Alterations of bone mineral density of the femurs in hemiplegia.

We evaluated the bone mineral density (BMD) of the bilateral femurs in 112 patients with hemiplegia using dual-energy X-ray absorptiometry in order to elucidate the effect of disuse and immobilization. BMD of the paretic side was significantly reduced compared with that of the non-paretic side in hemiplegic patients (femoral neck 0.582 +/- 0.014 g/cm2 versus 0.623 +/- 0.014 g/cm2 and total femur 0.645 +/- 0.02 g/cm2 versus 0.702 +/- 0.017 g/cm2; mean +/- SEM, P < 0.01, respectively). Femoral BMD in both the paretic and nonparetic limb had significantly (P < 0.01) lower values than in age- and sex-matched controls, but the paretic side had a more significant reduction of BMD; femoral neck -20% versus -14% and total femur -24% versus -18%. In addition, patients with impaired activities of daily living (ADL), evaluated by a mobility score, had significantly decreased BMD ratios of paretic/nonparetic side than patients with improved ADL (femoral neck 91% versus 97%, P < 0.01 and total femur 89% versus 94%, P < 0.05). Our results indicated that BMD of both femurs of patients with hemiplegia was reduced, although the paretic side showed a greater BMD decrease. This decrease might be prevented or reduced by improvement of ADL.