Measuring and Monitoring Skeletal Muscle Mass after Stroke: A Review of Current Methods and Clinical Applications

J Stroke Cerebrovasc Dis. 2021 Jun;30(6):105736. doi: 10.1016/j.jstrokecerebrovasdis.2021.105736. Epub 2021 Mar 20.


Objectives: Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke.

Material and methods: Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke.

Results: In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources.

Conclusions: We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.

Keywords: Bioelectrical impedance analysis; Computed tomography; Diaphragm; Rectus femoris muscle; Sarcopenia; Stroke; Temporal muscle; Ultrasound.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon*
  • Anthropometry
  • Biomarkers / analysis
  • Body Composition*
  • Electric Impedance
  • Humans
  • Muscle, Skeletal / diagnostic imaging*
  • Muscle, Skeletal / physiopathology
  • Nutrition Assessment
  • Nutritional Status
  • Organ Size
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Sarcopenia / diagnostic imaging*
  • Sarcopenia / physiopathology
  • Sarcopenia / therapy
  • Stroke / diagnostic imaging*
  • Stroke / physiopathology
  • Stroke / therapy
  • Stroke Rehabilitation
  • Tomography, X-Ray Computed*
  • Ultrasonography*


  • Biomarkers