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Guerrini A, Siotto M, Cocco C, Germanotta M, Cipollini V, Cortellini L, Pavan A, Lattanzi S, Insalaco S, Khazrai YM, Aprile IG. Usefulness of body composition assessment by bioelectrical impedance vector analysis in subacute post-stroke patients in rehabilitation. Sci Rep 2025; 15:1774. [PMID: 39800724 PMCID: PMC11725591 DOI: 10.1038/s41598-024-84968-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025] Open
Abstract
Bioelectrical Impedance Vector Analysis (BIVA) is a valuable tool for evaluating hydration and body composition, but its application in subacute post-stroke patients remains unexplored. This study aimed to fill this gap by analyzing BIVA in a cohort of 87 subacute post-stroke patients (42 women, mean age 69 ± 12) undergoing rehabilitation. At admission (T0), diagnosis of malnutrition with GLIM criteria and of sarcopenia with EWGSOP2 was done, and patients were analyzed with BIVA. The change in modified Barthel Index (mBIT1-mBIT0) was assessed to evaluate the improvement in functional recovery. BIVA revealed that both adult patients (< 65 years, n = 29) and elderly patients (≥ 65 years, n = 58) exhibited high body fluid overload and low muscle mass. Additionally, BIVA revealed a significant rightward shift of the bioimpedance vectors in malnourished (n = 37) versus non-malnourished patients (T2 = 56.9, p < 0.001, D = 1.68) and in sarcopenic (n = 24) versus non-sarcopenic patients (T2 = 36.4, p < 0.001, D = 1.5). Lastly, the BIVA distinguished patients with greater improvement (n = 53) from patients with lower improvement (n = 34) (T2 = 10.6, p = 0.007, D = 0.7). In conclusion, BIVA is an effective, easy-to-use tool for evaluating hydration, nutritional status, and recovery in post-stroke rehabilitation.
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Affiliation(s)
- Alessandro Guerrini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
- Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128, Rome, Italy
| | | | - Carola Cocco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
| | | | - Laura Cortellini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
| | - Arianna Pavan
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
| | | | - Sabina Insalaco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143, Florence, Italy
| | - Yeganeh Manon Khazrai
- Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128, Rome, Italy
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Elizabeth NSH, Yanni T, May LS, Fen TH, Janice LX, Peijun K, Pheng OS, Jie TS, Will LNH. Indirect calorimetry directed feeding and cycling in the older ICU population: a pilot randomised controlled trial. BMC Anesthesiol 2024; 24:171. [PMID: 38714926 PMCID: PMC11075192 DOI: 10.1186/s12871-024-02507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Older critically ill patients experience rapid muscle loss during stay in an intensive care unit (ICU) due to physiological stress and increased catabolism. This may lead to increased ICU length of stay, delayed weaning from ventilation and persistent functional limitations. We hypothesized that with optimal nutrition and early physical therapy acting in synergism, we can reduce muscle mass loss and improve functional outcomes. METHODS This was a prospective, single blinded randomized, controlled single-center pilot study to compare the lean muscle mass (measured at bilateral quadriceps femoris using ultrasound) of older ICU patients at 4 time points over 14 days between the control and intervention groups. The control group received standard weight-based empiric feeding and standard ICU physiotherapy. The intervention group received indirect calorimetry directed feeding adjusted daily and 60 min per day of cycle ergometry. 21 patients were recruited and randomized with 11 patients in the control arm and 10 patients in the intervention arm. Secondary outcome measures included ICU and hospital mortality, length of stay, functional assessments of mobility and assessment of strength. RESULTS Median age was 64 in the control group and 66 in the intervention group. Median calories achieved was 24.5 kcal/kg per day in the control group and 23.3 kcal/kg per day in the intervention group. Cycle ergometry was applied to patients in the intervention group for a median of 60 min a day and a patient had a median of 8.5 sessions in 14 days. Muscle mass decreased by a median of 4.7cm2 in the right quadriceps femoris in the control group and 1.8cm2 in the intervention group (p = 0.19), while the left quadriceps femoris decreased by 1.9cm2 in the control group and 0.1cm2 in the intervention group (p = 0.51). CONCLUSION In this pilot study, we found a trend towards decrease muscle loss in bilateral quadriceps femoris with our combined interventions. However, it did not reach statistical significance likely due to small number of patients recruited in the study. However, we conclude that the intervention is feasible and potentially beneficial and may warrant a larger scale study to achieve statistical significance. TRIAL REGISTRATION This study was registered on Clinicaltrials.gov on 30th May 2018 with identifier NCT03540732.
