Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Tokushima, Japan.
Department of Rehabilitation, Kasei Tamura Hospital, Wakayama, Wakayama, Japan.
Nutrition. 2021 Oct;90:111277. doi: 10.1016/j.nut.2021.111277. Epub 2021 Apr 20.
This study examined the relationships between intramuscular adipose tissue of the quadriceps on the paretic and non-paretic sides at admission and activities of daily living (ADL) at discharge in patients who had a stroke.
This prospective cohort study included 44 stroke inpatients. ADL were assessed at discharge using the Barthel index (BI) score. Ultrasound images were acquired at admission using B-mode ultrasound imaging. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed based on echo intensity and muscle thickness, respectively. Relationships between BI score at discharge and quadriceps echo intensity or thickness on the paretic and non-paretic sides were assessed using partial correlation coefficients. Age, sex, days from onset of stroke, Fugl-Meyer assessment lower extremity score, and subcutaneous fat thickness of the thigh were used as the control variables in the partial correlation analysis.
BI score at discharge was significantly related to quadriceps echo intensity on the paretic (partial correlation coefficient = -0.377, P = 0.018) and non-paretic (partial correlation coefficient = -0.364, P = 0.023) sides. By contrast, quadriceps thickness on the paretic (partial correlation coefficient = 0.284, P = 0.075) and non-paretic (partial correlation coefficient = 0.278, P = 0.083) sides were not significantly related to BI score at discharge.
The present study revealed the negative relationship between intramuscular adipose tissue of the quadriceps on the paretic and non-paretic sides at admission and ADL at discharge. Assessments and interventions of intramuscular adipose tissue in the quadriceps may be essential for predicting and improving ADL of patients who have had a stroke.
本研究旨在探讨入院时患侧和非患侧股四头肌内的肌肉脂肪组织与脑卒中患者出院时日常生活活动（ADL）之间的关系。
本前瞻性队列研究纳入了 44 名脑卒中住院患者。出院时使用巴氏指数（BI）评分评估 ADL。入院时使用 B 型超声成像采集股四头肌的超声图像。根据回声强度和肌肉厚度评估股四头肌的肌肉内脂肪组织和肌肉质量。使用偏相关系数评估出院时 BI 评分与患侧和非患侧股四头肌回声强度或厚度之间的关系。偏相关分析中，年龄、性别、脑卒中发病天数、Fugl-Meyer 下肢评估评分和大腿皮下脂肪厚度用作控制变量。
出院时 BI 评分与患侧（偏相关系数= -0.377，P=0.018）和非患侧（偏相关系数= -0.364，P=0.023）股四头肌回声强度显著相关。相比之下，患侧（偏相关系数=0.284，P=0.075）和非患侧（偏相关系数=0.278，P=0.083）股四头肌厚度与出院时 BI 评分无显著相关性。
本研究揭示了入院时患侧和非患侧股四头肌内的肌肉脂肪组织与脑卒中患者出院时 ADL 之间的负相关关系。股四头肌内肌肉脂肪组织的评估和干预可能对预测和改善脑卒中患者的 ADL 至关重要。
