Greater Quadriceps Muscle Mass at Post-Acute Care Admission is Associated with Better Swallowing Ability at Discharge among Adults with Stroke
Greater Quadriceps Muscle Mass at Post-Acute Care Admission is Associated with Better Swallowing Ability at Discharge among Adults with Stroke
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成人中风患者在急性护理入院后的股四头肌质量与出院时更好的吞咽能力相关
DOI：
10.1016/j.jamda.2021.04.019
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发表时间：
2021
影响因子：
7.6
通讯作者：
Moriyama Hideki
中科院分区：
文献类型：
--
作者：
Akazawa Naoki;Kishi Masaki;Hino Toshikazu;Tsuji Ryota;Tamura Kimiyuki;Hioka Akemi;Moriyama Hideki
目的探讨急性卒中患者入院后肌肉质量、肌内脂肪组织与吞咽能力恢复的关系。DesignProspective研究。背景和参与者本研究以医院为基础，纳入了62例住院脑卒中患者。方法主要观察患者出院时的吞咽能力。采用食物摄入水平量表（FILS）评估吞咽能力。FILS变化是通过从出院FILS中减去入院FILS来计算的。入院时使用b超成像获取超声图像。分别根据肌肉厚度和回声强度评估股四头肌的肌肉质量和肌内脂肪组织。采用左右股四头肌的平均肌肉厚度和回声强度进行分析。进行多元回归分析以确定与出院时FILS和FILS变化独立相关的因素。自变量为肱四头肌的肌肉厚度和回声强度、入院时的FILS、年龄、性别、体重指数、距中风发作天数、c反应蛋白、更新的Charlson合并症指数、药物数量、康复治疗单位数和入院时的Barthel指数评分。结果股四头肌的肌肉厚度与放电时FILS （β = 0.27）和FILS变化（β = 0.40）有显著的独立相关性。股四头肌回波强度与放电时FILS （β = 0.22）和FILS变化（β = 0.31）无显著独立相关。结论和意义我们的研究结果表明，急性期卒中患者入院时更大的股四头肌肌肉量与出院时更好的吞咽能力相关。入院时评估股四头肌肌肉质量对于预测吞咽能力的恢复很重要，对股四头肌肌肉质量的干预可能对改善卒中患者的吞咽能力有效。
ObjectivesThis study aimed to examine the relationship between muscle mass and intramuscular adipose tissue of the quadriceps at post-acute care admission and recovery of swallowing ability in patients with stroke.DesignProspective study.Setting and ParticipantsThis study was hospital-based and included 62 inpatients with stroke.MethodsThe primary outcome was swallowing ability at discharge. The swallowing ability was assessed using the Food Intake Level Scale (FILS). The FILS change was calculated by subtracting FILS at admission from FILS at discharge. Ultrasound images were acquired at admission using B-mode ultrasound imaging. Muscle mass and intramuscular adipose tissue of the quadriceps were assessed based on muscle thickness and echo intensity, respectively. The mean muscle thickness and echo intensity of the right and left quadriceps were used in the analysis. A multiple regression analysis was performed to identify the factors independently associated with the FILS at discharge and FILS change. The independent variables were the muscle thickness and echo intensity of the quadriceps, FILS at admission, age, sex, body mass index, days from stroke onset, C-reactive protein, updated Charlson comorbidity index, number of medications, unit number of rehabilitation therapy, and Barthel Index score at admission.ResultsMuscle thickness of the quadriceps was significantly and independently associated with FILS at discharge (β = 0.27) and FILS change (β = 0.40). Echo intensity of the quadriceps was not significantly and independently associated with FILS at discharge (β = 0.22) and FILS change (β = 0.31).Conclusions and ImplicationsOur results indicated that greater quadriceps muscle mass at post-acute care admission was associated with better swallowing ability at discharge in patients with stroke. Assessing muscle mass of the quadriceps at admission is important for predicting recovery of swallowing ability and interventions for quadriceps muscle mass may be effective for improving swallowing ability of patients with stroke.