Please use this identifier to cite or link to this item:
PIRA download icon_1.1View/Download Full Text
Title: The impact of stroke on bone properties and muscle-bone relationship : a systematic review and meta-analysis
Authors: Yang, FZ 
Jehu, DAM
Ouyang, H 
Lam, FMH 
Pang, MYC 
Issue Date: Feb-2020
Source: Osteoporosis international, Feb. 2020, v. 31, no. 2, p. 211-224
Abstract: To systematically review available evidence related to the characteristics of bone changes post-stroke and the relationship between various aspects of muscle function (e.g., strength, spasticity) and bone properties after stroke onset. An extensive online database search was undertaken (last search in January 2019). Articles that examined the bone properties in stroke patients were included. The quality of the studies was evaluated with the National Institutes of Health (NIH) Study Quality Assessment Tools. Publication bias of meta-analyses was assessed using the Egger’s regression asymmetry test. The selection and evaluation of the articles were conducted by two independent researchers. Fifty-nine studies were identified. In subacute and chronic stroke studies, the skeletal sites in the paretic limbs sustained a more pronounced decline in bone quality than did their counterparts in the non-paretic limbs. The rate of changes showed a decelerating trend as post-stroke duration increased, but the timing of achieving the steady rate differed across skeletal sites. The magnitude of bone changes in the paretic upper limb was more pronounced than the paretic lower limb. There was a strong relationship between muscle strength/mass and bone density/strength index. Muscle spasticity seemed to have a negative impact on bone integrity in the paretic upper limb, but its influence on bone properties in the paretic lower limb was uncertain. Substantial bone changes in the paretic limbs occurred particularly in the first few months after stroke onset. Early intervention, muscle strength training, and long-term management strategies may be important to enhance bone health post-stroke. This review has also revealed the knowledge gaps which should be addressed in future research.
Keywords: Bone properties
Muscle function
Muscle spasticity
Publisher: Springer
Journal: Osteoporosis international 
ISSN: 0937-941X
EISSN: 1433-2965
DOI: 10.1007/s00198-019-05175-4
Rights: © International Osteoporosis Foundation and National Osteoporosis Foundation 2019
This is a post-peer-review, pre-copyedit version of an article published in Osteoporosis International. The final authenticated version is available online at:
Appears in Collections:Journal/Magazine Article

Files in This Item:
File Description SizeFormat 
a0590-n40_systematic review one bone and stroke_final_v5.pdfPre-Published version559.21 kBAdobe PDFView/Open
Open Access Information
Status open access
File Version Final Accepted Manuscript
View full-text via PolyU eLinks SFX Query
Show full item record

Page views

Last Week
Last month
Citations as of May 28, 2023


Citations as of May 28, 2023


Citations as of Jun 1, 2023


Citations as of Jun 1, 2023

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.