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Affiliation(s)
- Ng Shu Hui Elizabeth
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore.
| | - Tan Yanni
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Leong Siaw May
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Tiong Hui Fen
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Li Xuanhui Janice
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Kwan Peijun
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Ong Sze Pheng
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Toh Shi Jie
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
| | - Loh Ne Hooi Will
- Department of Anaesthesia, National University Hospital of Singapore, 5 Lower Kent Ridge Road, 119074, Singapore, Singapore
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Keawon T, Saiphoklang N. Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease. Ther Adv Respir Dis 2024; 18:17534666241281675. [PMID: 39367749 PMCID: PMC11457192 DOI: 10.1177/17534666241281675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 08/21/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation resulting from a combination of small airway disease (SAD) and parenchymal destruction. Although various diagnostic methods for SAD exist, access to these tools can be limited. OBJECTIVES This study aimed to explore the correlation between handgrip strength (HGS) and SAD in COPD patients. DESIGN Cross-sectional prospective study. METHODS HGS was measured using a hand dynamometer. SAD was evaluated using impulse oscillometry, with results reported as the difference between respiratory resistance at 5 and 20 Hz (R5-R20). SAD was defined as R5-R20 ⩾0.07 kPa/L/s. The receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting SAD. RESULTS Sixty-four patients (90.6% male) were included. The average age was 72.1 ± 8.3 years, and body mass index was 23.4 ± 4.2 kg/m2. FEV1 was 71.6 ± 21.3%, and HGS was 30.2 ± 8.1 kg. R5-R20 was 0.11 ± 0.08 kPa/L/s. SAD was found in 64.1% of patients. A negative correlation between HGS and R5-R20 was observed (r = -0.332, p = 0.007). The best cutoff value for HGS in detecting SAD was determined to be 28.25 kg, with a sensitivity of 73.9%, specificity of 65.9%, and an area under ROC curve of 0.685 (95% CI 0.550-0.819, p = 0.015). CONCLUSION SAD is common in COPD patients, and HGS is significantly negatively correlated with SAD. This tool might serve as an alternative or adjunctive assessment for small airway dysfunction in COPD patients. REGISTRATION This study was registered with ClinicalTrials.gov with number NCT06223139.
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Affiliation(s)
- Thanapon Keawon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Klongluang, Pathumthani, Thailand
| | - Narongkorn Saiphoklang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, 99/209 Paholyotin Road, Klong Luang, Pathum Thani 12120, Thailand
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Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data. Nutrients 2022; 14:nu14224825. [PMID: 36432512 PMCID: PMC9693787 DOI: 10.3390/nu14224825] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022] Open
Abstract
After a stroke, patients can suffer from sarcopenia, which can affect recovery. This could be closely related to an impairment in nutritional status. In this preliminary analysis of a longitudinal prospective study, we screened 110 subjects admitted to our rehabilitation center after a stroke. We then enrolled 61 patients, who underwent a 6-week course of rehabilitation treatment. We identified a group of 18 sarcopenic patients (SG), according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), by evaluating muscle strength with the handgrip test, and muscle mass with bioelectrical impedance analysis (BIA). With respect to the non-sarcopenic group (NSG), the SG at admission (T0) had worse muscle quality, according to the BIA-derived phase angle, and a lower score of MNA®-SF. In contrast to the NSG, the SG also exhibited lower values for both BMI and the Geriatric Nutritional Risk Index (GNRI) at T0 and T1. Moreover, 33% of the SG had a major risk of nutrition-related complications (GNRI at T0 < 92) and discarded on average more food during the six weeks of rehabilitation (about one-third of the average daily plate waste). Of note is the fact that the Barthel Index’s change from baseline indicated that the SG had a worse functional recovery than the NGS. These results suggest that an accurate diagnosis of sarcopenia, along with a proper evaluation of the nutritional status on admission to rehabilitation centers, appears strictly necessary to design individual, targeted physical and nutritional intervention for post-stroke patients, to improve their ability outcomes.
