Churilov Irina, Churilov Leonid, Brock Kim, Murphy David, MacIsaac Richard J, Ekinci Elif I
Department of Rehabilitation, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
Department of Medicine, Austin Health, Melbourne Medical School, The University of Melbourne, Heidelberg, VIC, Australia.
Front Rehabil Sci. 2021 Oct 21;2:692896. doi: 10.3389/fresc.2021.692896. eCollection 2021.
To investigate the association between sarcopenia and functional improvement in patients older and younger than 65 years upon completion of an inpatient rehabilitation program. Prospective cohort study. Adult consecutive patients who completed the inpatient rehabilitation program at a metropolitan tertiary referral hospital general inpatient rehabilitation unit. Sarcopenia status was determined using the European Working Group on Sarcopenia in Older People 2 algorithm, using muscle mass measured by BioImpedance Analysis and grip strength. Progress in rehabilitation was measured using change in the Functional Independence Measure and Goal Attainment Scaling score. To investigate the age group by sarcopenia status interaction we used quantile regression models with bootstrapped standard error estimation for functional improvement and linear regression model with robust standard error estimation for GAS score. 257 participants [128 (50%) male, median age 63 years (IQR: 52-72)], 33(13%) with sarcopenia, completed inpatient rehabilitation [median length of stay 16 days (IQR: 11-27.5)]. Participants' median Functional Independence Measure change was 24 (IQR 15-33.5) and mean total Goal Attainment Scaling score was 57.6 (SD 10.2). Adjusting for admission Functional Independence Measure score, the median difference in Functional Independence Measure change between participants with and without sarcopenia was: -4.3 (95% CI: -10.6, 1.9); = 0.17 in participants 65 years and younger, and 4.6 (95% CI: 1.0, 8.2); = 0.01 in participants older than 65; age-by-sarcopenia interaction = 0.02. Unlike younger people, older people with sarcopenia have greater functional improvement in inpatient rehabilitation than those without sarcopenia.
为了研究65岁及以上和65岁以下患者在完成住院康复计划后肌肉减少症与功能改善之间的关联。前瞻性队列研究。在一家大都市三级转诊医院的普通住院康复科完成住院康复计划的成年连续患者。采用欧洲老年人肌肉减少症工作组2算法，通过生物电阻抗分析测量肌肉量和握力来确定肌肉减少症状态。使用功能独立性测量和目标达成量表评分的变化来衡量康复进展。为了研究按肌肉减少症状态分组的年龄组之间的相互作用，我们使用了带有自抽样标准误差估计的分位数回归模型来评估功能改善情况，并使用带有稳健标准误差估计的线性回归模型来评估目标达成量表评分。257名参与者[128名（50%）男性，中位年龄63岁（四分位间距：52 - 72岁）]，33名（13%）患有肌肉减少症，完成了住院康复[中位住院时长16天（四分位间距：11 - 27.5天）]。参与者功能独立性测量的中位变化为24（四分位间距15 - 33.5），目标达成量表总平均分是57.6（标准差10.2）。在校正入院时的功能独立性测量评分后，有和没有肌肉减少症的参与者在功能独立性测量变化方面的中位差异为：-4.3（95%置信区间：-10.6，1.9）；65岁及以下参与者中P = 0.17，65岁以上参与者中为4.6（95%置信区间：1.0，8.2）；P = 0.01；年龄与肌肉减少症的相互作用P = 0.02。与年轻人不同，患有肌肉减少症的老年人在住院康复中的功能改善比没有肌肉减少症的老年人更大。
