Effects of muscle mass and muscle quality estimated by phase angle on functional outcomes in older patients undergoing rehabilitation: A prospective cohort study
Effects of muscle mass and muscle quality estimated by phase angle on functional outcomes in older patients undergoing rehabilitation: A prospective cohort study
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通过相位角估计的肌肉质量和肌肉质量对接受康复的老年患者功能结果的影响：一项前瞻性队列研究
DOI：
10.1002/ncp.10920
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发表时间：
2022
影响因子：
3.1
通讯作者：
Nakayama Mai
中科院分区：
文献类型：
--
作者：
Ohtsubo Takuro;Nozoe Masafumi;Kanai Masashi;Ueno Katsuhiro;Nakayama Mai
背景骨骼肌质量和肌肉质量都是老年患者预后不良的重要预测因素。然而，通过相角(PHA)估计的肌肉质量和肌肉质量对接受康复治疗的老年患者的功能结果的影响尚未有报道。本研究旨在探讨老年康复患者的肢体骨骼肌指数和肌肉质量是否与日常生活活动能力和身体功能独立相关。方法前瞻性队列研究包括一家亚急性康复医院的老年患者(n= 443)。通过生物电阻抗分析测量基线SMI和PHA，并根据每个临界值确定低SMI或低PHA。主要结果是出院时使用运动功能独立性测量(FIM-M)分数测量的ADL能力和使用短物理性能电池(SPPB)分数测量的身体功能。通过调整混杂因素的多元回归分析，确定低SMI和低PHA与出院时FIM-M或SPPB评分之间的关系。结果出院时FIM-M和SPPB评分在正常组和低PHA组之间有显著差异(P<； 0.001)。多元回归分析显示，出院时PHA降低与FIM-M(β= −0.109，P= 0.013)和SPPB评分(β= 0.535，P<； 0.001)独立相关，而低SMI与这些功能结果无关。结论在接受康复治疗的老年患者中，PHA评估的肌肉质量下降与ADL能力和身体功能低下独立相关。
BackgroundBoth skeletal muscle mass and muscle quality are important predictors of poor prognosis in older patients. However, the effects of muscle mass and muscle quality estimated by the phase angle (PhA) on functional outcomes in older patients undergoing rehabilitation have yet to be reported. This study aimed to investigate whether appendicular skeletal muscle index (SMI) and muscle quality estimated by PhA were independently associated with activities of daily living (ADL) and physical function in older patients undergoing rehabilitation.MethodsThis prospective cohort study included older patients in a subacute rehabilitation hospital (n= 443). Baseline SMI and PhA were measured using bioelectrical impedance analysis, and low SMI or low PhA were determined using each cutoff value. The primary outcomes were ADL abilities measured using the functional independence measure for motor function (FIM‐M) score and physical function measured using the short physical performance battery (SPPB) score at hospital discharge. Association between low SMI and low PhA and FIM‐M or SPPB scores at discharge were determined using multiple regression analysis adjusted for confounding factors.ResultsThere were significant differences between the normal‐ and low‐PhA groups in the FIM‐M and SPPB scores at discharge (P< 0.001). In multiple regression analysis, low PhA was independently associated with FIM‐M (β= −0.109,P= 0.013) and SPPB scores (β= 0.535,P< 0.001) at discharge; however, low SMI was not independently associated with these functional outcomes.ConclusionDecreased muscle quality estimated by the PhA was independently associated with poor ADL abilities and poor physical function in older patients undergoing rehabilitation.