Impact of trunk and appendicular skeletal muscle mass on improving swallowing function in acute stroke patients

J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106636. doi: 10.1016/j.jstrokecerebrovasdis.2022.106636. Epub 2022 Jul 30.

Abstract

Objectives: To investigate the effect of trunk and appendicular skeletal muscle mass on the swallowing function at discharge in acute stroke patients.

Materials and methods: This retrospective cohort study included patients hospitalized after acute strokes. Skeletal muscle mass was measured by bioelectrical impedance analysis within 5 days of admission. The primary outcome was swallowing function at acute hospital discharge, assessed using the Functional Oral Intake Scale (FOIS). Secondary outcomes were Functional Independence Measure-eating (FIM-eating) scores and length of hospital stay.

Results: Data from 231 patients (age 72.2 years; 151 men) were included in the analysis. The median trunk muscle mass index (TMI) was 8.2 and 6.8 kg/m2 in men and women, respectively. The median appendicular skeletal muscle mass index (ASMI) was 7.7 and 5.7 kg/m2 in men and women, respectively. The high TMI group had higher FIM-eating scores at discharge in each sex (p < 0.001). The high ASMI group had higher FOIS (p = 0.039 and 0.048) and FIM-eating scores at discharge (p = 0.046 and 0.047) in men and women, respectively. On multivariate analysis, TMI was independently associated with FIM-eating scores (β = 0.330, p < 0.001); ASMI was independently associated with FOIS (β = 0.229, p = 0.039) and FIM-eating scores (β = 0.111, p = 0.032).

Conclusions: Skeletal muscle mass had site-specific impacts on swallowing function and eating activities. This finding may contribute to the design of more individualized rehabilitation programs.

Keywords: Acute phase; Cerebrovascular disease dysphagia; Sarcopenia; Skeletal muscle mass.

MeSH terms

  • Aged
  • Deglutition
  • Female
  • Humans
  • Male
  • Muscle, Skeletal
  • Retrospective Studies
  • Stroke Rehabilitation*
  • Stroke* / complications
  • Stroke* / diagnosis
  • Stroke* / therapy