Association of Admission Sarcopenia With 3-Month Recovery of Trunk Control and Gait in Subacute Stroke Patients With Impaired Balance

Objective: To examine whether sarcopenia at rehabilitation admission is associated with 3-month recovery of balance, trunk control, and gait in subacute stroke patients with impaired balance.Methods: This retrospective cohort study included 49 subacute stroke patients who received inpatient rehabilitation for at least 3 months. Participants were classified at admission into sarcopenia group (SG, n=18) and non-sarcopenia group (NSG, n=31) according to the Asian Working Group for Sarcopenia 2019 criteria, using unaffected-side grip strength and skeletal muscle index. The Berg Balance Scale (BBS) was the principal outcome, with the Korean- Trunk Impairment Scale (K-TIS), Motricity Index of Lower Extremity (MI-LE), and Functional Ambulation Category (FAC) as secondary outcomes. Changes were compared by analysis of covariance adjusted for baseline, and threshold-based proportions by Fisher’s exact test.Results: Baseline outcome scores were comparable except for a lower FAC in the SG (p=0.02). After 3 months, the NSG showed greater improvements in all four outcomes, with significant baseline-adjusted differences after Bonferroni correction for BBS (5.87; 95% confidence interval [CI], 1.98 to 9.76), K-TIS (3.68; 95% CI, 1.52 to 5.83), and MI-LE (8.75; 95% CI, 4.65 to 12.85), persisting under stepwise covariate adjustment. The ordinal FAC was compared categorically: fewer SG patients improved by ≥1 category (22.2% vs. 58.1%, p=0.02).Conclusion: Sarcopenia assessed at rehabilitation admission was associated with smaller 3-month gains in trunk control, balance, lower extremity muscle strength, and gait in this selected cohort of subacute stroke inpatients. Prospective studies with pre-stroke or hyperacute muscle assessment are needed to determine whether premorbid sarcopenia independently predicts recovery.