To systematically review available evidence related to the characteristics of bone changes post-stroke and the relationship between various aspects of muscle function (e.g., strength, spasticity) and bone properties after stroke onset. An extensive online database search was undertaken (last search in January 2019). Articles that examined the bone properties in stroke patients were included. The quality of the studies was evaluated with the National Institutes of Health (NIH) Study Quality Assessment Tools. Publication bias of meta-analyses was assessed using the Egger's regression asymmetry test. The selection and evaluation of the articles were conducted by two independent researchers. Fifty-nine studies were identified. In subacute and chronic stroke studies, the skeletal sites in the paretic limbs sustained a more pronounced decline in bone quality than did their counterparts in the non-paretic limbs. The rate of changes showed a decelerating trend as post-stroke duration increased, but the timing of achieving the steady rate differed across skeletal sites. The magnitude of bone changes in the paretic upper limb was more pronounced than the paretic lower limb. There was a strong relationship between muscle strength/mass and bone density/strength index. Muscle spasticity seemed to have a negative impact on bone integrity in the paretic upper limb, but its influence on bone properties in the paretic lower limb was uncertain. Substantial bone changes in the paretic limbs occurred particularly in the first few months after stroke onset. Early intervention, muscle strength training, and long-term management strategies may be important to enhance bone health post-stroke. This review has also revealed the knowledge gaps which should be addressed in future research.

中文翻译：

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中风对骨质和肌肉骨骼关系的影响：系统评价和荟萃分析。

为了系统地审查与中风后骨骼变化特征以及中风发作后肌肉功能各个方面（例如，力量，痉挛）和骨骼性质之间的关系有关的可用证据。进行了广泛的在线数据库搜索（2019年1月进行最后搜索）。包括检查中风患者骨质的文章。使用美国国立卫生研究院（NIH）研究质量评估工具评估研究质量。使用Egger回归不对称检验评估荟萃分析的出版偏倚。文章的选择和评估由两名独立的研究人员进行。确定了59项研究。在亚急性和慢性中风研究中，与非前肢相比，前肢的骨骼部位的骨质下降更为明显。变化的速率显示出随着中风后持续时间的增加而减速的趋势，但是在骨骼部位实现稳定速率的时机不同。上颌骨上肢的骨骼变化幅度比下颌骨上肢明显。肌肉力量/质量与骨密度/强度指数之间存在很强的关系。肌肉痉挛似乎对坐骨上肢的骨骼完整性有负面影响，但尚不确定对坐骨下肢的骨骼性质的影响。在卒中后的最初几个月中，尤其是在前肢出现了明显的骨骼变化。早期干预，肌肉力量训练，长期的管理策略对于增强卒中后骨骼健康可能很重要。这次审查还揭示了未来研究中应解决的知识空白。