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康复病房中运动疗法增加脑卒中后老年患者的骨骼肌质量。

Elderly Patients after Stroke Increase Skeletal Muscle Mass by Exercise Therapy in Rehabilitation Wards.

机构信息

Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa 904-2151, Japan.

Ginowan Memorial Hospital, 3-3-13 Ginowan, Ginowan city, Okinawa 901-2211, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2021 Sep;30(9):105958. doi: 10.1016/j.jstrokecerebrovasdis.2021.105958. Epub 2021 Jul 22.

Abstract

BACKGROUND

Loss of skeletal muscle is a critical health issue that frequently occurs due to aging and various pathologies. No studies have reported increases in appendicular skeletal muscle mass among elderly patients after stroke. Our hypothesis was that even older individuals after stroke could increase skeletal muscle mass by rehabilitation.

OBJECTIVES

This study aimed to evaluate changes to skeletal muscle mass in elderly patients after stroke rehabilitation and to assess factors associated with skeletal muscle mass increases.

MATERIALS AND METHODS

Participants in this case-control study were 159 patients ≥ 80 years old in rehabilitation wards after stroke. Body mass index (BMI), appendicular skeletal muscle index (SMI), Functional Independence Measure (FIM), interval from onset to transfer, presence of hemiplegia, National Institutes of Health Stroke Scale (NIHSS), length of hospital stay for rehabilitation, period of exercise therapy per day, and protein intake were examined. Multivariate logistic regression analysis was performed to identify association between these values and SMI increases.

RESULTS

SMI at discharge was significantly increased (5.30 kg/m) compared to baseline (5.20kg/m; p = 0.002). Multiple logistic regression analysis showed that length of hospital stay and protein intake were significantly associated with SMI increases, with odds ratios of 1.013 (95% confidence interval, 1.005-1.022) and 3.746 (95% confidence interval, 1.077-13.028), respectively.

CONCLUSIONS

The SMI of patients ≥ 80 years old increased significantly with rehabilitation after stroke. In addition, length of hospital stay and protein intake were independently associated with increases in SMI.

摘要

背景

骨骼肌丧失是一个严重的健康问题,经常由于衰老和各种病理原因而发生。没有研究报告脑卒中后老年患者四肢骨骼肌量增加。我们的假设是,即使是脑卒中后的老年人也可以通过康复来增加骨骼肌量。

目的

本研究旨在评估脑卒中后康复老年患者骨骼肌量的变化,并评估与骨骼肌量增加相关的因素。

材料和方法

这项病例对照研究的参与者是 159 名 80 岁以上在脑卒中康复病房的患者。检查了体重指数(BMI)、四肢骨骼肌指数(SMI)、功能独立性测量(FIM)、从发病到转移的间隔时间、偏瘫的存在、美国国立卫生研究院脑卒中量表(NIHSS)、康复住院时间、每天运动治疗的时间和蛋白质摄入量。进行了多变量逻辑回归分析,以确定这些值与 SMI 增加之间的关联。

结果

与基线相比(5.20kg/m),出院时 SMI 显著增加(5.30kg/m;p=0.002)。多变量逻辑回归分析显示,住院时间和蛋白质摄入量与 SMI 增加显著相关,优势比分别为 1.013(95%置信区间,1.005-1.022)和 3.746(95%置信区间,1.077-13.028)。

结论

脑卒中后康复治疗可显著增加 80 岁以上患者的 SMI。此外,住院时间和蛋白质摄入量与 SMI 的增加独立相关。

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