Stroke

Background: After stroke, loss of bone density, bone structure, reduced muscle mass, and changes in glucose metabolism contribute to increased risk of bone fracture, cardiovascular disease and development of diabetes. Physical activity may improve these outcomes.

Principal Investigators:
Borschmann K, Bernhardt J, Iuliano-Burns S, Pang MYC, Ekinci E, Brodtmann A,
King K.

Coordinating centre: National Stroke Research Institute (a part of the Florey Neuroscience Institutes)

Participating centres: National Stroke Research Institute (a part of the Florey Neuroscience Institutes); Austin Hospital; Repatriation Hospital; Department of Medicine, University of Melbourne; Department of Rehabilitation Sciences, Hong Kong Polytechnic University

Aims: To investigate the time course and magnitude of changes to bone, muscle and glucose metabolism from stroke onset to 2 years post stroke. To investigate the relationships between physical activity and changes to bone, muscle and glucose metabolism.

Study Design: Longitudinal observational study of 45 participants.

Method: People with first ever stroke who have hemiplegia, no history of diabetes and who are unable to walk within the first week of stroke are recruited from the Austin Hospital stroke unit. Key outcomes of interest are volumetric bone mineral density (BMD) and structure of radius and tibia (measured by high-resolution micro-PQCT), total body BMD, fat and muscle mass (measured by dual-energy X-ray absorptiometry (DXA), glucose tolerance and physical activity.  Baseline assessment occurs at 1-2 weeks, with follow ups at 1,3,6,12,18 and 24 months after stroke.

Recruitment: Recruitment commenced in June 2010 and will continue until June 2013.

The following publications have arisen from this study:
Borschmann K, Pang MYC,  Bernhardt J, Iuliano-Burns S. Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke. International Journal of Stroke. Epub 4 October 2011
    
Borschmann K. Exercise protects bone after stroke, or does it? A narrative review of the evidence. Stroke Research and Treatment, 2012. Article ID 103697.

Funding: Funding for this project was obtained from the Austin Health Medical Research Fund, LaTrobe University Faculty Research Grant and Australian Research Council.