Validity of Quadriceps Muscle Thickness Measurement in Patients with Subacute Stroke during Hospitalization for Assessment of Muscle Wasting and Physical Function.
BACKGROUND
Many patients with stroke have difficulty performing voluntary muscle contraction; thus, measurement of patients' muscle power or leg strength is challenging. We investigated the validity of quadriceps muscle thickness (QMT) measurement using ultrasonography (US) for the assessment of muscle wasting and physical function in patients with subacute stroke during hospitalization for convalescent rehabilitation.


METHODS
Participants included 52 men with ischemic or hemorrhagic stroke (mean age, 69 ± 11 years) who were hospitalized for inpatient convalescent rehabilitation. The QMT of both legs was measured using US, and functional outcome was assessed according to the modified Rankin Scale (mRS) score and the leg motor selectivity score (6 motor stages defined by Brunnstrom).


RESULTS
There was a significant correlation between QMT and leg motor selectivity score (paretic limb: r = .60, P < .001; nonparetic limb: r = .54, P < .001). Additionally, there were significant interaction effects between the QMT of the paretic limb (mRS scores = 1 or 2, 3, 4, and 5 = 3.52 ± .84 cm, 3.19 ± .52 cm, 2.50 ± .46 cm, and 2.20 ± .71 cm, respectively; F = 11.2; P < .0001), the QMT of the nonparetic limb (mRS scores = 1 or 2, 3, 4, and 5 = 3.72 ± .82 cm, 3.16 ± .49 cm, 2.91 ± .54 cm, and 2.42 ± .82 cm, respectively; F = 8.3; P < .001), and functional outcome.


CONCLUSIONS
QMT measurement is a valid method to assess muscle wasting and physical function in patients with subacute stroke during hospitalization for convalescent rehabilitation.
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.
Masafumi
M
Nozoe
Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
Hiroki
H
Kubo
Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
Asami
A
Furuichi
Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
Masashi
M
Kanai
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
Sachie
S
Takashima
Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan.
Shinichi
S
Shimada
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
Kyoshi
K
Mase
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009133:Muscular Atrophy / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D009929:Organ Size; D010291:Paresis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D014463:Ultrasonography / Q000379:methods
Muscle; hospitalization; subacute stroke; ultrasonography