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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

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Abstract

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.

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Data availability

All data generated or analyzed during this study will be made available at the time of publication and can be obtained upon request.

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Funding

Zhenhui Yang and Tiev Miller were granted full-time research studentships by the Hong Kong Polytechnic University (RUBE and RL27). This study was supported by the Hong Kong Research Grants Council (General Research Fund no. PolyU 151025/14M).

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Authors and Affiliations

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

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

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

    Z. Yang

Authors
  1. Z. Yang
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  2. T. Miller
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  3. M. Y. C. Pang
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Corresponding author

Correspondence to M. Y. C. Pang.

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Ethics approval

Ethical approval was obtained from the Human Subjects Ethics Sub-committee of the University. All of the experimental procedures were conducted in accordance with the Helsinki Declaration for human experiments.

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The details of the study were explained to the participants before informed written consent was obtained.

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Consent to use information and data collected during the course of the study for education and knowledge dissemination purposes was granted by the participants

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No custom software or code was used. R Studio is an open source program and SPSS is commercially available.

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Yang, Z., Miller, T. & Pang, M.Y.C. 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. Osteoporos Int 32, 951–959 (2021). https://doi.org/10.1007/s00198-020-05716-2

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  • DOI: https://doi.org/10.1007/s00198-020-05716-2

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