Journal of Orthopedics Research and Rehabilitation · Apr 30, 2026
Association between bone mineral density and clinical-demographic characteristics in patients with post-stroke hemiplegia
By Ceyhan Z, Karaçeşme MA
Aims: This study aimed to investigate the association between bone mineral density and clinical-demographic characteristics in patients with post-stroke hemiplegia and to evaluate potential factors associated with osteoporosis. Methods: This retrospective, cross-sectional study included 80 patients with post-stroke hemiplegia who met the inclusion criteria and were followed at Physical Medicine and Rehabilitation Hospital between January 1, 2025, and October 1, 2025. Data were obtained through retrospective review of hospital information system records and patient files. Demographic and clinical characteristics were recorded. Bone mineral density (BMD) values were obtained from dual-energy X-ray absorptiometry (DXA) measurements. Functional status and independence were assessed using the Functional Independence Measure (FIM), while ambulation level was evaluated using the Functional Ambulation Scale (FAS). Serum calcium, parathyroid hormone, and vitamin D levels were also recorded. Associations between variables were analyzed using Spearman’s correlation analysis, and statistical significance was set at p < 0.05. Results: The mean age of the patients was 65.8±9.5 years, and 56.2% were female. Ischemic stroke was present in 86.2% of patients, and the median stroke duration was 16 (1–288) months. While 16.2% of patients had a prior diagnosis of osteoporosis, this rate increased to 37.5% when newly diagnosed cases were included. No significant difference was found in stroke duration between patients with and without osteoporosis (p = 0.167). No significant differences were observed in FIM, FAS, calcium, parathyroid hormone, and vitamin D levels according to sex, osteoporosis status, comorbidities, or smoking/alcohol use (all p > 0.05). Only parathyroid hormone levels were significantly lower in the hemorrhagic stroke group (p = 0.046), while vitamin D levels tended to be lower in the osteoporosis group (p = 0.059). A statistically significant, moderate, negative correlation was found between age and femoral neck bone mineral density (r = -0.451, p < 0.001). Conclusion: Osteoporosis is common in patients with post-stroke hemiplegia, and age has a significant negative impact on femoral neck bone mineral density. However, functional status and ambulation level alone are insufficient to explain bone loss. These findings highlight the multifactorial nature of post-stroke osteoporosis and emphasize the clinical importance of early screening and preventive strategies in at-risk patients.