Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke
Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk....
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| Veröffentlicht in: | International journal of stroke 2012-06, Vol.7 (4), p.330-335 |
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| container_title | International journal of stroke |
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| creator | Borschmann, Karen Pang, Marco Y. C. Bernhardt, Julie Iuliano-Burns, Sandra |
| description | Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk. The purpose of this systematic review was to investigate the skeletal effects of physical activity in adults affected by stroke. A search of electronic databases was undertaken.
Selection criteria of trials were
prospective and controlled
physical activity-based intervention
participants with history of stroke, and
bone-related outcome measures.
Effect sizes were calculated for outcomes of paretic and nonparetic limbs. Three of 349 identified records met the inclusion criteria. Small effect sizes were found in favor of physical activity in adults with chronic stroke (n=95, 40% female, average age 63·8 years, more than one-year poststroke). Patients in intervention groups had significantly higher changes in femoral neck bone mineral density, tibial cortical thickness and trabecular bone mineral content of the paretic limb, compared with controls (P |
| doi_str_mv | 10.1111/j.1747-4949.2011.00645.x |
| format | Article |
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Selection criteria of trials were
prospective and controlled
physical activity-based intervention
participants with history of stroke, and
bone-related outcome measures.
Effect sizes were calculated for outcomes of paretic and nonparetic limbs. Three of 349 identified records met the inclusion criteria. Small effect sizes were found in favor of physical activity in adults with chronic stroke (n=95, 40% female, average age 63·8 years, more than one-year poststroke). Patients in intervention groups had significantly higher changes in femoral neck bone mineral density, tibial cortical thickness and trabecular bone mineral content of the paretic limb, compared with controls (P<0·05). It is not known whether these benefits reduced fracture risk. There are limited studies investigating the skeletal effect of physical activity for adults poststroke. Given the increased risk of, and poor outcomes following a fracture after stroke, randomized trials are warranted to investigate the benefits of physical activity on bone, after stroke. Interventions are likely to be beneficial if implemented soon after stroke, when bone loss appears to be rapid and pronounced.</description><identifier>ISSN: 1747-4930</identifier><identifier>EISSN: 1747-4949</identifier><identifier>DOI: 10.1111/j.1747-4949.2011.00645.x</identifier><identifier>PMID: 21967614</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Bed Rest ; bone ; Bone Density ; Bone Diseases, Metabolic - physiopathology ; Bone Diseases, Metabolic - prevention & control ; Clinical Trials as Topic ; exercise ; Exercise Therapy - methods ; Female ; fracture ; Fractures, Bone - physiopathology ; Fractures, Bone - prevention & control ; Humans ; Male ; Middle Aged ; osteoporosis ; physical activity ; Risk Factors ; stroke ; Stroke - complications ; Stroke - physiopathology ; systematic review</subject><ispartof>International journal of stroke, 2012-06, Vol.7 (4), p.330-335</ispartof><rights>2012 The Authors</rights><rights>2012 The Authors.International Journal of Stroke © 2012 World Stroke Organization</rights><rights>2012 The Authors.International Journal of Stroke © 2012 World Stroke Organization.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5025-8df648ca5b0ead3b730f5638a270244d1dbdf9ffe76fcfcfc88678fab0b0cfc3</citedby><cites>FETCH-LOGICAL-c5025-8df648ca5b0ead3b730f5638a270244d1dbdf9ffe76fcfcfc88678fab0b0cfc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1111/j.1747-4949.2011.00645.x$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1111/j.1747-4949.2011.00645.x$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,782,786,1419,21828,27933,27934,43630,43631,45583,45584</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21967614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borschmann, Karen</creatorcontrib><creatorcontrib>Pang, Marco Y. C.</creatorcontrib><creatorcontrib>Bernhardt, Julie</creatorcontrib><creatorcontrib>Iuliano-Burns, Sandra</creatorcontrib><title>Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke</title><title>International journal of stroke</title><addtitle>Int J Stroke</addtitle><description>Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk. The purpose of this systematic review was to investigate the skeletal effects of physical activity in adults affected by stroke. A search of electronic databases was undertaken.
Selection criteria of trials were
prospective and controlled
physical activity-based intervention
participants with history of stroke, and
bone-related outcome measures.
