Abstract
Objectives
This study aimed to examine the relationship between muscle mass and intramuscular
adipose tissue of the quadriceps at post-acute care admission and recovery of swallowing
ability in patients with stroke.
Design
Prospective study.
Setting and Participants
This study was hospital-based and included 62 inpatients with stroke.
Methods
The primary outcome was swallowing ability at discharge. The swallowing ability was
assessed using the Food Intake Level Scale (FILS). The FILS change was calculated
by subtracting FILS at admission from FILS at discharge. Ultrasound images were acquired
at admission using B-mode ultrasound imaging. Muscle mass and intramuscular adipose
tissue of the quadriceps were assessed based on muscle thickness and echo intensity,
respectively. The mean muscle thickness and echo intensity of the right and left quadriceps
were used in the analysis. A multiple regression analysis was performed to identify
the factors independently associated with the FILS at discharge and FILS change. The
independent variables were the muscle thickness and echo intensity of the quadriceps,
FILS at admission, age, sex, body mass index, days from stroke onset, C-reactive protein,
updated Charlson comorbidity index, number of medications, unit number of rehabilitation
therapy, and Barthel Index score at admission.
Results
Muscle thickness of the quadriceps was significantly and independently associated
with FILS at discharge (β = 0.27) and FILS change (β = 0.40). Echo intensity of the
quadriceps was not significantly and independently associated with FILS at discharge
(β = 0.22) and FILS change (β = 0.31).
Conclusions and Implications
Our results indicated that greater quadriceps muscle mass at post-acute care admission
was associated with better swallowing ability at discharge in patients with stroke.
Assessing muscle mass of the quadriceps at admission is important for predicting recovery
of swallowing ability and interventions for quadriceps muscle mass may be effective
for improving swallowing ability of patients with stroke.
Keywords
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Article info
Publication history
Published online: May 20, 2021
Footnotes
This work was supported by JSPS KAKENHI, Japan Grant Number JP17K18294, JP20K19661.
The authors declare that there is no conflict of interest.
Identification
Copyright
© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
