Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study.

Tatsuya Matsushita,Anna Yamanouchi,Ryusei Nakashima,Shinta Nishioka,Shiori Taguchi,Hidetaka Wakabayashi

doi:10.3390/healthcare8030255

Tatsuya Matsushita, Anna Yamanouchi + Show 4 more

Open Access

https://doi.org/10.3390/healthcare8030255

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Abstract

Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, −16.157 to −5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.

Highlights

Obesity is frequently observed in patients with stroke and results in adverse outcomes
Convalescent rehabilitation wards aim to maximize the recovery of activities of daily living (ADL) capability and enable patients to return to their own homes by utilizing the skills of multidisciplinary rehabilitation teams that involve medical doctors, nurses, physical therapists, occupational therapists, speech–language–hearing therapists, social workers, registered dietitians, care workers, dental hygienists, and pharmacists [20]
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Summary

Introduction

Obesity is frequently observed in patients with stroke and results in adverse outcomes. 19.4–31.4% of patients after stroke are classified as obese, and this varies with setting [1,2,3]. Loss of muscle mass commonly occurs after stroke and is accompanied by increased fat mass deposition in the paretic limb [5,6,7]. Decreased muscle mass and strength and increased fat mass are observed in the nonparetic limb during a similar time course after stroke [8,9]. Fat mass in the paretic limb and whole body may increase after stroke, resulting in increased risk of recurrent stroke [10]

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