, affichait une augmentation de densité miné rale ...

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Balance, falls, and bone health: Role of exercise in reducing fracture risk after stroke

Cited by 63 publications

References 142 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Exercise perceptions among people with stroke: barriers and facilitators to participation

Changes in Bone Density and Geometry of the Upper Extremities after Stroke: A Case Report

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