Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

Increasing physical activity (PA) is an important rehabilitation target for patients with sub-acute stroke during hospitalization in order to recover physical function and prevent stroke recurrence. However, the characteristics of low PA in stroke patients during hospitalization who were targets for increased intervention have not been reported. The purpose of this study was to investigate the relationship between the daily number of steps and physical function and quadriceps muscle thickness (QMT) in patients with sub-acute stroke during hospitalization for convalescence rehabilitation. Twenty-nine patients with ischemic or haemorrhagic stroke (mean age, 69 ± 11 years) hospitalized for inpatient convalescent rehabilitation were included. PA was measured using a three-dimensional accelerometer that calculates the daily number of steps taken. Physical function was measured by a short physical performance battery (SPPB; 0–12 points) and the leg motor selectivity score (6 motor stages defined by Brunnstrom), and the QMT of both legs was measured using ultrasonography. PA was significantly correlated with the SPPB score (r = 0.63, p = 0.0002), QMT on the paretic side (r = 0.41, p = 0.02), and QMT on non-paretic side (r = 0.56, p = 0.002). There were no significant effects of the leg motor selectivity score on daily PA (F = 1.37, p = 0.27). In the multiple regression analysis, only the SPPB score showed significant linear regression (β = 0.44, p = 0.02). PA in male patients with sub-acute stroke during hospitalization was related to physical function and QMT and not with the severity of paresis.

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Can Hip Joint Position affect Quadriceps Muscle Responses during Knee Extension Exercise?

International Journal of Sports Medicine ◽

10.1055/a-1179-8374 ◽

2020 ◽

Vol 41 (13) ◽

pp. 929-935

Author(s):

Denis César Leite Vieira ◽

Marco Aurélio Araujo Dourado ◽

Lucas Ugliara ◽

Joao Luiz Quagliotti Durigan ◽

Brad J. Schoenfeld ◽

...

Keyword(s):

Vastus Lateralis ◽

Muscle Thickness ◽

Rectus Femoris ◽

Peak Torque ◽

Quadriceps Muscle ◽

Knee Extension ◽

Knee Extensors ◽

Work Output ◽

Before And After ◽

Knee Extension Exercise

AbstractThis study investigated the acute effects of seated and supine knee extension exercise on muscle swelling, torque, and work output. Twelve resistance-trained men performed two isokinetic concentric-only knee-extension training protocols at different hip positions in a counter-balanced order. They completed the knee extension exercise in the seated (hip angle at 85°) and supine (hip angle at 180°) positions. The torque and work output were assessed during each set. Moreover, muscle thickness of the middle and proximal vastus lateralis and rectus femoris were evaluated before and after each protocol and used as an indicator of muscle swelling. Middle rectus femoris and proximal vastus lateralis thickness increased significantly (p=0.01) with no difference between exercise variations. However, the middle vastus lateralis thickness increased (p=0.01) only after the seated knee extension exercise (~7%). Knee extensors’ peak torque and work output were approximately 8% higher (p=0.04) in the seated when compared to the supine hip position. There was a similar decrease in torque and work output throughout both protocols (p=0.98). In conclusion, seated knee extension exercises produced greater torque, work output, and muscle swelling in the vastus lateralis when compared to the supine knee extension exercise.

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The Effects of Anterior Cruciate Ligament Reconstruction on Individual Quadriceps Muscle Thickness and Circulating Biomarkers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16244895 ◽

2019 ◽

Vol 16 (24) ◽

pp. 4895 ◽

Cited By ~ 2

Author(s):

Jae-Ho Yang ◽

Seung-Pyo Eun ◽

Dong-Ho Park ◽

Hyo-Bum Kwak ◽

Eunwook Chang

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Muscle Atrophy ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Circulating Biomarkers ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Anterior cruciate ligament reconstruction (ACLR) frequently results in quadriceps atrophy. The present study investigated the effect of ACLR on the muscle thickness of the different constituent muscles of the quadriceps and circulating biomarkers related to muscle atrophy and hypertrophy. Fourteen subjects underwent anterior cruciate ligament reconstruction following injury. Quadriceps muscle thicknesses were measured using ultrasound, and circulating biomarkers in the blood were measured using enzyme-linked immunosorbent assays (ELISAs) at the preoperative visit (PRE) and at two postoperative visits (PO1, PO2) in the early stages post-surgery. Differences between time points were analyzed using one-way repeated measures analysis of variance (ANOVA) tests. The most important finding was that severe muscle atrophy occurred in the vastus intermedius (VI) after ACLR (PRE: 20.45 ± 6.82 mm, PO1: 16.05 ± 6.13 mm, PO2: 13.18 ± 4.7 mm, F = 59.0, p < 0.001). Furthermore, the myostatin level was slightly increased, and IGF-1 was significantly reduced throughout the entire period. Therefore, we suggest that inducing selective hypertrophy in the vastus intermedius during the process of rehabilitation would be important for athletes and individuals who engage in explosive sports. Moreover, inhibiting myostatin level increases and maintaining IGF-1 levels in the early phase of recovery after ACLR to prevent muscle atrophy may provide a pharmaceutical option for rehabilitation after anterior cruciate ligament injury.

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Reliability of standardized ultrasound measurements of quadriceps muscle thickness in neurological critically ill patients: a comparison to computed tomography measures.

Journal of Rehabilitation Medicine ◽

10.2340/16501977-2638 ◽

2020 ◽

pp. 0

Author(s):

C Tourel ◽

L Burnol ◽

J Lanoiselé ◽

S Molliex ◽

M Viallon ◽

...

Keyword(s):

Computed Tomography ◽

Critically Ill ◽

Critically Ill Patients ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Ultrasound Measurements

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Changes in Quadriceps Muscle Thickness, Disease Severity, Nutritional Status, and C-Reactive Protein after Acute Stroke

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2016.06.020 ◽

2016 ◽

Vol 25 (10) ◽

pp. 2470-2474 ◽

Cited By ~ 18

Author(s):

Masafumi Nozoe ◽

Masashi Kanai ◽

Hiroki Kubo ◽

Yuka Kitamura ◽

Miho Yamamoto ◽

...

Keyword(s):

Nutritional Status ◽

Acute Stroke ◽

Disease Severity ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

C Reactive Protein ◽

Reactive Protein

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Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

European Neurology ◽

10.1159/000500415 ◽

2019 ◽

Vol 81 (1-2) ◽

pp. 56-62 ◽

Cited By ~ 1

Author(s):

Hisashi Maeda ◽

Ken Imada ◽

Koji Ishida ◽

Hiroshi Akima

Keyword(s):

Muscle Thickness ◽

Quadriceps Muscle ◽

Muscle Quality ◽

Quality Loss ◽

Echo Intensity ◽

Stroke Patients ◽

Post Stroke ◽

Paretic Limb ◽

Motor Paralysis ◽

Relationship Of

Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage (β = –0.26, p < 0.01), body weight (β = 0.68, p < 0.01), and serum albumin (β = 0.34, p < 0.01), with an adjusted R2 of 0.81. The MT in the non-paretic limb was explained by the muscle EI (β = –0.55, p < 0.01) and age (β = –0.40, p < 0.01), with an adjusted R2 of 0.69. The muscle EI was explained by the MT in the paretic limb (β = –0.34, p < 0.01) and non-paretic limb (β = –0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.

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