Objectives: This study aimed to investigate the association between muscle strength and adjusted appendicular skeletal muscle mass (ASM) in patients who have had strokes with the Functional Independence Measure (FIM) and the probability of being discharged.
Methods: A retrospective cohort study was conducted for older patients who have had strokes admitted to convalescent rehabilitation wards between January 2017 and October 2020. Hand-grip strength (HGS) was used to assess muscle strength. ASM was measured with a bioelectrical impedance analysis, and then divided by height-squared, body weight, body mass index (BMI), body fat mass (BFM), and body fat percentage (BFP) to calculate the adjusted ASM. The primary outcome was FIM at the time of discharge, and the secondary outcome was the probability of being discharged to their home. Multivariate analyses were conducted to adjust for confounding effects.
Results: The data of 699 participants (female: 47%; median age, 79 y) were analyzed. HGS was independently associated with FIM at the time of discharge in men (partial regression coefficient [B] = 0.482; 95% confidence interval [CI], 0.225-0.740) and women (B = 0.664; 95% CI, 0.263-1.065) and also was independently associated with being discharged to their home in men (odds ratio [OR]: 1.070; 95% CI, 1.030-1.100) and women (OR: 1.070; 95% CI, 1.000-1.130). Conversely, none of the adjusted ASM indices were associated with the outcomes. The cutoff value of HGS for discharge to home was 15.1 kg for men and 9.5 kg for women.
Conclusions: In patients who have had strokes, HGS independently predicted FIM at the time of discharge and the probability of being discharged to their home. The adjusted ASM methods had less predictive value for functional and discharge outcomes.
Keywords: Activities of daily living; Muscle mass; Muscle strength; Rehabilitation; Stroke.
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