Skeletal Muscle Changes in the First Three Months of Stroke Recovery: A Systematic Review.

David Beckwée, Lotte Cuypers, Nina Lefeber, Emma De Keersmaecker, Ellen Scheys, Wout Van Hees, Stany Perkisas, Sylvie De Raedt, Eric Kerckhofs, Ivan Bautmans, Eva Swinnen

Journal: Journal of rehabilitation medicine 2022;54():jrm00308

PMID: 35848335

Free Full Text on PubMed Central View on PubMed

Abstract

BACKGROUND

Rehabilitation is important in the first months after a stroke for recovery of functional ability, but it is also challenging, since distinct recovery trajectories are seen. Therefore, studying the early changes in muscle characteristics over time (e.g. muscle strength, muscle mass and muscle volume), which are known to be associated with functional abilities, may deepen our understanding of underlying recovery mechanisms of stroke survivors.

OBJECTIVE

This systematic review aims to describe the longitudinal changes in skeletal muscles, including muscle strength, muscle mass and muscle volume, during the first 3 months post-stroke.

METHODS

Electronic searches were conducted in Medline, Scopus and CENTRAL. Longitudinal cohort studies or controlled interventional trials that report data about patients in the first 3 months after stroke were identified. Skeletal muscle characteristics should be measured at least twice within 3 months post-stroke by objective, quantitative assessment methods (e.g. dynamometry, ultrasound, computed tomography). Effect sizes were calculated as Hedges' g using standardized mean differences.

RESULTS

A total of 38 studies (1,097 subjects) were found eligible. Results revealed an mean increase on the paretic side for upper and lower limb muscle strength (small to moderate effect sizes), whereas muscle thickness decreased (moderate to large effect sizes). Similar, but smaller, effects were found on the non-paretic side. There were insufficient data available to draw conclusions about lean muscle mass and muscle cross-sectional area. No studies aimed at investigating distinct trajectories of the muscle changes.

CONCLUSION

Muscle strength and thickness changes during the first 3 months after stroke in both the paretic and non-paretic side. Future studies should aim to understand "how" the stroke-induced muscle strength changes are achieved. Exploring existing data from longitudinal studies, by using cluster analyses, such as pattern recognition, could add to the current knowledge-base.

Address: Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium. [email protected].; Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium.; Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; Movement and Nutrition for Health and Performance research group, Vrije Universiteit Brussel, Brussels, Belgium.; Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium.; Ziekenhuis Netwerk Antwerpen (ZNA), University Center for Geriatrics, Antwerp, Belgium.; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium.; Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium.; Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium.

DOI: 10.2340/jrm.v54.573

Link outs

Free resources

Full Text Sources:

Medical:

MeSH Terms: Humans, Longitudinal Studies, Muscle, Skeletal, Muscular Diseases, Paresis, Stroke, Stroke Rehabilitation