Sarcopenia Affects Physical Function of Stroke Patients in the Convalescent Ward: A Prospective Cohort Study

Yuto Kameyama, Yoshinobu Yoshimoto, Ryota Ashizawa, Hiroya Honda, Kohei Yoshizawa
Purpose:

This study aimed to determine whether sarcopenia at admission affects physical function at discharge in patients with stroke in a convalescent ward.

Methods:

This prospective cohort study involved 122 patients with stroke aged 65 years or older who were admitted to a convalescent ward between November 2021 and August 2024 (mean age 76.6 ± 7.4 years). The exposure factor was the presence of sarcopenia at admission, determined according to the criteria of the Asian Working Group for Sarcopenia 2019. The outcome measure was physical function at discharge, assessed using the Short Physical Performance Battery (SPPB). The SPPB evaluates balance, gait, and lower limb muscle strength, with each item rated on a scale of 0–4, resulting in a total score of 0–12. Higher scores indicate better physical function. In the statistical analysis, the dependent variable was the SPPB score at discharge, while the independent variable was the presence of sarcopenia at admission. Confounding factors, including sex, age, body mass index (BMI), stroke type, premorbid modified Rankin Scale, National Institutes of Health Stroke Scale (NIHSS), Charlson comorbidity index, upper limb Brunnstrom recovery stage (BRS), lower limb BRS, and SPPB score at admission, were included in the multiple regression analysis.

Results:

In the multiple regression analysis, sarcopenia at admission was identified as an independent factor for the SPPB at discharge (β=−0.114, B=−1.179, 95% confidence interval: −2.342-−0.017, p=0.047. The NIHSS, which assesses stroke severity, along with the upper limb BRS and lower limb BRS that evaluate the degree of motor paralysis, were not identified as independent factors for the SPPB at discharge (NIHSS: β=−0.168, B=−0.184, 95% confidence interval: −0.399-­0.031, p=0.092, upper limb BRS: β=0.052, B=0.135, 95% confidence interval: −0.503-0.774, p=0.675, lower limb BRS: β=0.008, B=0.022, 95% confidence interval: −0.731-0.776, p=0.953).

Conclusion(s):

The results indicate that sarcopenia at admission affects physical function at discharge, even when considering stroke-specific symptoms in patients in the convalescent ward. Sarcopenia is associated with various factors, including the amount of physical activity, which may significantly influence physical function at discharge.

Implications:

The results of this study suggest the need to prevent and improve sarcopenia in patients with stroke to enhance their physical function.

Funding acknowledgements:
This study did not receive any specific grants from funding agencies in the public, commercial, or non-profit sectors.
Keywords:
Stroke
Sarcopenia
Physical function
Primary topic:
Neurology: stroke
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was conducted with the approval of Seirei Christopher University (Hamamatsu, Japan) and Hamamatsu Rehabilitation Hospital (Hamamatsu, Japan).
Provide the ethics approval number:
21-038-H01 and 23-73
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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