Abstract
Objectives: The purpose of this study is to identify whether there is an association between sarcopenia and physical function outcomes of patients with stroke. Methods: A systematic search of Pubmed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang database was conducted to identify studies in Chinese and English from the inception of the database to March 2021. Documents were checked for relevancy. Articles exploring the association between sarcopenia and the physical function of patients with stroke were included. The quality of the literature was evaluated using the Newcastle-Ottawa scale tool. Stata 15.0 software was used to conduct meta-analysis. Results: Eight studies met the criteria for inclusion. A meta-analysis of four studies showed that sarcopenia was related to an increased risk of poor physical function of patients with stroke (total OR=3.11, 95% CI: 2.22-4.34, P<0.0001). Descriptive analysis was performed in the rest of studies. Overall, a correlation between the two factors was found in patients with stroke. Some studies suggested a difference based on gender and severity of the disease condition. The studies included in this review were of high methodological quality. The Egger's test (P=0.217) showed no publication bias. Conclusions: This review concludes that sarcopenia is an independent predictive factor of physical function of patients with stroke. Clinicians should pay attention to gender differences and severity of disease condition. Therefore, screening, diagnosis, treatment, and prevention of sarcopenia should be part of the routine clinical practice when providing care to stroke patients.
Highlights
Sarcopenia is an under-evaluated and under-treated condition in patients with stroke
A systematic review reported that only 7 trials assessed the prevalence of sarcopenia in stroke patients, with a pooled prevalence estimate of 42%1
The revised guideline published by the European Working Group on Sarcopenia in Older People (EWGSOP2) propose new insights that muscle strength is the principal determinant of sarcopenia as opposed to muscle mass[3]
Summary
Sarcopenia is an under-evaluated and under-treated condition in patients with stroke. A systematic review reported that only 7 trials assessed the prevalence of sarcopenia in stroke patients, with a pooled prevalence estimate of 42%1. Recent clinical studies have shown that sarcopenia was observed in 53.6% of stroke patients[2]. Sarcopenia is defined as “progressive and systemic skeletal muscle disease related to increased occurrence of adverse health outcome” 3. Causes of sarcopenia in patients with stroke, such as denervation, muscle mass loss, systemic catabolic activation, and muscle fiber displacement, can overlap. Sarcopenia is frequently observed among the elderly population, leading to complications such as falls, disability, loss of independence, hospitalization, cognitive and mobility impairments, and mortality[3,5,6,7]. Early identification, diagnosis and treatment of sarcopenia are of great significance
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