Background:
Sarcopenia is characterized by decreased muscle mass, muscle strength, and physical performance. Previous studies suggest that sarcopenia as well as body mass index (BMI) associated with post-stroke functional outcome. However, the effect of BMI in chronic post-stroke patient with sarcopenia has not been studied. In this study, we analyzed the association between BMI and functional outcome in chronic stroke patients with sarcopenia.
Methods:
Patients with history of neuropathy or myopathy, and severe medical comorbidities were excluded. Sarcopenia was diagnosed with criteria of Asian Working Group for Sarcopenia consisting of decreased skeletal muscle index (SMI) of bioelectrical impedance analysis, hand grip strength and 4-m gait speed. BMI, motricity index, Fugl-Meyer Assessment (FMA), Modified Barthel Index (MBI), Berg Balance Scale (BBS), and Functional Ambulatory Category (FAC) were measured at admission and discharge. Patients were divided into 2 groups according to BMI; underweight group (<18.5kg/m2) and normal group (18.5 to 25 kg/m2). The difference of outcome measures between two subgroups at initial, discharge and the change were analyzed.
Results:
We enrolled fifteen first-ever chronic stroke patients (interval between onset of stroke and enrollment; >6 months) with sarcopenia (six females; mean age of 69.5 years). We found no significant difference of age, gender, and chronicity of stroke between two subgroups (Table 1). The mean interval between initial and follow-up evaluation was 28.4 days. The FMA measured on the affected and unaffected side did not show significant difference in initial and discharge, but the significant difference was found in change of FMA, which was attributed to noticeable change of upper extremities FMA (Table 2). We also found that MBI, BBS, FAC, and motricity index had no significant difference between 2 subgroups.
Conclusion:
In this study, we found that under-BMI affected negatively neurological recovery of upper extremities in chronic post-stroke patients with sarcopenia significantly. Therefore, we postulate that state of sarcopenia with under-BMI impede recovery of chronic post-stroke patient. Further study with larger sample size should be performed to prove the hypothesis. |
