Clinical Nutrition ESPEN · May 16, 2025

Muscle mass at admission and increased muscle mass during hospitalization as predictors for improved walking function in patients with stroke

By Sato K, Arasaki N, Agena S et al.

BACKGROUND & AIMS: The muscle mass at hospital admission that contributes the most to improved walking ability and the muscle mass to focus on during hospitalization have not yet been fully investigated. This study examined the effects of site-specific muscle mass measurements at admission and their increase during hospitalization on walking ability (walking independence and walking speed) of patients with cerebral infarction at discharge from the hospital. METHODS: This study included patients with cerebral infarction aged ≥65 years. Patients were considered to be walking independently if they had a Functional Independence Measure locomotion walking score ≥6. Walking speed was evaluated using the 10-min walking test. The primary and secondary outcome measures were independent walking and walking speed, respectively. RESULTS: The average age of the 135 participants was 77.2 years; 78 (57.8 %) were men. The multivariate logistic regression analysis demonstrated no significant association between muscle mass (at admission or its gain during hospitalization) and independent walking at discharge. However, it also revealed that the limb muscle mass index (LMI) at admission and an increase in the LMI on the paralyzed side during hospitalization were independently associated with the comfortable and fastest walking speeds. CONCLUSION: For patients with cerebral infarction, muscle mass at admission and its increase during hospitalization were associated with walking speed, not with walking independence. These findings suggest that early assessment and targeted interventions to maintain or increase muscle mass, particularly on the paralyzed side, may benefit walking speed and mobility improvements of these patients during rehabilitation.

doi.org/10.1016/j.clnesp.2025.05.016PubMed 40383257Populations