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Published on: February 1, 2018
Association between sarcopenia and MCID-defined motor recovery in patients with paraplegia following spinal cord
Jeonga Seo1, Minjae Cho2, Seongeun Park1
1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Study Design:
Retrospective cohort study.
Objectives:
To evaluate the association between appendicular skeletal muscle mass index (ASMI) and minimal clinically important difference (MCID)-defined motor recovery in patients with paraplegia due to spinal cord injury (SCI), and to identify ASMI thresholds associated with MCID-defined motor recovery.
Setting:
Single tertiary rehabilitation center.
Methods:
Adult participants with thoracic or lumbar SCI admitted within 6 months of injury between 2017 and 2025 were included. ASMI was measured at admission using bioelectrical impedance analysis. The primary outcome was MCID-defined improvement in lower extremity motor score (LEMS) during inpatient rehabilitation. Logistic regression and receiver operating characteristic analyses were performed. Subgroup and interaction analyses were conducted.
Results:
A total of 204 patients were analyzed, of whom 111 (54.4%) achieved MCID-defined recovery. Higher ASMI was independently associated with MCID achievement (adjusted OR 1.52, 95% CI 1.04-2.27; p = 0.035). The multivariable model showed good discrimination (AUC 0.82), whereas ASMI alone had limited performance (AUC 0.59). Sex-specific ASMI thresholds were identified (6.97 kg/m² in males and 5.85 kg/m² in females), with higher discrimination in females. Patients above these thresholds had greater LEMS improvement and higher functional scores at discharge. Significant interactions were observed for sex and injury completeness.
Conclusions:
Higher ASMI at admission is associated with greater likelihood of clinically meaningful motor recovery in paraplegic SCI. ASMI may serve as a practical adjunct marker for outcome stratification, and the sex-specific thresholds may help contextualize muscle mass status in relation to motor recovery after paraplegic SCI.
