Elderly Patients after Stroke Increase Skeletal Muscle Mass by Exercise Therapy in Rehabilitation Wards

Abstract

BackgroundLoss of skeletal muscle is a critical health issue that frequently occurs due to aging and various pathologies. No studies have reported increases in appendicular skeletal muscle mass among elderly patients after stroke. Our hypothesis was that even older individuals after stroke could increase skeletal muscle mass by rehabilitation. ObjectivesThis study aimed to evaluate changes to skeletal muscle mass in elderly patients after stroke rehabilitation and to assess factors associated with skeletal muscle mass increases. Materials and MethodsParticipants in this case-control study were 159 patients ≥ 80 years old in rehabilitation wards after stroke. Body mass index (BMI), appendicular skeletal muscle index (SMI), Functional Independence Measure (FIM), interval from onset to transfer, presence of hemiplegia, National Institutes of Health Stroke Scale (NIHSS), length of hospital stay for rehabilitation, period of exercise therapy per day, and protein intake were examined. Multivariate logistic regression analysis was performed to identify association between these values and SMI increases. ResultsSMI at discharge was significantly increased (5.30 kg/m2) compared to baseline (5.20kg/m2; p = 0.002). Multiple logistic regression analysis showed that length of hospital stay and protein intake were significantly associated with SMI increases, with odds ratios of 1.013 (95% confidence interval, 1.005–1.022) and 3.746 (95% confidence interval, 1.077–13.028), respectively. ConclusionsThe SMI of patients ≥ 80 years old increased significantly with rehabilitation after stroke. In addition, length of hospital stay and protein intake were independently associated with increases in SMI.