Abstract：
BACKGROUND: The clinical importance of skeletal muscle characteristics for improving gait ability of stroke survivors is increasing. We aimed to examine the association between muscle quantity and quality at discharge and changes in gait independence at the time of 1 year after discharge in patients with stroke.
METHODS: This prospective observational study included 100 patients with stroke who were admitted to a convalescent rehabilitation ward. We defined muscle quantity and quality operationally as muscle thickness and echo intensity observed in ultrasonography images, respectively, and measured quadriceps muscle on the paretic and non-paretic sides at the time of discharge. The outcome measured in our study was changes in gait independence 1 year after discharge, as assessed by the Functional Independence Measure gait assessment tool score.
RESULTS: Among the study participants, 23 (23.0 %) were assessed to have reduced gait independence, while 77 (77.0 %) were evaluated to have improved or maintained gait independence. Our multivariate logistic regression analysis revealed that only muscle quantity on the paretic side was significantly associated with an improvement or maintenance of gait independence (odds ratios 3.32; 95 % confidence interval 1.01-10.95; p = 0.049).
CONCLUSIONS: Our findings revealed that an improvement in gait independence 1 year after discharge was influenced by quadriceps muscle quantity on the paretic side at the time of discharge in patients with subacute stroke. This finding highlights the importance of lower limb muscle quantity on the paretic side as a clinically significant factor that influences the improvement in gait ability after hospital discharge.
METHODS: This prospective observational study included 100 patients with stroke who were admitted to a convalescent rehabilitation ward. We defined muscle quantity and quality operationally as muscle thickness and echo intensity observed in ultrasonography images, respectively, and measured quadriceps muscle on the paretic and non-paretic sides at the time of discharge. The outcome measured in our study was changes in gait independence 1 year after discharge, as assessed by the Functional Independence Measure gait assessment tool score.
RESULTS: Among the study participants, 23 (23.0 %) were assessed to have reduced gait independence, while 77 (77.0 %) were evaluated to have improved or maintained gait independence. Our multivariate logistic regression analysis revealed that only muscle quantity on the paretic side was significantly associated with an improvement or maintenance of gait independence (odds ratios 3.32; 95 % confidence interval 1.01-10.95; p = 0.049).
CONCLUSIONS: Our findings revealed that an improvement in gait independence 1 year after discharge was influenced by quadriceps muscle quantity on the paretic side at the time of discharge in patients with subacute stroke. This finding highlights the importance of lower limb muscle quantity on the paretic side as a clinically significant factor that influences the improvement in gait ability after hospital discharge.
摘要：
背景：骨骼肌特征对改善中风幸存者步态能力的临床重要性正在增加。我们旨在研究中风患者出院时肌肉数量和质量与出院后1年步态独立性变化之间的关系。
方法：这项前瞻性观察性研究包括100名中风患者，他们被送进康复病房。我们将肌肉数量和质量定义为在超声图像中观察到的肌肉厚度和回声强度，分别,并在出院时测量了股四头肌和非股四头肌。我们研究中测量的结果是出院后1年步态独立性的变化，通过功能独立性测量步态评估工具评分进行评估。
结果：在研究参与者中，23（23.0％）被评估为步态独立性降低，77（77.0％）被评估为改善或维持步态独立性。我们的多变量逻辑回归分析显示，只有麻痹侧的肌肉量与步态独立性的改善或维持显着相关（比值比3.32；95％置信区间1.01-10.95；p=0.049）。
结论：我们的发现表明，亚急性卒中患者出院后1年步态独立性的改善受出院时股四头肌数量的影响。这一发现强调了瘫痪侧下肢肌肉数量作为影响出院后步态能力改善的临床重要因素的重要性。
方法：这项前瞻性观察性研究包括100名中风患者，他们被送进康复病房。我们将肌肉数量和质量定义为在超声图像中观察到的肌肉厚度和回声强度，分别,并在出院时测量了股四头肌和非股四头肌。我们研究中测量的结果是出院后1年步态独立性的变化，通过功能独立性测量步态评估工具评分进行评估。
结果：在研究参与者中，23（23.0％）被评估为步态独立性降低，77（77.0％）被评估为改善或维持步态独立性。我们的多变量逻辑回归分析显示，只有麻痹侧的肌肉量与步态独立性的改善或维持显着相关（比值比3.32；95％置信区间1.01-10.95；p=0.049）。
结论：我们的发现表明，亚急性卒中患者出院后1年步态独立性的改善受出院时股四头肌数量的影响。这一发现强调了瘫痪侧下肢肌肉数量作为影响出院后步态能力改善的临床重要因素的重要性。
