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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemiplegia is associated with excessive bone loss in the paralyzed arm. The forearm bone mineral content was measured at a proximal cortical site and a distal trabecular site of both the normal and hemiplegic arms in 74 patients with hemiplegia. By comparing the ratios of bone mineral content in the two arms, the effect of immobilization could be quantitated independently of the large population variance in bone mineral content. Bone loss, estimated from this single comparison of bone mineral content in the normal and hemiplegic arms, at the trabecular and cortical sites was positively correlated with the duration of stroke and negatively correlated with reduction in forearm function. At the trabecular site females had a proportionately greater bone loss than males, indicating an interaction between gender and immobilization associated bone loss at this site. The regression line of excess bone loss in the hemiplegic limb against time had a negative slope of 1.3% and 1.5% a year of the starting value for the trabecular and cortical sites, respectively, over the 15 years studied. This study indicates that a reduction in function is associated with significant bone loss occurring over prolonged periods that may account, at least in part, for the significant osteoporosis seen in elderly people and in subjects with conditions resulting in reduced mobility such as arthritis, obstructive airways disease, and neurological disease.
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PMID:Forearm bone loss in hemiplegia: a model for the study of immobilization osteoporosis. 321 23

We studied a group of hemiplegic patients to determine the amount of bone loss of the paretic versus the normal limb and to evaluate the importance of several variables in determining this difference. Thirty consecutive subjects with hemiplegia caused by a cerebral vascular accident were studied: 15 postmenopausal women (average age 65.1 years) and 15 men (average age 58.3 years) (average age of entire group, 63.2 years; age range of entire group, 27-84 years). The mean duration of immobilization was 7.7 months for women (range 1-40 months) and 10.5 months for men (range 1-48 months). All subjects had a complete physical examination, underwent bilateral femoral neck DEXA, and filled out a questionnaire. The percent difference (delta) between the paretic and normal limb was 6.1% in the women and 3.8% in the men. Logistic regression analysis, after control for age and sex, indicated that the degree of demineralization depended significantly and directly on the duration of immobilization and depended inversely on the time elapsed since menopause. Our data evidence the importance of immobilization osteoporosis and point to the role of hormonal factors in its pathogenesis.
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PMID:[The determinants of bone mineral density in hemiplegic patients. Preliminary data]. 757 12

Etiological factors in finger osteoarthritis are both local (single injury or repetitive joint use) and general. Epidemiological studies, twin studies, and studies of the ethnic influence have established that genetic factors play a role. The disease is more common in postmenopausal women, suggesting an influence of hormonal factors. Findings from studies of associations between finger osteoarthritis and osteoarthritis at other sites (spine, hips, knees), hyperostosis, and obesity, as well as the fact that the disease is less common in patients with osteoporosis and absent in hemiplegia, suggest that the concept of "osteoarthritic disease" is relevant.
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PMID:Etiologic factors in finger osteoarthritis. 758 77

Handicap has heavy economic implications. Pensions, whose the amount is about 127 billions of french francs, are paid, every year, to disabled persons. But the medical charges of these persons, paid by the social security, are not established, nor the wealth undoing. On the other hand, a lot of jobs are run to take care of the handicapped and many rehabilitation units and homes are devoted to them (33,000 beds) as well as adapted employment (81,000 places). The risk of dependency in the elderly has led to a deep change in the allocation of many savings. Rehabilitation cost-effective programs are contributive to reduce handicaps; significant demonstrations has been given for many common diseases as low back pain, post-stroke hemiplegia, osteoporosis.
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PMID:[Medical and economic aspects of handicaps]. 789 11

Bone loss in humans has been reported where there is reduced mechanical loading such as in space flight, spinal cord injury, and stroke. Whether osteoporotic patients are susceptible to further bone loss in states of underloading such as hemiparesis is unknown. Here we report the case of a 64-year-old man with established idiopathic osteoporosis and atherosclerosis who presented with a right middle cerebral artery territory stroke. Annual bone mineral density measurements were made at the left hip and spine before and after left hemiparesis. The left total hip T-score was -3.2 before the stroke. Following stroke, there was rapid and sustained bone loss with a reduction in bone mineral density (BMD) of 21.6% over 3 years despite oral bisphosphonate therapy. There was also an unexpected decline in vertebral BMD after the stroke. This is the first report of the accelerated effect of hemiplegia on bone loss in an already osteoporotic skeleton.
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PMID:Rapid long-term bone loss following stroke in a man with osteoporosis and atherosclerosis. 1519 47

