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The link between osteoporosis (where the bones become fragile and brittle and more prone to breaking) and stroke is still not entirely clear but we know that people affected by stroke have a higher risk of developing osteoporosis than people of similar age without stroke. Bone loss after stroke is often rapid and more pronounced in the side of the body that was affected by the stroke. Although the cause of bone loss is unclear, the amount of bone loss experienced by people with stroke appears related to the length of time they are immobile, the extent of muscle weakness and atrophy (shrinking muscles) and reduced weight bearing activities (like walking) and fitness.

Associate Professor Julie Bernhardt, who is a member of the NSF Clinical Council and a specialist in stroke rehabilitation, says research is continuing into the best way of preventing osteoporosis after stroke but stroke survivors should be careful to reduce their risk of falling.

She recommends that you:
1. Reduce risks of falls by having an assessment of your home environment completed; this may include checking lighting, floor coverings and bathrooms.
2. Hand rails in some rooms may be useful
3. Make sure that your medications are monitored regularly (drug interactions and sleeping pills can increase your risk of falls)
4. Take part in regular exercise to help maintain your mobility, strength and balance.

Falls are common both in hospital and out. Therapy and nursing staff are particularly concerned about people affected by stroke having a fall and they may require that someone is with the person at all times when they walk, particularly in the early phase of rehabilitation. Not all falls lead to injury however, so it is always the case that the rehabilitation team weigh up the need for the stroke survivor to have independence (and practice being independent), with the possible risk of falling. Something that should be covered in a rehabilitation plan is teaching the person how to get up again if they fall but are not injured. This can be a really helpful thing to learn!

There is still a lot we need to learn about the link between stroke and bone loss and the most effective ways to prevent or slow it. There are a number of researchers around Australia interested in this issue and they hope to answer some of these questions in the coming years. In the mean time, be active and exercise as much as you can. It seems to be a promising intervention to help general well being and health as well as your bones.