Background: Hemi-osteoporosis is a common secondary complication of stroke. No systematic reviews of pharmacological and non-pharmacological agents for post-stroke bone health have estimated the magnitude and precision of effect sizes to guide better clinical practice.
Objectives: To examine the benefits and harms of pharmacological and non-pharmacological agents on bone health in post-stroke individuals.
Methods: Eight databases were searched (PubMed, Cochrane library, Scopus, CINAHL Complete, Embase, PEDro, Clinicaltrils.gov and ICTRP) up to June 2023. Any controlled studies that applied physical exercise, supplements, or medications and measured bone-related outcomes in people with stroke were included. PEDro and the GRADE approach were used to examine the methodological quality of included articles and quality of evidence for outcomes. Effect sizes were calculated as standardized mean differences (SMD) and risk ratio (RR). Review Manager 5.4 was used for data synthetization.
Results: Twenty-four articles from 21 trials involving 22,500 participants (3,827 in 11 non-pharmacological and 18,673 in 10 pharmacological trials) were included. Eight trials were included in the meta-analysis. The methodological quality of half of the included non-pharmacological studies was either poor or fair, whereas it was good to excellent in 8 of 10 pharmacological studies. Meta-analysis revealed a beneficial effect of exercise on the bone mineral density (BMD) of the paretic hip (SMD: 0.50, 95 % CI: 0.16; 0.85; low-quality evidence). The effects of anti-resorptive medications on the BMD of the paretic hip were mixed and thus inconclusive (low-quality evidence). High-quality evidence showed that the administration of antidepressants increased the risk of fracture (RR: 2.36, 95 % CI 1.64-3.39).
Conclusion: Exercise under supervision may be beneficial for hip bone health in post-stroke individuals. The effect of anti-resorptive medications on hip BMD is uncertain. The adverse effects of antidepressants on fracture risk among post-stroke individuals warrant further attention. Further high-quality studies are required to better understand this issue.
Registration: PROSPERO CRD42022359186.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.rehab.2024.101823 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identification and validation of transcriptome-wide association study-derived genes as potential druggable targets for osteoarthritis.
Bone Joint Res
March 2025
Department of Orthopedics, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China.
Aims: Osteoarthritis (OA) is a widespread chronic degenerative joint disease with an increasing global impact. The pathogenesis of OA involves complex interactions between genetic and environmental factors. Despite this, the specific genetic mechanisms underlying OA remain only partially understood, hindering the development of targeted therapeutic strategies.
View Article and Find Full Text PDFCase Report: Coexistence of Rosai-Dorfman disease and B-cell acute lymphoblastic leukemia in an adolescent.
Front Pediatr
February 2025
Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rosai-Dorfman disease (RDD) is an unusual, non-malignant proliferative disorder involving non-Langerhans cell histiocytes, characterized by a wide range of clinical presentations and distinctive atypical morphological patterns. The concurrent manifestation of acute lymphoblastic leukemia (ALL) alongside RDD is exceptionally rare. Here, we present the case of a 14-year-old male patient diagnosed with ALL who, during the consolidation phase of chemotherapy, developed multifocal bone, dural, and liver lesions, as confirmed through CT and MRI imaging.
View Article and Find Full Text PDFInjectable photosensitive bone cement enhancing angiogenesis and osteogenic differentiation for the treatment of bone nonunion.
APL Bioeng
March 2025
Institutes of Health Central Plain, The Third Affiliated Hospital of Xinxiang Medical University, Clinical Medical Center of Tissue Engineering and Regeneration, Xinxiang Medical University, Xinxiang 453003, People's Republic of China.
Nonunion fractures present a significant clinical challenge because of their complex microenvironment, which includes poor vascularization, insufficient osteogenesis, infection, and separation of fracture ends. The current clinical treatments have certain limitations. Inspired by this phenomenon, sandcastle worms secrete adhesive proteins that bind sand grains, shell fragments, and mineral particles, thereby constructing their "castles.
View Article and Find Full Text PDFDifferential expression of plasma extracellular vesicles microRNAs and exploration of their association with bone metabolism in childhood trauma participants treated in a psychosomatic clinic.
Front Endocrinol (Lausanne)
March 2025
Medical Sociology and Psychobiology, University of Potsdam, Potsdam, Germany.
Introduction: Early life stress (ELS) impacts neurotransmitters and cell communication, potentially disrupting neurological and physiological processes. Recently, ELS has been implicated in impaired bone metabolism, with extracellular vesicles (EVs) and their cargo, microRNAs (miRNAs), might affecting this process. This research aimed to elucidate the association between childhood trauma, a specific form of ELS, and bone metabolism through studying miRNA in EVs within three steps: firstly, examining alterations of EV miRNAs between ELS and controls, secondly analyzing associations between altered EV miRNAs and bone markers, and thirdly exploring the target gene prediction and enrichment pathways of altered EV miRNAs.
View Article and Find Full Text PDFThe Effect of Protein Intake on Bone Disease, Kidney Disease, and Sarcopenia: A Systematic Review.
Curr Dev Nutr
March 2025
Minnesota Evidence-Based Practice Center, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
Background: Protein is essential for optimal growth, function, and maintenance of health. Its impact on bone, kidney health, and sarcopenia progression remains debated.
Objectives: This review examines the association between dietary protein intake and the risk of bone disease, kidney disease, and sarcopenia to inform protein dietary reference intake updates.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!