No Bones About It, Stroke Ups Risk of Fractures
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However, risk of fracture declined over time, according to
study author John Kanis, MD, of the Center for Metabolic Bone disease at the
University of Sheffield Medical School in England.
"The high incidence of new fractures within the first year
of hospitalization for stroke suggests that such patients should be
preferentially targeted for treatment. It is possible that short courses of
treatment at the time of stroke would provide important therapeutic
[benefits]," Kanis reports.
Risk of fracture varied by age and sex, Kanis and colleagues
found. Overall, risk of fracture was higher in women than in men. And in people
aged 50-54, the fracture risk was up to 12 times higher than those in the
Bone loss also contributes to the higher risk of fracture among
people hospitalized for stroke. Bone loss can be as great as 2% per week during
prolonged bed rest, which may occur during poststroke hospitalization, and
brittle bones increase the risk of fracture during a fall.
So what's a person to do?
A lot of times people who have had a stroke refuse to use a
cane or a walker, says Gilroy.
"You need to use mechanical aids to help stabilize
you," Gilroy says. "If you don't do that you will fall, and you have a
high risk of fracture."
Gilroy also advises caregivers to insist that the patients use
walking aids. "Don't take no for an answer," he says.
"Modern walkers are light years away from old-fashioned
walkers," he says, pointing out that the newer models are lightweight and
come with handlebars and brakes.
Because stroke patients have balance deficits after the stroke,
"the patient needs to be under supervision and/or guarded appropriately so
he or she can be protected, especially outside or on wet surfaces, when falls
are more likely," says Jim Pye, a senior physical therapist at Temple
University Medical Center in Philadelphia.
Pick up throw rugs and bathroom mats that are likely to promote
slipping, he suggests.
And encourage the patient to "use your bones more," Pye
Generally, stroke patients don't walk as much or maintain the
active lifestyle they had prior to the stroke, "so their bones get weaker.
And they are at a greater risk of fractures if and when they fall," Pye