Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA -
NeuroRecovery Research Center, TIRR Memorial Hermann Hospital, Houston, TX, USA -
Eur J Phys Rehabil Med. 2022 Oct;58(5):683-692. doi: 10.23736/S1973-9087.22.07514-1. Epub 2022 Sep 5.
Sarcopenia, generally described as "aging-related loss of skeletal muscle mass and function", can occur secondary to a systemic disease.
This project aimed to study the prevalence of sarcopenia in chronic ambulatory stroke survivors and its associated risk factors using the two most recent diagnostic criteria.
A cross-sectional observational study.
A scientific laboratory.
Chronic stroke.
Twenty-eight ambulatory chronic stroke survivors (12 females; mean age=57.8±11.8 years; time after stroke=76±45 months), hand-grip strength, gait speed, and appendicular skeletal muscle mass (ASM) were measured to define sarcopenia. Risk factors, including motor impairment and spasticity, were identified using regression analysis.
The prevalence of sarcopenia varied between 18% and 25% depending on the diagnostic criteria used. A significant difference was seen in the prevalence of low hand grip strength on the affected side (96%) when compared to the contralateral side (25%). The prevalence of slow gait speed was 86% while low ASM was present in 89% of the subjects. Low ASM was marginally negatively correlated with time since stroke and gait speed, but no correlation was observed with age, motor impairment, or spasticity. ASM loss, bone loss and fat deposition were significantly greater in the affected upper limb than in the affected lower limb. Regression analyses showed that time since stroke was a factor associated with bone and muscle loss in the affected upper limb, spasticity had a protective role for muscle loss in the affected lower limb, and walking had a protective role for bone loss in the lower limb.
The prevalence of sarcopenia in stroke survivors is high and is a multifactorial process that is not age-related. Different risk factors contribute to muscle loss in the upper and lower limbs after stroke.
Clinicians need to be aware of high prevalence of sarcopenia in chronic stroke survivors. Sarcopenia is more evident in the upper than lower limbs. Clinicians also need to understand potential protective roles of some factors, such as spasticity and walking for the muscles in the lower limb.
肌少症通常被描述为“与衰老相关的骨骼肌质量和功能丧失”，可继发于全身性疾病。
本项目旨在使用最新的两种诊断标准研究慢性门诊脑卒中幸存者肌少症的患病率及其相关危险因素。
横断面观察性研究。
科学实验室。
慢性脑卒中。
测量 28 名慢性门诊脑卒中幸存者（女性 12 名；平均年龄 57.8±11.8 岁；脑卒中后时间=76±45 个月）的握力、步态速度和四肢骨骼肌质量（ASM）以定义肌少症。使用回归分析确定包括运动障碍和痉挛在内的危险因素。
根据使用的诊断标准，肌少症的患病率在 18%至 25%之间有所不同。与对侧相比，患侧握力降低的患病率有显著差异（96%）。步态速度缓慢的患病率为 86%，而 ASM 降低的患病率为 89%。ASM 降低与脑卒中后时间和步态速度呈负相关，但与年龄、运动障碍或痉挛无相关性。患侧上肢的 ASM 丢失、骨丢失和脂肪沉积明显大于患侧下肢。回归分析表明，脑卒中后时间是患侧上肢骨和肌肉丢失的相关因素，痉挛对患侧下肢肌肉丢失具有保护作用，行走对下肢骨丢失具有保护作用。
脑卒中幸存者肌少症的患病率较高，且是多因素的，与年龄无关。不同的危险因素导致脑卒中后上肢和下肢肌肉丢失。
临床医生需要意识到慢性脑卒中幸存者肌少症的高患病率。肌少症在上肢比下肢更为明显。临床医生还需要了解一些因素的潜在保护作用，例如痉挛和行走对下肢肌肉的作用。
