Celik Berna, Ones Kadriye, Ince Nurhan
Department of Physical Medicine and Rehabilitation, Istanbul 70. Yil Physical Medicine and Rehabilitation Teaching Hospital, Istanbul, Turkey.
Int J Rehabil Res. 2008 Mar;31(1):93-6. doi: 10.1097/MRR.0b013e3282f7521a.
The aim of this study was to compare the body composition, including lean tissue mass, fat tissue mass, and bone mineral content, of the paretic leg with that of the nonaffected leg in patients with stroke and to evaluate the effects of time since stroke, spasticity, and motor recovery on the body composition specifically within the first year after stroke. Thirty-five stroke patients with mean age and standard deviation of 62.69+/-9.54 years were included in the study. A full physical examination including Brunnstrom motor recovery and modified Ashworth spasticity scale was performed. Fat tissue mass (grams), lean tissue mass (grams), and bone mineral content (grams) of both the paretic and nonaffected lower extremities were obtained from the total body scans determined by using dual-energy X-ray absorptiometry (Lunar DPX-PRO). Lean tissue mass and bone mineral content of the paretic side were found to be significantly lower than those of the nonaffected side (P<0.05). A significant correlation was found between the lean tissue mass and bone mineral content of both the paretic and nonaffected legs after adjusting for age and weight (P=0.000, r=0.679; P=0.000, r=0.634, respectively). Bone mineral content and lean tissue mass of both the paretic and nonaffected sides showed a significant negative correlation with time since stroke in patients with stroke for < or =1 year (P<0.05). A higher lean tissue mass and bone mineral content were found in patients with moderate to high spasticity in comparison with patients with low or no spasticity (P<0.05). Stroke causes loss of lean tissue mass and bone mineral content prominently in the paretic side. The loss increases with increasing time since stroke. Spasticity seems to help in preventing the loss of bone mineral content and lean tissue mass.
本研究旨在比较中风患者患侧腿与未受影响腿的身体成分,包括瘦组织质量、脂肪组织质量和骨矿物质含量,并特别评估中风后1年内中风时间、痉挛状态和运动恢复对身体成分的影响。35名平均年龄为62.69±9.54岁的中风患者纳入本研究。进行了包括Brunnstrom运动恢复和改良Ashworth痉挛量表在内的全面体格检查。通过双能X线吸收法(Lunar DPX-PRO)全身扫描获得患侧和未受影响下肢的脂肪组织质量(克)、瘦组织质量(克)和骨矿物质含量(克)。发现患侧的瘦组织质量和骨矿物质含量显著低于未受影响侧(P<0.05)。在调整年龄和体重后,患侧和未受影响侧的瘦组织质量与骨矿物质含量之间均存在显著相关性(分别为P=0.000,r=0.679;P=0.000,r=0.634)。对于中风时间≤1年的患者,患侧和未受影响侧的骨矿物质含量和瘦组织质量与中风后时间均呈显著负相关(P<0.05)。与低痉挛或无痉挛患者相比,中重度痉挛患者的瘦组织质量和骨矿物质含量更高(P<0.05)。中风导致患侧明显丧失瘦组织质量和骨矿物质含量。这种丧失随着中风后时间的增加而增加。痉挛似乎有助于防止骨矿物质含量和瘦组织质量的丧失。