Aging after stroke: how to define post-stroke sarcopenia and what are its risk factors?
Sheng Li, Javier Gonzalez-Buonomo, Jaskiran Ghuman and 7 others
PMID 36062331WHAT IT FOUND
Standard sarcopenia tests fail in chronic stroke survivors because the weak paretic hand triggers false positives.
When using only the unaffected hand, prevalence drops to 18-25%. The affected upper limb loses more muscle and bone than the lower limb, suggesting walking and spasticity protect the legs.
Key findings
01Using the paretic hand for grip strength diagnosis falsely labels almost all chronic stroke survivors as having sarcopenia, whereas using the unaffected hand yields a prevalence of 18-25%.
02Relative muscle loss is significantly greater than bone loss in the affected limbs, and both are much greater in the upper limb than the lower limb.
03Higher spasticity in the lower limb is marginally associated with less muscle loss, suggesting involuntary muscle activation may be protective.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study is cross-sectional, so it cannot determine if sarcopenia worsens over time or if specific factors cause it. The sample size was small (28 participants), which limited the statistical power to detect risk factors. Most participants had received botulinum toxin injections, which can cause muscle atrophy, making it difficult to separate the effects of the injections from the effects of stroke. The findings only apply to chronic survivors who can already walk, so they do not generalize to non-ambulatory patients or those in the early stages of recovery.
Declared interests
No conflicts of interest or funding sources are reported in the provided text.
The easy way to misread this
Do not interpret the high prevalence of sarcopenia using affected-hand grip strength as evidence of severe systemic muscle wasting. It is an artifact of the stroke-induced weakness in that specific hand. The true prevalence of low muscle mass is lower, around 18-25%, when using the unaffected hand.