亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度と関連要因の検討
〔目的〕亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度に関連する要因を検討した．〔対象と方法〕対象は亜急性期入院脳卒中患者41名とした．超音波診断装置により大腿直筋と内側広筋の筋厚と筋輝度を測定し，健患差を比較した．各筋厚，筋輝度と年齢，体格，罹患期間，栄養状態，病前の歩行能力，運動麻痺の重症度，歩行能力との間で相関分析と重回帰分析を行った．〔結果〕筋厚，筋輝度ともに有意な健患差を認めなかった．麻痺側内側広筋の筋厚で，病前の歩行能力に加えて罹患期間や運動麻痺の重症度が関連した．〔結語〕麻痺側内側広筋の筋厚は，運動麻痺が重度で病前の歩行能力が低く，罹患期間が長期化した者で低値を示す傾向にあ...
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| Published in | 理学療法科学 Vol. 37; no. 1; pp. 39 - 44 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
理学療法科学学会
2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-1667 2434-2807 |
| DOI | 10.1589/rika.37.39 |
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| Abstract | 〔目的〕亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度に関連する要因を検討した．〔対象と方法〕対象は亜急性期入院脳卒中患者41名とした．超音波診断装置により大腿直筋と内側広筋の筋厚と筋輝度を測定し，健患差を比較した．各筋厚，筋輝度と年齢，体格，罹患期間，栄養状態，病前の歩行能力，運動麻痺の重症度，歩行能力との間で相関分析と重回帰分析を行った．〔結果〕筋厚，筋輝度ともに有意な健患差を認めなかった．麻痺側内側広筋の筋厚で，病前の歩行能力に加えて罹患期間や運動麻痺の重症度が関連した．〔結語〕麻痺側内側広筋の筋厚は，運動麻痺が重度で病前の歩行能力が低く，罹患期間が長期化した者で低値を示す傾向にあった．亜急性期脳卒中患者の大腿部骨格筋の筋厚，筋輝度にはそれぞれ異なる要因が関連していた． |
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| AbstractList | 〔目的〕亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度に関連する要因を検討した．〔対象と方法〕対象は亜急性期入院脳卒中患者41名とした．超音波診断装置により大腿直筋と内側広筋の筋厚と筋輝度を測定し，健患差を比較した．各筋厚，筋輝度と年齢，体格，罹患期間，栄養状態，病前の歩行能力，運動麻痺の重症度，歩行能力との間で相関分析と重回帰分析を行った．〔結果〕筋厚，筋輝度ともに有意な健患差を認めなかった．麻痺側内側広筋の筋厚で，病前の歩行能力に加えて罹患期間や運動麻痺の重症度が関連した．〔結語〕麻痺側内側広筋の筋厚は，運動麻痺が重度で病前の歩行能力が低く，罹患期間が長期化した者で低値を示す傾向にあった．亜急性期脳卒中患者の大腿部骨格筋の筋厚，筋輝度にはそれぞれ異なる要因が関連していた． 「要旨」: 〔目的〕亜急性期脳卒中患者における大腿部骨格筋の筋厚, 筋輝度に関連する要因を検討した. 〔対象と方法〕対象は亜急性期入院脳卒中患者41名とした. 超音波診断装置により大腿直筋と内側広筋の筋厚と筋輝度を測定し, 健患差を比較した. 各筋厚, 筋輝度と年齢, 体格, 罹患期間, 栄養状態, 病前の歩行能力, 運動麻痺の重症度, 歩行能力との間で相関分析と重回帰分析を行った. 〔結果〕筋厚, 筋輝度ともに有意な健患差を認めなかった. 麻痺側内側広筋の筋厚で, 病前の歩行能力に加えて罹患期間や運動麻痺の重症度が関連した. 〔結語〕麻痺側内側広筋の筋厚は, 運動麻痺が重度で病前の歩行能力が低く, 罹患期間が長期化した者で低値を示す傾向にあった. 亜急性期脳卒中患者の大腿部骨格筋の筋厚, 筋輝度にはそれぞれ異なる要因が関連していた. |
| Author | 松岡, 秀典 星野, 涼 五十嵐, 達也 臼田, 滋 |
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| DOI | 10.1589/rika.37.39 |
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| References | 10) Maeda H, Imada K, Ishida K, et al.: Relationship of quadriceps muscle thickness with motor paralysis and muscle echo intensity in post-stroke patients. Eur Neurol, 2019, 81: 56-62. 3) Pillen S, Tak RO, Zwarts MJ, et al.: Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol, 2009, 35: 443-446. 23) Pinto RS, Correa CS, Radaelli R, et al.: Short-term strength training improves muscle quality and functional capacity of elderly women. Age (Dordr), 2014, 36: 365-372. 14) Nozoe M, Kanai M, Kubo H, et al.: Changes in quadriceps muscle thickness, disease severity, nutritional status, and C-reactive protein after acute stroke. J Stroke Cerebrovasc Dis, 2016, 25: 2470-2474. 29) Rosenberg IH: Summary comments: epidemiological and methodological problem in determining nutritional status of older persons. Am J Clin Nutr, 1989, 50: 1231-1233. 12) Maeda H, Imada K, Ishida K, et al.: Quadriceps thickness and echo intensity predict gait independence in individuals with severe and mild hemiparetic stroke. Eur Neurol, 2020, 83: 167-173. 15) Nozoe M, Kanai M, Kubo H, et al.: Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke. J Clin Neurosci, 2020, 74: 141-145. 2) Reimers K, Reimers CD, Wagner S, et al.: Skeletal muscle sonography: a correlative study of echogenicity and morphology. J Ultrasound Med, 1993, 12: 73-77. 28) Nozoe M, Kubo H, Furuichi A, et al.: Validity of quadriceps muscle thickness measurement in patients with subacute stroke during hospitalization for assessment of muscle wasting and physical function. J Stroke Cerebrovasc Dis, 2017, 26: 438-441. 