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

Yang, Z.; Miller, T.; Pang, M. Y. C.

Affiliations

¹Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China

²Department of Physical Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China

Abstract and keywords

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

Links

DOI: 10.1007/s00198-020-05716-2

PubMed: 33161439

WoS: 000587265100001

History

Received: 2020-06-03

Accepted: 2020-10-25

Online: 2020-11-07

Cited Works (5)

Year	Entry
1995	Turner CH, Owan I, Takano Y. Mechanotransduction in bone: role of strain rate. Am J Physiol Endocrinol Metab. September 1995;269(3):E438-E442.
1999	Burger EH, Klein-Nulend J. Mechanotransduction in bone: role of the lacunocanalicular network. FASEB J. May 1999;12(9001):S101-S112.
1974	Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr. December 1974;19(6):716-723.
2002	Burr DB, Robling AG, Turner CH. Effects of biomechanical stress on bones in animals. Bone. May 2002;30(5):781-786.
2003	Turner CH, Robling AG. Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev. January 2003;31(1):45-50.

Cited By (2)

Year	Entry
2023	Coussens M, Banica T, Lapauw B, De Wandele I, Rombaut L, Malfait F, Calders P. Bone parameters in hypermobile cEhlers-Danlos syndrome and hypermobility spectrum disorder: a comparative cross-sectional study. Bone. January 2023;166:116583.
2022	Coussens M, Lapauw B, Verroken C, Goemaere S, De Wandele I, Malfait F, Banica T, Calders P. Bone mass, density, geometry, and stress–strain index in adults with osteogenesis imperfecta type I and their associations with physical activity and muscle function parameters. J Bone Miner Res. December 2022;37(12):2456-2465.