title: Changes in Quadriceps Muscle Thickness, Disease Severity, Nutritional Status, and C-Reactive Protein after Acute Stroke.
abstract: BACKGROUND
  Lower leg muscle wasting is common in stroke patients; however, patient characteristics in the acute phase are rarely studied. This study aimed to examine the relationship between changes in quadriceps muscle thickness and disease severity, nutritional status, and C-reactive protein (CRP) levels after acute stroke.
  
  
  METHODS
  Thirty-one consecutive patients with acute intracerebral hemorrhage or ischemic stroke had quadriceps muscle thickness measured in the paretic and nonparetic limbs within 1 week after admission (first week) and 2 weeks after the first examination (last week) using ultrasonography. We also determined the relationship between the percentage change in muscle thickness and disease severity, nutritional status, and CRP levels on admission.
  
  
  RESULTS
  There was a significant correlation between changes in muscle thickness for both paretic and nonparetic sides and National Institutes of Health Stroke Scale (NIHSS) scores (paretic limb: r = -.46, P = .01; nonparetic limb: r = -.54, P = .002, respectively); however, there was no significant correlation with nutritional status on admission. Quadriceps muscle thickness was reduced more in the CRP-positive (≥.3 mg/dL) patients than in the CRP-negative (<.3 mg/dL) patients in the nonparetic limb (positive: -21.4 ± 12.1, negative: -11.4 ± 16.4%; P = .039), but not in the paretic limb (positive: -23.4 ± 9.0, negative: -19.1 ± 15.7; P = .27).
  
  
  CONCLUSIONS
  A high NIHSS score and a positive CRP on admission were both significantly correlated with decreased quadriceps muscle thickness after acute stroke. Nutritional status on admission was not correlated with changes in quadriceps muscle thickness for these patients.
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan; Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan. Electronic address: nozoe@konan-wu.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nozoe
authors.affiliation: Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanai
authors.affiliation: Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kubo
authors.affiliation: Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kitamura
authors.affiliation: Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Furuichi
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
authors.forename: Sachie
authors.initials: S
authors.lastname: Takashima
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
authors.forename: Kyoshi
authors.initials: K
authors.lastname: Mase
authors.affiliation: Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shimada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015596:Nutrition Assessment; D009752:Nutritional Status; D010291:Paresis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010343:Patient Admission; D011237:Predictive Value of Tests; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: C-reactive protein; Muscle wasting; nutritional status; ultrasonography