Skeletal muscle changes following stroke: a systematic review and comparison to healthy individuals.
Jennifer L Hunnicutt, Chris M Gregory
PMID 28251861WHAT IT FOUND
Chronic stroke paretic leg lean mass averaged 92% of nonparetic leg lean mass, and paretic knee extensor strength averaged 64% of nonparetic strength.
Both limbs showed knee extensor strength deficits relative to age-matched controls.
Key findings
01Paretic leg lean mass averaged 92% of nonparetic leg lean mass, paretic thigh muscle size averaged 87%, and paretic lower leg muscle size averaged 95%.
02Paretic knee extensor strength averaged 64% of nonparetic strength, knee flexor strength averaged 65%, dorsiflexor strength averaged 65%, and plantarflexor strength averaged 48%.
03Relative to age-matched control data, paretic and nonparetic knee extensor strength exhibited deficits. Compared with adults 10 years older than the stroke sample, the paretic limb showed significant deficits in muscle size and strength.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Risk of bias was high because the review included many study designs, and several studies lacked blinding or complete outcome data. The included stroke participants were mostly mid to high functioning independent walkers, so the findings may not apply to more severely impaired patients. Different methods and units prevented pooling of all muscle size and strength data, so the review used relative comparisons instead. None of the included studies measured total body skeletal muscle mass, which is the outcome recommended for sarcopenia diagnosis. The search required studies to report both muscle size and strength, so studies reporting only one may have been missed.
The easy way to misread this
Do not read these muscle deficits as proof that strength training will improve walking. The review measured muscle size and strength across observational studies and did not test an intervention.