Deans' stroke musings: Predictive ability of hand-grip strength and muscle mass on functional prognosis in stroke rehabilitation patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, May 9, 2022

Predictive ability of hand-grip strength and muscle mass on functional prognosis in stroke rehabilitation patients

But you're not predicting recovery, you're predicting failure to recover. SOLVE THE FUCKING 100% RECOVERY PROBLEM. SURVIVORS WANT NOTHING LESS.

ShintaNishiokaPh.D.AnnaYamanouchi YukaOkazaki KanaOishi RyuseiNakashima YoshiharuTokunagaM.D., Ph. D.ShinyaOnizukaM.D., Ph. D.

https://doi.org/10.1016/j.nut.2022.111724 Get rights and content

Highlights

•: Hand-grip strength independently predicted functional outcomes in stroke patients.
•: Adjusted skeletal muscle mass index did not show the relationship with the outcome.
•: The cutoff value of hand-grip strength for returning home was 15.1 kg for males.
•: For females, 9.5 kg was the cutoff value of hand-grip strength for returning home.

Abstract

Objective

: To investigate the association of muscle strength and adjusted appendicular skeletal muscle mass (ASM) with the Functional Independence Measure (FIM) and the probability of returning home in stroke patients.

Research Methods & Procedure

: A retrospective cohort study was conducted for older stroke patients admitted to convalescent rehabilitation wards between January 2017 and October 2020. Hand-grip strength (HGS) was used to assess muscle strength. ASM was measured by bioelectrical impedance analysis and then divided by height-squared, body weight, body mass index, body fat mass, and body fat percentage to calculate the adjusted ASM. The primary outcome was FIM at discharge and the secondary outcome was the probability of returning home. Multivariate analyses were conducted to adjust confounding effects.

Results

: The data of 699 participants (female, 47%; median age, 79 years) were analyzed. HGS was independently associated with FIM at discharge in males (partial regression coefficient [B] = 0.482; 95% confidence interval [CI] = 0.225–0.740) and females (B = 0.664; 95% CI = 0.263–1.065) and with returning home in males (odds ratio [OR] = 1.070; 95% CI = 1.030–1.100) and females (OR = 1.070 [95% CI = 1.000–1.130). Conversely, none of the adjusted ASM indices were associated with the outcomes. The cutoff value of HGS for returning home was 15.1 kg for males and 9.5 kg for females

Conclusions

: HGS independently predicted FIM at discharge and the probability of returning home(Not good enough! Are you even measuring 100% recovery? No, then you are OK with failure! Survivors aren't!) in stroke patients. The adjusted ASM methods had less predictive value for functional and discharge outcomes.