Increased intramuscular adipose tissue of the quadriceps is related to decreased activities of daily living in patients who have had a stroke

Naoki Akazawa; Masaki Kishi; Toshikazu Hino; Ryota Tsuji; Kimiyuki Tamura; Akemi Hioka; Hideki Moriyama

doi:10.1016/j.nut.2021.111277

Increased intramuscular adipose tissue of the quadriceps is related to decreased activities of daily living in patients who have had a stroke

Nutrition. 2021 Oct:90:111277. doi: 10.1016/j.nut.2021.111277. Epub 2021 Apr 20.

Authors

Naoki Akazawa¹, Masaki Kishi², Toshikazu Hino², Ryota Tsuji², Kimiyuki Tamura², Akemi Hioka³, Hideki Moriyama⁴

Affiliations

¹ Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Tokushima, Japan. Electronic address: akazawa@tks.bunri-u.ac.jp.
² Department of Rehabilitation, Kasei Tamura Hospital, Wakayama, Wakayama, Japan.
³ Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Tokushima, Japan.
⁴ Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Hyogo, Japan.

PMID: 34010746
DOI: 10.1016/j.nut.2021.111277

Abstract

Objective: This study examined the relationships between intramuscular adipose tissue of the quadriceps on the paretic and non-paretic sides at admission and activities of daily living (ADL) at discharge in patients who had a stroke.

Methods: This prospective cohort study included 44 stroke inpatients. ADL were assessed at discharge using the Barthel index (BI) score. Ultrasound images were acquired at admission using B-mode ultrasound imaging. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed based on echo intensity and muscle thickness, respectively. Relationships between BI score at discharge and quadriceps echo intensity or thickness on the paretic and non-paretic sides were assessed using partial correlation coefficients. Age, sex, days from onset of stroke, Fugl-Meyer assessment lower extremity score, and subcutaneous fat thickness of the thigh were used as the control variables in the partial correlation analysis.

Results: BI score at discharge was significantly related to quadriceps echo intensity on the paretic (partial correlation coefficient = -0.377, P = 0.018) and non-paretic (partial correlation coefficient = -0.364, P = 0.023) sides. By contrast, quadriceps thickness on the paretic (partial correlation coefficient = 0.284, P = 0.075) and non-paretic (partial correlation coefficient = 0.278, P = 0.083) sides were not significantly related to BI score at discharge.

Conclusions: The present study revealed the negative relationship between intramuscular adipose tissue of the quadriceps on the paretic and non-paretic sides at admission and ADL at discharge. Assessments and interventions of intramuscular adipose tissue in the quadriceps may be essential for predicting and improving ADL of patients who have had a stroke.

Keywords: Activities of daily living; Intramuscular adipose tissue; Muscle mass; Quadriceps; Stroke patients.

MeSH terms

Activities of Daily Living*
Adipose Tissue
Humans
Prospective Studies
Quadriceps Muscle / diagnostic imaging
Stroke* / diagnostic imaging