Is a Second Physical and Anthropometric Assessment Useful for Predicting Functional Outcomes in Patients with Stroke?

Tomoyuki Ogino, Kazuki Okuda, Ayaki Shirahata, Kenta Yamamoto, Masafumi Nozoe
Purpose:

The purpose of this study is to determine the utility of a second physical and anthropometric assessment for predicting functional outcomes in patients with stroke.

Methods:

This retrospective observational cohort study was conducted in a single stroke center and included patients with acute stroke who were hospitalized between November 2020 and July 2023. We conducted assessments at admission and at discharge, measuring the following: lower leg muscle strength by the Motricity Index (LLMI), trunk function by the Trunk Control Test (TCT), grip strength using the non-paretic limb (GS), and muscle mass by calf circumference on the non-paretic limb (CC). The primary outcome was the modified Rankin Scale (mRS) at 3 months after stroke. We also defined mRS 3 or return to premorbid mRS (RTR) as a favorable outcome. Logistic regression analysis was performed to clarify the impact of these first and second assessments in these patients. 

Results:

A total of 368 acute stroke patients (median age: 79 years, interquartile range: 70-86) were included. Among them, 219 patients (60%) showed a favorable outcome. After adjusting for potential confounding factors, LLMI on admission (aOR 1.05, 95% CI 1.04-1.07) and changes in LLMI during hospitalization (aOR 1.04, 95% CI 1.02-1.06) were predictive of a favorable outcome. Similarly, TCT on admission (aOR 1.04, 95% CI 1.03-1.05) and changes in TCT (aOR 1.03, 95% CI 1.01-1.04) were associated with favorable outcomes, as were CC on admission (aOR 0.39, 95% CI 0.20-0.77) and changes in CC per 1 mm (aOR 1.04, 95% CI 1.01-1.07). While no significant association was found between changes in GS during hospitalization, low GS on admission was associated with a worse outcome (aOR 0.28, 95% CI 0.12-0.65).

Conclusion(s):

The second physical and anthropometric assessments, including lower limb muscle strength, trunk function, and muscle mass, are useful for predicting functional outcomes in patients with stroke. However, non-paretic limb muscle strength changes during hospitalization was not associated with functional outcomes.

Implications:

The second physical and anthropometric assessment is useful for predicting functional outcomes, except for grip strength, in patients with stroke.

Funding acknowledgements:
This work was supported by the JSPS KAKENHI (Grant number: 21K11182).
Keywords:
stroke
physical assessment
anthropometric assessment
Primary topic:
Neurology: stroke
Second topic:
Neurology
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the Konan Medical Center Research Ethics Committee
Provide the ethics approval number:
2020-12
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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