Objective To investigate the effect of decreased Skeletal Muscle Index (SMI) and hand grip strength on functional recovery in subacute ambulatory stroke patients.
Methods Subacute stroke patients who were referred to the rehabilitation center were recruited. Decreased SMI and hand grip strength were diagnosed according to the Asian Working Group on Sarcopenia. Diagnostic criteria were decreased SMI and decreased unaffected hand grip strength. SMI was measured by bioelectrical impedance analysis. Unaffected hand grip strength was measured with a hand dynamometer. Patients were divided into two groups, decreased group (DG) and not-decreased group (NDG), according to the presence of decreased SMI and hand grip strength. Both groups received conventional stroke rehabilitation for 3 weeks. All patients were evaluated at the baseline and at 3 weeks after treatment. Functional status was evaluated with 4-meter walk test (4MWT), 6-minute walk test (6MWT), Timed Up and Go test (TUG), and Modified Barthel Index (MBI).
Results Both groups showed improvement in 4MWT, TUG, and MBI. NDG showed improvement in 6MWT. Comparing improvements between the two groups, NDG showed more improvement in 6MWT and TUG than DG.
Conclusion The presence of decreased SMI and hand grip strength had negative effects on functional recovery in subacute ambulatory stroke patients.
Citations
Citations to this article as recorded by
Prevalence of Stroke‐Related Sarcopenia: A Systematic Review and Meta‐Analysis Lavinia Pereira dos Santos, Bruna Machado Staico, Anna Balsamão Vaz, Ana Carolina Joviano Galvão, Ana Luiza Miranda de Oliveira, Maria Clara Ferreira, Amanda Leopoldino, Janaíne Cunha Polese Physiotherapy Research International.2026;[Epub] CrossRef
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