Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke
Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke
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DOI：
10.1016/j.jocn.2020.02.020
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发表时间：
2020-04-01
影响因子：
2
通讯作者：
Mase, Kyoshi
中科院分区：
文献类型：
--
作者：
Nozoe, Masafumi;Kanai, Masashi;Mase, Kyoshi
背景：中风患者的肌肉萎缩是功能结果不佳的一个因素。然而，关于急性期下肢肌肉萎缩与依赖性行走之间关系的研究很少。本研究探讨了急性期下肢肌肉萎缩是否与中风后 3 个月的依赖行走状态相关。 方法：在这项观察性队列研究中，我们在入院后 1 周和 3 周内，使用超声检查法测量了急性中风不能走动患者的偏瘫和非偏瘫肢体的股四头肌厚度。根据患者的行走能力将患者分为两组：中风后 3 个月时依赖的功能性行走类别 (FAC) 0-3 和独立的功能性行走类别 (FAC 4-5)。结果：总共纳入了 55 名患者并完成了随访，其中 28 名患者 (51%) 在中风后 3 个月时处于依赖的行走状态。在非麻痹肢体中观察到肌肉萎缩的显着差异（-5.5% [8.7%] : -16.8% [13.6%]，独立组：依赖组，P < 0.001），但在麻痹肢体中没有观察到显着差异（-15.0% [14.3%] : -18.7% [15.1%]，P = 0.36）。即使在调整协变量后，非麻痹肢体的肌肉萎缩也是依赖性行走的一个显着的独立预测因素（调整后的比值比，0.87；95％置信区间，0.76-0.99，P = 0.033）。结论：急性期非麻痹下肢的中风后肌肉萎缩与中风后的依赖性行走独立相关。 (C) 2020 年由爱思唯尔有限公司出版。
Background: Muscle wasting in patients with stroke is a factor for a poor functional outcome. However, there have been few studies on the relationships between lower limb muscle wasting during the acute phase and dependent ambulation. This study examined whether lower limb muscle wasting during the acute phase is associated with the dependent ambulation status at 3 months after stroke.Methods: In this observational cohort study, we measured the quadriceps muscle thickness in the paretic and non-paretic limbs within 1 and 3 weeks after admission using ultrasonography in non-ambulatory patients with acute stroke. Patients were categorized into two groups based on their ambulation ability: dependent, functional ambulation category (FAC) 0-3 and independent, FAC 4-5) at 3 months after stroke.Results: In total, 55 patients were included and completed follow-up, and 28 patients (51%) had an ambulation status of dependent at 3 months after stroke. Significant differences in muscle wasting were observed in the non-paretic limb (-5.5% [8.7%] : -16.8% [13.6%], independent group: dependent group, respectively, P < 0.001), but not in the paretic limb (-15.0% [14.3%] : -18.7% [15.1%], P = 0.36). Even after adjusting for covariates, muscle wasting in the non-paretic limb was a significant independent predictor of dependent ambulation (adjusted odds ratio, 0.87; 95% confidence interval, 0.76-0.99, P = 0.033).Conclusion: Post-stroke muscle wasting in the non-paretic lower limb during the acute phase is independently associated with dependent ambulation after stroke. (C) 2020 Published by Elsevier Ltd.