Nozoe M1, Kanai M2, Kubo H2, Takeuchi Y2, Kobayashi M2, Yamamoto M2, Furuichi A2, Shimada S3, Mase K1
1Konan Women’s University, Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Kobe, Japan, 2Itami Kousei Neurosurgical Hospital, Department of Rehabilitation, Itami, Japan, 3Itami Kousei Neurosurgical Hospital, Department of Neurosurgical, Itami, Japan
Background: Poststroke muscle wasting occurs during the acute phase, but studies about the relationship between acute-phase muscle wasting and long-term functional outcome are limited.
Purpose: To determine whether lower limb muscle wasting during the acute phase is associated with functional outcome at 3 months after stroke.
Methods: In 64 consecutive non-ambulatory patients with acute intracerebral hemorrhage or ischemic stroke (age: median [IQR], 67 [16] years; 14 females), the quadriceps muscle thickness in paretic and non-paretic limbs were measured within 1 week after admission (first week) and 2 weeks after the first examination (last week) using ultrasonography. Other clinical characteristics, including age, sex, and National Institutes of Health Stroke Scale (NIHSS) score, were also assessed in the first measurement. The primary outcome was favourable outcome 3 months after stroke, defined as a modified Rankin Scale score of 0-3. Crude and adjusted odds ratios for favorable outcome at 3 months after stroke was determined using a multivariate logistic regression analysis.
Results: Archived follow-up was conducted for 58 patients. Finally, 28 patients (48%) had a favourable outcome at 3 months after stroke. Significant differences in NIHSS score (favourable vs poor, 9.0 [4.0] vs 17.5 [10.3]; p 0.001) and muscle wasting were observed in the non-paretic limb (−5.1% [9.8%] vs −19.3% [22.7%], p = 0.004) but not in the paretic limb (−16.0% [17.7%] vs −16.2% [22.5%], p = 0.79). Even after adjusting for covariates, muscle wasting in the non-paretic limb was a significant independent predictor of favourable outcome (adjusted odds ratio, 0.896; 95% confidence interval, 0.809-0.993, p = 0.036).
Conclusion(s): Poststroke muscle wasting in the non-paretic lower limb during the acute phase is independently associated functional outcome after stroke.
Implications: Our results indicate that poststroke muscle wasting in the non-paretic lower limb, not in the paretic limb, is a useful predictor of poor functional outcome after stroke.
Keywords: acute stroke, muscle wasting, functional outcome
Funding acknowledgements: This study was supported by a research grant from JSPS KAKENHI (grant No. 17K13106).
Purpose: To determine whether lower limb muscle wasting during the acute phase is associated with functional outcome at 3 months after stroke.
Methods: In 64 consecutive non-ambulatory patients with acute intracerebral hemorrhage or ischemic stroke (age: median [IQR], 67 [16] years; 14 females), the quadriceps muscle thickness in paretic and non-paretic limbs were measured within 1 week after admission (first week) and 2 weeks after the first examination (last week) using ultrasonography. Other clinical characteristics, including age, sex, and National Institutes of Health Stroke Scale (NIHSS) score, were also assessed in the first measurement. The primary outcome was favourable outcome 3 months after stroke, defined as a modified Rankin Scale score of 0-3. Crude and adjusted odds ratios for favorable outcome at 3 months after stroke was determined using a multivariate logistic regression analysis.
Results: Archived follow-up was conducted for 58 patients. Finally, 28 patients (48%) had a favourable outcome at 3 months after stroke. Significant differences in NIHSS score (favourable vs poor, 9.0 [4.0] vs 17.5 [10.3]; p 0.001) and muscle wasting were observed in the non-paretic limb (−5.1% [9.8%] vs −19.3% [22.7%], p = 0.004) but not in the paretic limb (−16.0% [17.7%] vs −16.2% [22.5%], p = 0.79). Even after adjusting for covariates, muscle wasting in the non-paretic limb was a significant independent predictor of favourable outcome (adjusted odds ratio, 0.896; 95% confidence interval, 0.809-0.993, p = 0.036).
Conclusion(s): Poststroke muscle wasting in the non-paretic lower limb during the acute phase is independently associated functional outcome after stroke.
Implications: Our results indicate that poststroke muscle wasting in the non-paretic lower limb, not in the paretic limb, is a useful predictor of poor functional outcome after stroke.
Keywords: acute stroke, muscle wasting, functional outcome
Funding acknowledgements: This study was supported by a research grant from JSPS KAKENHI (grant No. 17K13106).
Topic: Neurology: stroke; Neurology
Ethics approval required: Yes
Institution: Konan Women’s University
Ethics committee: Research Ethics Committee of Konan Women’s University
Ethics number: 2015020
All authors, affiliations and abstracts have been published as submitted.