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Song X, Zhang X, Weng Y, Liu Y, Shan Q, Chen W, Ma W, Dong Q, Qu D, Guo Y, Xiong J, Deng F, Fu Q, Xin Y. Effects of Acupuncture Combined with Biofeedback Therapy on Limb Motor Rehabilitation in Patients with Acute Stroke: Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9582077. [PMID: 35845965 PMCID: PMC9277156 DOI: 10.1155/2022/9582077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
Objective The purpose of the systematic review is to verify the effect of biofeedback therapy on limb motor rehabilitation in patients with acute stroke and to provide evidence-based medicine for the promotion and use of biofeedback therapy. Methods The randomized controlled trials (RCT) of biofeedback therapy in the treatment of cerebral palsy were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang Database, and Chinese Biomedical Literature Database (CBM). The starting time and ending time of this study are from the time of building the database of the number of pieces to October 31, 2018. The data included in this study were extracted by two independent researchers and evaluated the bias risk of all the literature included in the study according to the Cochrane manual 5.1.0 criteria. RevMan5.4 statistical software was used to analyze the collected data by meta. Results This systematic review included 9 RCT studies with a total of 1410 patients. The results of meta-analysis showed that there were significant differences in the improvement of lower limb muscle tension, comprehensive spasm scale score, EMG score, and passive range of motion of ankle joint between biofeedback therapy and routine rehabilitation therapy. Conclusion Biofeedback therapy can improve lower limb muscle tension, spasticity, EMG integral value, and passive range of motion of ankle joint in children with cerebral palsy and provide better conditions for improving the motor ability of lower extremities in children with cerebral palsy. However, more studies and follow-up with higher methodological quality and longer intervention time are needed to further verify.
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Affiliation(s)
- Xinrong Song
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Xiaoge Zhang
- Department of Rehabilitation, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
| | - Yan Weng
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Yu Liu
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Qi Shan
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Wenna Chen
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Wanwan Ma
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Qi Dong
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Dandan Qu
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Yibo Guo
- Department of Intensive Care Unit, Songxian People's Hospital, Luoyang 471400, China
| | - Jie Xiong
- Department of Neurology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
| | - Fuhua Deng
- Harbin Medical University, Pharmacy College, Harbin, Heilongjiang 150081, China
| | - Qizhi Fu
- Department of Intensive Care Unit(Internal Medicine), The First Affiliated Hospital, And College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Yufu Xin
- Department of Rehabilitation, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
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Kim DH, Park J, Lee CW, Lee SY. Natural aging course of lumbar extensor muscle mass and strength in community-dwelling older women: a 1-year prospective observational study. Aging Clin Exp Res 2022; 34:2099-2105. [PMID: 35668336 DOI: 10.1007/s40520-022-02156-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although the loss of skeletal limb muscle mass and muscle strength in the elderly have been demonstrated, the aging process of the back muscles to maintain core stability is not well known. This 1-year prospective observational study aimed to investigate the natural aging course of the lumbar extensor muscles (LEMs) compared with the extremity muscles and determine whether muscle strength or mass decreases more in community-dwelling older women. METHODS Twenty-four older urban-dwelling women aged 70 years or older were initially enrolled. Their demographic variables, conventional and spinal sarcopenia indices, and functional outcome parameters were evaluated. We also measured back extensor strength, radiological parameters for spinal sagittal balance on whole-spine radiography, and volumetric parameters of the LEM on computed tomography. RESULTS After the exclusion of 6 subjects, 18 older women were finally analyzed. All variables related to extremity muscle mass, muscle strength, physical performance, and LEM volume declined over the study period, but the changes were insignificant. However, back extensor strength decreased significantly (median, first, and third quartile: 35.20 [30.80, 44.00] N to 31.40 [29.25, 37.90] N, P = 0.026). Among spinal sagittal balance-related parameters, lumbar lordosis (44.25 [39.30, 47.35]° to 43.15 [31.43, 45.75]°, P = 0.043) and sagittal vertical axis (33.85 [3.57, 58.75] mm to 45.15 [25.35, 58.68] mm, P = 0.004) showed significant changes during the study. CONCLUSIONS When the natural aging course of LEM in women aged 70 years or older was observed for 1 year, muscle mass decreased less than back extensor strength and spinal sagittal balance. Measurements of back extensor strength and spinal sagittal balance are necessary for the clinical evaluation of spinal aging.
