Relationship between bone strength index of the hemiparetic tibial diaphysis and muscle strength in people with chronic
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ORIGINAL ARTICLE
Relationship between bone strength index of the hemiparetic tibial diaphysis and muscle strength in people with chronic stroke: influence of muscle contraction type and speed Z. Yang 1,2
&
T. Miller 1
&
M. Y. C. Pang 1
Received: 3 June 2020 / Accepted: 25 October 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary This study was conducted to examine the association between the tibial bone strength index and leg muscle strength of different contraction types and speeds among people with chronic stroke. We found that concentric muscle power at moderate speed was more associated with tibial bone strength index than other types. Introduction To compare the influence of muscle strength of different contraction types and speeds on the bone strength index of tibial diaphysis in people with chronic stroke. Methods Eighty individuals with chronic stroke (age: 62.6 ± 8.0 years; men/women: 46/34; post-stroke duration: 9.0 ± 5.4 years) underwent scanning of the tibia at the 66% site on both sides using peripheral quantitative computed tomography. Each participant was also evaluated for isometric and dynamic (at 60°/s and 120°/s) strength of knee flexors/extensors and ankle dorsiflexors/plantarflexors using an isokinetic dynamometer. For a given contraction type and speed, the strength values of the four muscle groups were summed to yield a composite score. Multiple regression analysis was used to identify the association of the percent side-to-side difference (%SSD) in tibial polar-stress-strain index (p-SSI) with %SSD in muscle strength of different contraction types and speeds. Results The p-SSI and all muscle strength parameters on the paretic side had lower values than the non-paretic side (p ≤ 0.001). The %SSD in concentric muscle power at angular speed of 60°/s (R2 = 0.317, p = 0.006) and 120°/s (R2 = 0.298, p = 0.020) remained independently associated with that in p-SSI, after controlling for age, sex, body mass index, post-stroke duration, motor impairment, spasticity, and physical activity level. The effect of isometric strength and eccentric muscle power was not significant in multivariate analysis. Conclusions Concentric muscle power was more predictive of %SSD in p-SSI at the tibial diaphysis than other contraction types and may be an important target for intervention to promote bone health in people with chronic stroke. Keywords Bone density . Muscle strength . Osteoporosis . Rehabilitation . Stroke
Introduction
* M. Y. C. Pang [email protected] Z. Yang [email protected] T. Miller [email protected] 1
Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
2
Department of Physical Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
Stroke is one of the most disabling conditions worldwide [1]. It is well known that people with stroke have an elevated risk of fragility fractures [2, 3], leading to complications such as increased morbidity [4
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