Longitudinal assessment of lower limb muscle quantity and quality in acute stroke patients

This longitudinal study evaluated acute-phase stroke patients, examining changes in skeletal muscle quantity and quality. The research aimed to determine when muscle quality deteriorates, its relationship with muscle quantity, and contributing factors.

Prospective observational study.

Forty stroke patients.

Muscle quantity was assessed as the thickness of the anterior and lateral mid-thigh, while muscle quality was assessed by echo intensity of the rectus femoris and vastus lateralis. Measurements on paretic and non-paretic limbs were taken on the first day after stroke onset and on the 10th day.

Muscle thickness of all regions of paretic and non-paretic limbs significantly decreased at 10 days, whereas echo intensity significantly increased only in the paretic limb. A significant negative correlation between changes in muscle thickness and echo intensity was observed in the paretic limb only. Multiple regression analysis revealed that the only variable that explains the changes in echo intensity was the changes in muscle thickness of the paretic limb.

Muscle quality begins to deteriorate as early as the acute phase of stroke. To prevent this deterioration, it is important to encourage skeletal muscle activity during the acute phase of immobilization and to minimise the reduction in muscle quantity.