Association between decreased paretic quadriceps muscle thickness in the acute phase of stroke and functional outcomes at 3 months

BACKGROUND: Skeletal muscle mass is important for functional recovery after stroke. The association between acute-phase longitudinal muscle loss and subsequent functional outcomes has not been fully elucidated. OBJECTIVE: We examined whether early changes in paretic quadriceps muscle thickness are associated with functional outcomes at 3 months after acute stroke. METHODS: This post-hoc analysis used data from a randomized controlled trial in patients with acute stroke. Forty-nine patients with acute stroke (National Institutes of Health Stroke Scale [NIHSS] ≥4) were included. Quadriceps muscle thickness was measured using ultrasound at admission and 2 weeks later. The percentage change in paretic quadriceps muscle thickness was used as the primary independent variable. Functional outcome at 3 months was assessed using the modified Rankin Scale and dichotomized as favorable (0-3) or poor (4-6). Modified Poisson regression analyses were performed, adjusting for age and admission NIHSS. RESULTS: = 0.010). No significant association was observed for changes in non-paretic muscle thickness. CONCLUSIONS: Greater acute-phase reduction in paretic quadriceps muscle thickness was independently associated with poor functional outcomes at 3 months after stroke and may provide clinically useful information for early prognostic prediction.