Relationship of Functional Outcome With Sarcopenia and Objectively Measured Physical Activity in Patients With Stroke Undergoing Rehabilitation

Abstract

This study aimed to investigate the relationship of Functional Independence Measure for motor function (FIM-M) with sarcopenia, and physical activity in patients with stroke undergoing rehabilitation. This cross-sectional study included patients with stroke at a single convalescent rehabilitation hospital. Sarcopenia was diagnosed based on the Asia Working Group for Sarcopenia 2019 criteria. Physical activity was measured as the duration of light-intensity physical activity and moderate to vigorous physical activity using a triaxial accelerometer. Of 80 patients (median age: 72.0 years), 46 (57.5%) were diagnosed with sarcopenia. In multivariate linear regression analysis, FIM-M score was significantly associated with sarcopenia (β = −0.15, p = .043) and light-intensity physical activity (β = 0.55, p < .001). In another model, FIM-M score was significantly associated with moderate to vigorous physical activity (β = 0.27, p = .002) but not with sarcopenia. This study demonstrated that FIM-M was partially associated with sarcopenia and associated with physical activity regardless of intensity in patients with stroke.

Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

“…Indeed, median age of stroke onset has increased over the past 20 years, and the median age of ischemic stroke onset in women has risen to above the age of 80 years since 2016 [ 8 ]. The high rate of the aging population may have led to an increasing number studies on stroke-related sarcopenia in Japan, which have mostly been conducted in convalescent rehabilitation wards [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Convalescent rehabilitation wards are a unique setting for intensive rehabilitation after the acute phase of stroke [ 41 ].…”

“…The prevalence of sarcopenia in stroke patients in acute hospitals has been reported to be 8.5–33.8% [ 12 , 13 , 14 , 15 , 16 ], and sarcopenia leads to unfavorable outcomes 90 days after stroke [ 15 ]. In post-acute rehabilitation hospitals, approximately 50% of patients suffer from sarcopenia on admission [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], and sarcopenia inhibits functional recovery and return to home in patients with stroke [ 25 ]. In addition, in several studies, pre-stroke sarcopenia was diagnosed using the SARC-F questionnaire [ 33 , 34 , 35 , 36 ], and pre-stroke sarcopenia was a predictor of functional outcome after 3 months [ 34 ].…”

Association of Objectively Measured Physical Activity with Physical Function in Patients with Sarcopenia during Hospitalized Rehabilitation

“…Reliability and validity of sitting, standing, and walking activities have been demonstrated in patients with subacute stroke [ 27 , 28 ]. All participants wore the activity monitor attached to their belts between 7:00 AM and 7:00 PM, which included the rehabilitation time, except during bathing, for 5 consecutive days [ 21 , 29 ]. MET data were recorded every 60 s for 12 h and processed using the manufacturer’s software (HMS-HJA-IC01J; OMRON, Kyoto, Japan).…”

“…MET data were recorded every 60 s for 12 h and processed using the manufacturer’s software (HMS-HJA-IC01J; OMRON, Kyoto, Japan). The MET data were classified into two categories based on intensity: LIPA was 1.6–2.9 METs, and MVPA ≥3 METs [ 21 , 29 ]. The total minutes and average duration of LIPA and MVPA were calculated daily for 5 consecutive days [ 21 , 29 ].…”

“…The MET data were classified into two categories based on intensity: LIPA was 1.6–2.9 METs, and MVPA ≥3 METs [ 21 , 29 ]. The total minutes and average duration of LIPA and MVPA were calculated daily for 5 consecutive days [ 21 , 29 ].…”