Risk of hip fractures in stroke patients is higher than that in a reference population. Hyperhomocysteinemia is regarded as a risk factor for ischemic stroke. The high prevalence of osteoporosis among patients with homocystinuria suggests that hyperhomocysteine may also increase the risk of fractures. To determine the association between homocysteine concentration and the risk of hip fractures, we studied a cohort of stroke patients with hemiplegia. Age-adjusted incidence rates of a hip fracture were calculated for quartiles of homocysteine concentrations. Cox proportional-hazard regression was used to calculate hazard ratios for quartiles of homocysteine levels. The initial enrolment of 433 hemiplegic patients with ischemic stroke, older than 65 years old, were followed for up to 10 years. The mean plasma homocysteine concentration at the enrolment was 14.1 +/- 5.2 micromol/L. There were 33 hip fractures among men and 46 among women during the mean follow-up period of 9.0 years. The age-adjusted incidence rates per 1000 person-years for hip fractures increased almost linearly from 2.89 in the lowest to 27.87 in the highest quartiles of homocysteine levels. We conclude that hyperhomocysteinemia is one of the risk factors for hip fractures in stroke patients.
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PMID:Homocysteine as a predictive factor for hip fracture in stroke patients. 3071 Oct 56

Hip fracture is the most serious complication of osteoporosis and has been recognized as a major public health problem. The prevention of hip fractures is an high-priority issue because of the rapid increase of the number of elderly people in Japan. The General Research Committee for the Prevention and Treatment of Osteoporosis in Silver Health Science Researches sponsored by the Ministry of Health and Welfare (Director, Hajime Orimo) first undertook a nationwide survey of femoral neck fracture in 1987. This nationwide survey has been continued every 5 years, in 1992, 1997, and 2002. The total number of new cases was nearly 120,000 in the latest survey, and has been rising in every survey. Total number of new cases was about 1.4 times the baseline 1987 figures in 1992, 1.7 times in 1997, and 2.2 times in 2002. The total number of new female patients was about three times higher than that of new male patients, a finding identical to those of the previous surveys. The incidences of hip fracture (per 10,000) according to sex and age was increased in both men and women, particularly among individuals 80 years old or over. The Epidemiological Research Group on Osteoporosis, Ministry of Health and Welfare (Chairman; Hajime Orimo) undertook a nation-wide case-control study to clarify the risk factors for hip fractures among Japanese in 1994. Cases of hip fracture in people aged 65-89 were selected from 21 hospitals in seven areas of Japan. Two sex- and age-matched controls were selected from the same residential area for each case using resident registration lists. During this 1-year survey, 249 cases of hip fractures (43 men and 206 women) were reported. The following risk factors for hip fractures were identified using multivariate analysis: past history of stroke with hemiplegia, sleep disturbance, sleeping in a Western-style bed, and drinking more than 3 cups of coffee daily.
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PMID:Epidemiology of hip fracture in Japan: incidence and risk factors. 1598 19

Cranial and spinal trauma are a frequent cause of disability in the general population. Post-traumatic paraplegia or quadriplegia or hemiplegia from vascular injury (CVA) can lead to early complications (respiratory, cardiovascular, urinary, cutaneous, infectious...) that may have an impact on the immediate prognosis. Neurologic and orthopedic complications occur later and further impair the quality of life of patients. Orthopedic complications include: neurogenic paraosteoarthropathy (NPOA) or neurogenic osteoma or myositis ossificans (NMO). The nomenclature currently in use is NMO; Osseous complications: osteoporosis and secondary insufficiency fractures; Joint complications: degenerative arthropathy and stiffness; Overuse mechanical complications; Muscular complications; Infectious complications: arthritis and myositis complicating skin ulcers and bed sores. The purpose of this paper is to describe these neuro-orthopedic complications and review their imaging features.
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PMID:[Imaging features of neurologic and orthopedic complications from severe trauma]. 2124 35

The aim of the study was to investigate the effects of weight training time on bone mineral density (BMD) of patients with secondary osteoporosis after hemiplegia. A total of 129 hemiplegic patients with stroke, 75 males and 54 females, aged 50-75 years, were recruited in this study. Male patients were randomly divided into 3 groups (25 cases each) receiving 30 min (group M30), 60 min (group M60), or 90 min (group M90) daily upright bed weight training. Female patients were similarly randomly allocated into groups F30, F60 and F90 (18 cases each) with daily upright bed weight training for 30, 60 and 90 min, respectively. After 3 months of training, BMD at anteroposterior lumbar spine (L1-L4) and ipsilateral femoral neck were examined by dual-energy X-ray absorptiometry. Compared to pre-treatment, no statistical difference in BMD was found after 3 months in males who underwent daily 30-min weight training (group M30). By contrast, a significant increase in BMD was seen at lumbar and femoral neck in groups M60 and M90 after 3 months (all p<0.05). By pair-wise comparison, we found that BMD at lumbar and at femoral neck was significantly higher in groups M60 vs. M30 and in groups M90 vs. M60 (all p<0.05). For female subjects, daily 90-min weight training significantly increased BMD at lumbar and at femoral neck in group F90 (both p<0.05), but daily 30- or 60-min weight training did not produce similar improvement after 3 months. By pair-wise comparison, we found a significantly higher BMD at lumbar and at femoral neck in groups F90 vs. F60 after 3 months of treatment (both p<0.05). In conclusion, in order to stimulate BMD and reverse osteoporosis in patients with secondary osteoporosis after hemiplegia, daily weight training for minimum 60 and 90 min was needed for males and females, respectively.
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PMID:Effects of weight training time on bone mineral density of patients with secondary osteoporosis after hemiplegia. 2845 Sep 26