Effect sizes were calculated for outcomes of paretic and nonparetic limbs. Three of 349 identified records met the inclusion criteria. Small effect sizes were found in favor of physical activity in adults with chronic stroke (n=95, 40% female, average age 63·8 years, more than one-year poststroke). Patients in intervention groups had significantly higher changes in femoral neck bone mineral density, tibial cortical thickness and trabecular bone mineral content of the paretic limb, compared with controls (P<0·05). It is not known whether these benefits reduced fracture risk. There are limited studies investigating the skeletal effect of physical activity for adults poststroke. Given the increased risk of, and poor outcomes following a fracture after stroke, randomized trials are warranted to investigate the benefits of physical activity on bone, after stroke. Interventions are likely to be beneficial if implemented soon after stroke, when bone loss appears to be rapid and pronounced.</description><subject>Bed Rest</subject><subject>bone</subject><subject>Bone Density</subject><subject>Bone Diseases, Metabolic - physiopathology</subject><subject>Bone Diseases, Metabolic - prevention & control</subject><subject>Clinical Trials as Topic</subject><subject>exercise</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>fracture</subject><subject>Fractures, Bone - physiopathology</subject><subject>Fractures, Bone - prevention & control</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>osteoporosis</subject><subject>physical activity</subject><subject>Risk Factors</subject><subject>stroke</subject><subject>Stroke - complications</subject><subject>Stroke - physiopathology</subject><subject>systematic review</subject><issn>1747-4930</issn><issn>1747-4949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcFu1DAQtRCIlsIvIB-5JNixHSeIC7TQllZwaCWOluOMW-9mk2B7u5s7H45Dykrcah88M35vxn4PIUxJTtN6v8qp5DLjNa_zglCaE1Jyke-foePDxfNDzMgRehXCihAuJCtfoqOC1qUsKT9Gv28ijKPr73Acdtq3AY8eHqCPbujxYHEz9IC7IQSsbQSPQ_TDGj5gjcMUImx0dAYnhoPdDI_3gMMaOoi6w2AtmBjm-ng_BWdSTZvoHlyc_mv3Gr2wugvw5vE8Qbdfv9yeXmTXP84vTz9dZ0aQQmRVa0teGS0aArpljWTEipJVupCk4LylbdPaOg2VpTXzrqpSVlY3pCEpYyfo3dJ29MOvLYSoNi4Y6Drdw7ANihLK6oIQQRK0WqDGp797sGr0bqP9lEBqtkCt1KyumpVWswXqrwVqn6hvH6dsmw20B-I_zRPg4wLYuQ6mJzdWl99uUpDoYqEHfQdqNWx9nzR7yruyheeSb_vDWO3XqpRMCvXz-7m6EtXZ2cUVU5_ZH2btt9A</recordid><startdate>201206</startdate><enddate>201206</enddate><creator>Borschmann, Karen</creator><creator>Pang, Marco Y. C.</creator><creator>Bernhardt, Julie</creator><creator>Iuliano-Burns, Sandra</creator><general>Blackwell Publishing Ltd</general><general>SAGE Publications</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201206</creationdate><title>Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke</title><author>Borschmann, Karen ; Pang, Marco Y. C. ; Bernhardt, Julie ; Iuliano-Burns, Sandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5025-8df648ca5b0ead3b730f5638a270244d1dbdf9ffe76fcfcfc88678fab0b0cfc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Bed Rest</topic><topic>bone</topic><topic>Bone Density</topic><topic>Bone Diseases, Metabolic - physiopathology</topic><topic>Bone Diseases, Metabolic - prevention & control</topic><topic>Clinical Trials as Topic</topic><topic>exercise</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>fracture</topic><topic>Fractures, Bone - physiopathology</topic><topic>Fractures, Bone - prevention & control</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>osteoporosis</topic><topic>physical activity</topic><topic>Risk Factors</topic><topic>stroke</topic><topic>Stroke - complications</topic><topic>Stroke - physiopathology</topic><topic>systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Borschmann, Karen</creatorcontrib><creatorcontrib>Pang, Marco Y. C.</creatorcontrib><creatorcontrib>Bernhardt, Julie</creatorcontrib><creatorcontrib>Iuliano-Burns, Sandra</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of stroke</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borschmann, Karen</au><au>Pang, Marco Y. C.</au><au>Bernhardt, Julie</au><au>Iuliano-Burns, Sandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke</atitle><jtitle>International journal of stroke</jtitle><addtitle>Int J Stroke</addtitle><date>2012-06</date><risdate>2012</risdate><volume>7</volume><issue>4</issue><spage>330</spage><epage>335</epage><pages>330-335</pages><issn>1747-4930</issn><eissn>1747-4949</eissn><abstract>Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk. The purpose of this systematic review was to investigate the skeletal effects of physical activity in adults affected by stroke. A search of electronic databases was undertaken.
Selection criteria of trials were
prospective and controlled
physical activity-based intervention
participants with history of stroke, and
bone-related outcome measures.
Effect sizes were calculated for outcomes of paretic and nonparetic limbs. Three of 349 identified records met the inclusion criteria. Small effect sizes were found in favor of physical activity in adults with chronic stroke (n=95, 40% female, average age 63·8 years, more than one-year poststroke). Patients in intervention groups had significantly higher changes in femoral neck bone mineral density, tibial cortical thickness and trabecular bone mineral content of the paretic limb, compared with controls (P<0·05). It is not known whether these benefits reduced fracture risk. There are limited studies investigating the skeletal effect of physical activity for adults poststroke. Given the increased risk of, and poor outcomes following a fracture after stroke, randomized trials are warranted to investigate the benefits of physical activity on bone, after stroke. Interventions are likely to be beneficial if implemented soon after stroke, when bone loss appears to be rapid and pronounced.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21967614</pmid><doi>10.1111/j.1747-4949.2011.00645.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of stroke, 2012-06, Vol.7 (4), p.330-335 |
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| subjects | Bed Rest bone Bone Density Bone Diseases, Metabolic - physiopathology Bone Diseases, Metabolic - prevention & control Clinical Trials as Topic exercise Exercise Therapy - methods Female fracture Fractures, Bone - physiopathology Fractures, Bone - prevention & control Humans Male Middle Aged osteoporosis physical activity Risk Factors stroke Stroke - complications Stroke - physiopathology systematic review |
| title | Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke |
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