Longitudinal bone loss in the paretic leg and its contributing factors in individuals with chronic stroke: a 2-year prospective cohort study
Bibliographic record
Abstract
Post-stroke fracture risk necessitates investigation of bone properties and contributing factors. The decline in paretic tibia failure load post-stroke was attributed to decreased trabecular bone density and thickness at 2-year follow-up. Less decline in bone strength was associated with better leg blood flow, walking speed, strength, and activity at baseline. PURPOSE: To delineate long-term changes in distal tibia bone properties after stroke and identify their associated factors. METHODS: High-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the bilateral distal tibia were performed in 46 chronic stroke participants (age, 60.4 ± 7.8 years; post-stroke onset, 6.3 ± 4.2 years) and 45 controls (age, 57.7 ± 6.3 years) at baseline and 2 years later. We measured the change in the estimated failure load (indicator of bone strength), volumetric bone mineral density (vBMD), geometry, and microstructure. Blood flow volume of the popliteal artery, muscle strength, sensory function, and gait speed were also assessed. RESULTS: In the paretic leg of stroke participants, a significant decline in estimated failure load was observed (- 3.39%, p < 0.01), which was greater than that of the non-paretic side (- 1.93%, p < 0.01) and controls (- 1.89 to - 2.18%, p < 0.05). The deterioration in estimated failure load was accompanied by a decline in trabecular vBMD and thickness. Greater arterial blood flow, higher walking velocity, better muscle strength, and higher physical activity level at baseline at 2-year follow-up portended less decline in estimated failure load. CONCLUSIONS: During the 2-year follow-up, there was a decline in estimated failure load of the paretic distal tibia among people with chronic stroke, attributed to a decreased trabecular density and thickness. Greater decline in estimated tibial bone strength was associated with lower arterial blood flow volume and motor function on the paretic side.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".