This case is the first to describe asymmetric bone loss in a patient with SCI. These findings are similar to those observed in the stroke population, in which a significantly
greater loss of bone occurs in the paretic side than the nonparetic side. This difference has been correlated with muscle strength , motor recovery , ability to ambulate, and amount of loading. BMD loss is also seen in the nonparetic side in chronic stroke, which may be the result of changes in use and weight-bearing patterns. In chronic stroke, an exercise program with emphasis on lower-limb weight bearing and treadmill gait training benefited BMD in the paretic leg. Analogous, muscle activity and ground reaction forces produced through ambulation may provide mechanical strain necessary to maintain BMD in SCI, as seen in recent studies in chronic stroke.