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Affiliation(s)
- Dong Hyun Kim
- Department of Radiology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Jinhee Park
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Chang Won Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.
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Lee SY, Lee HJ, Lim JY. Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr 2022; 102:104758. [DOI: 10.1016/j.archger.2022.104758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/02/2022]
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Prognostic Value of Isolated Sarcopenia or Malnutrition-Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients. Nutrients 2022; 14:nu14112207. [PMID: 35684006 PMCID: PMC9182528 DOI: 10.3390/nu14112207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Malnutrition-sarcopenia syndrome (MSS) is frequent in the hospital setting. However, data on the predictive validity of sarcopenia and MSS are scarce. We evaluated the association between sarcopenia and MSS and clinical adverse outcomes (prolonged length of hospital stay-LOS, six-month readmission, and death) using a prospective cohort study involving adult hospitalized patients (n = 550, 55.3 ± 14.9 years, 53.1% males). Sarcopenia was diagnosed according to the EWGSOP2, and malnutrition according to the Subjective Global Assessment (SGA). Around 34% were malnourished, 7% probable sarcopenic, 15% sarcopenic, and 2.5% severe sarcopenic. In-hospital death occurred in 12 patients, and the median LOS was 10.0 days. Within six months from discharge, 7.9% of patients died, and 33.8% were readmitted to the hospital. Probable sarcopenia/sarcopenia had increased 3.95 times (95% CI 1.11-13.91) the risk of in-hospital death and in 3.25 times (95% CI 1.56-6.62) the chance of mortality in six months. MSS had increased the odds of prolonged LOS (OR = 2.73; 95% CI 1.42-5.25), readmission (OR = 7.64; 95% CI 3.06-19.06), and death (OR = 1.15; 95% CI 1.08-1.21) within six months after discharge. Sarcopenia and MSS were predictors of worse clinical outcomes in hospitalized patients.
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Yao R, Yao L, Yuan C, Gao BL. Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia. Front Neurol 2022; 13:880907. [PMID: 35572926 PMCID: PMC9099210 DOI: 10.3389/fneur.2022.880907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/01/2022] [Indexed: 12/21/2022] Open
Abstract
Objective The purpose of this study was to investigate the accuracy of sarcopenia diagnosis in patients with stroke using calf circumference (CC), SARC-F questionnaire, and Ishii's score in comparison with the Asian Working Group for Sarcopenia 2019 (AWGS) sarcopenia diagnostic criteria. Materials and Methods In this cross-sectional study, a total of 364 consecutive patients with stroke were enrolled and evaluated with the CC measurement, SARC-F questionnaire, and Ishii's score. The diagnostic accuracy was analyzed. Results Based on the AWGS criteria, sarcopenia was present in 180 (49.5%) patients, with an age range of 49-74 (mean 63 ± 14.7) years. In all patients, the cutoff value of CC in the accuracy of diagnosing sarcopenia was 30.5 cm, with an AUC of 0.85, sensitivity of 81.8%, specificity of 90.1%, Kappa value of 0.72, and Youden index of 0.72. In the accuracy of diagnosing sarcopenia in all patients, Ishii's score had a cutoff value of 118, AUC of 0.78, sensitivity of 90.1%, specificity of 36.0%, Kappa value of 0.4, and Youden index of 0.55. For accuracy of diagnosing sarcopenia, the SARC-F questionnaire had a cutoff value of 5, AUC of 0.731, sensitivity of 94.7%, specificity of 40%, Kappa value of 0.34, and Youden index of 0.41. Conclusions Based on the AWGS criteria, calf circumference measurement has the optimal performance in screening stroke-related sarcopenia compared with the SARC-F questionnaire and Ishii's score. In patients with stroke, the cutoff value of calf circumference for sarcopenia is < 31 cm in men and 30 cm in women, and with an AUC of 0.85.
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Affiliation(s)
- Ruihong Yao
- Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Rehabilitation Medicine Department, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Changli Yuan
- Rehabilitation Medicine Department, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bu-Lang Gao
- Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China
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Lee SY. Handgrip Strength: An Irreplaceable Indicator of Muscle Function. Ann Rehabil Med 2021; 45:167-169. [PMID: 34233405 PMCID: PMC8273729 DOI: 10.5535/arm.21106] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 01/16/2023] Open
Affiliation(s)
- Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
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