Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study

Matsushita, Tatsuya; Nishioka, Shinta; Taguchi, S.; Yamanouchi, Anna; Nakashima, Ryusei; Wakabayashi, Hidetaka

doi:10.3390/healthcare8030255

Cited by 30 publications

(27 citation statements)

References 44 publications

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“…[ 39 , 40 ] In stroke patients, including those with subarachnoid hemorrhage (SAH), total body skeletal muscle mass is important so that they can obtain better functional outcomes after rehabilitation. [ 28 , 32 ] To measure the total body skeletal muscle mass, psoas muscle cross-sectional area at the level of the third lumbar vertebra on the abdominal computed tomography (CT),[ 18 ] gait speed, and handgrip strength is usually used. [ 8 ] However, it is difficult to measure muscle mass or muscle function of the SAH patients in those ways, because we do not usually perform abdominal CT and the SAH patients often have impaired consciousness and need of rest considering the risk of rerupture.…”

Section: Introductionmentioning

confidence: 99%

Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping

Katsuki

Kakizawa

Nishikawa

et al. 2021

Surgical Neurology International

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Background: Skeletal muscle mass is an important factor for various diseases’ outcomes. As for its indicators, temporal muscle thickness (TMT) and temporal muscle area (TMA) on the head computed tomography are useful, and TMT and TMA were reported as potential prognostic factors for aneurysmal subarachnoid hemorrhage (SAH). We examined the clinical characteristics, including TMT and TMA, of SAH patients aged 75 or younger. Methods: We retrospectively investigated 127 SAH patients with all World Federation of Neurosurgical Societies (WFNS) grades and treated by clipping between 2009 and 2019. Clinical outcome was measured with the modified Rankin Scale (mRS) at 6 months, with favorable outcome defined as mRS 0–2. The associations between the clinical variables and the outcomes were analyzed. Results: The mean age was 60.6 (32–74) years, and 65% were women. The mean ± standard deviation of WFNS grade was 2.8 ± 1.4. TMT and TMA were larger in the favorable outcome group than the poor one. Multivariate analysis revealed that age, smoking, WFNS grade, and TMT or TMA were associated with favorable outcome. Receiver operating characteristic analysis found that the threshold of TMT was 4.9 mm in female and 6.7 mm in male, and that of TMA was 193 mm2 in female and 333 mm2 in male. Conclusion: The odds ratios for TMT and TMA related to clinical outcome were lower than for smoking and WFNS grade; however, on multivariate analysis they remained independent prognostic factors in SAH patients aged 75 or younger treated by clipping. Further studies are needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping

Katsuki

Kakizawa

Nishikawa

et al. 2021

Surgical Neurology International

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“…Lower limb motor paralysis was evaluated by physical therapists using the Brunnstrom recovery stage (BRS) [ 25 ]. Patients were then classified into three groups: BRS I to IV, BRS V to VI and absence [ 12 , 26 ]. MUST is a malnutrition screening tool, being evaluated on the day of admission by registered dietitians.…”

Section: Methodsmentioning

confidence: 99%

Effect of Improvement in Sarcopenia on Functional and Discharge Outcomes in Stroke Rehabilitation Patients

Matsushita¹,

Nishioka²,

Taguchi³

et al. 2021

Nutrients

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This cross-sectional study investigated the proportion of patients’ recovery from sarcopenia status and the relationship between improvement in sarcopenia (IS) and function and discharge outcome in hospitalized patients with stroke. This study included patients with stroke, aged 65 years or more, with a diagnosis of sarcopenia, who were admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Patients were divided according to the presence or absence of sarcopenia at discharge: IS group and non-improvement in sarcopenia (NIS) group. Among the 227 participants (mean age: 80.5 years; 125 females), 30% (69/227) of the patients were in the IS group, while 70% (158/227) were in the NIS group. The IS group showed a higher Functional Independence Measure (FIM) than the NIS group (median 112 vs. 101, p = 0.003). The results demonstrated that IS was independently associated with higher FIM (partial regression coefficient, 5.378; 95% confidence interval (CI), 0.709–10.047). The IS group had higher odds of home discharge than the NIS group (odds ratio, 2.560; 95% CI, 0.912–7.170). In conclusion, recovery from sarcopenia may be associated with better function in patients with stroke.

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“…Lean body mass gradually decreases in both the affected and unaffected limbs after stroke [70]. At the time of rehabilitation, stroke-induced sarcopenia was observed in 53.5% of patients [71] and sarcopenic obesity was observed in 28% of patients [72]. Even with rehabilitation, muscle mass decreased by approximately 65% at hospital discharge and increased by approximately 30% 12 weeks after hospital discharge without returning to the admission level [62].…”

Section: Applications In Strokementioning

confidence: 99%

Measuring and Monitoring Skeletal Muscle Mass and Dysfunction After Stroke

Nakanishi¹,

Okura²,

Okamura³

et al. 2021

Preprint

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Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate re-habilitation and nutrition management. Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasonography, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it is mostly retrospectively conducted due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources. We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.

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Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study

Cited by 30 publications

References 44 publications

Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping

Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping

Effect of Improvement in Sarcopenia on Functional and Discharge Outcomes in Stroke Rehabilitation Patients

Measuring and Monitoring Skeletal Muscle Mass and Dysfunction After Stroke

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