16) Kokura Y, Kato M, Taniguchi Y, et al.: Energy intake during the acute phase and changes in femoral muscle thickness in older hemiplegic inpatients with stroke. Nutrition, 2020, 70: 110582. 20) Bouillanne O, Morineau G, Dupont C, et al.: Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr, 2005, 82: 777-783. 27) Fox TA: Dysplasia of the quadriceps mechanism: hypoplasia of the vastus medialis muscle as related to the hypermobile patella syndrome. Surg Clin North Am, 1975, 55: 199-226. 25) 五十嵐達也，松岡秀典，星野, 涼・他：急性期入院脳卒中者における超音波診断装置を用いた下肢筋厚，筋輝度測定の信頼性と最小可検変化量の検証．理学療法科学，2021, 36: 239-246. 18) Holden MK, Gill KM, Magliozzi MR, et al.: Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther, 1984, 64: 35-40. 22) English CK, Thoirs KA, Fisher L, et al.: Ultrasound is a reliable measure of muscle thickness in acute stroke patients, for some, but not all anatomical sites: a study of the intra-rater reliability of muscle thickness measures in acute stroke patients. Ultrasound Med Biol, 2012, 38: 368-376. 7) Nozoe M, Kanai M, Kubo H, et al.: Changes in quadriceps muscle thickness in acute non-ambulatory stroke survivors. Top Stroke Rehabil, 2016, 23: 8-14. 13) Ishimoto T, Taniguchi Y, Akazawa N: Longitudinal relationship between intramuscular fat in the quadriceps and gait independence in convalescent stroke patients. J Stroke Cerebrovasc Dis, 2020, 29: 105287. 9) Ryan AS, Dobrovolny CL, Smith GV, et al.: Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients. Arch Phys Med Rehabil, 2002, 83: 1703-1707. 5) Yuguchi S, Asahi R, Kamo T, et al.: Gastrocnemius thickness by ultrasonography indicates the low skeletal muscle mass in Japanese elderly people. Arch Gerontol Geriatr, 2020, 90: 104093. 11) Monjo H, Fukumoto Y, Asai T, et al.: Muscle thickness and echo intensity of the abdominal and lower extremity muscles in stroke survivors. J Clin Neurol, 2018, 14: 549-554. 19) Brunnstrom S: Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther, 1966, 46: 357-375. 24) Wilhelm EN, Rech A, Minozzo F, et al.: Relationship between quadriceps femoris echo intensity, muscle power, and functional capacity of older men. Age (Dordr), 2014, 36: 9625. 6) Yamada M, Kimura Y, Ishiyama D, et al.: Differential characteristics of skeletal muscle in community-dwelling older adults. J Am Med Dir Assoc, 2017, 18: 807.e9-807.e16. 21) Data Management Service of the Uniform Data System for Medical Rehabilitation and the Center for Functional Assessment Research: Guide for Use of the Uniform Data Set for Medical Rehabilitation, version 3.1. State University of New York at Buffalo, Buffalo, 1990. 4) Fukumoto Y, Ikezoe T, Yamada Y, et al.: Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol, 2012, 112: 1519-1525. 1) Ryan AS, Ivey FM, Prior S, et al.: Skeletal muscle hypertrophy and muscle myostatin reduction after resistive training in stroke survivors. Stroke, 2011, 42: 416-420. 17) Nozoe M, Kanai M, Kubo H, et al.: Prestroke sarcopenia and functional outcomes in elderly patients who have had an acute stroke: a prospective cohort study. Nutrition, 2019, 66: 44-47. 8) Monjo H, Fukumoto Y, Asai T, et al.: Differences in muscle thickness and echo intensity between stroke survivors and age- and sex-matched healthy older adults. Phys Ther Res, 2020, 23: 188-194. 26) Domholdt E: Physical Therapy Research: Principles and Applications, 2nd ed. WB Saunders, Philadelphia, 2000, pp347-335. |
| References_xml | – reference: 21) Data Management Service of the Uniform Data System for Medical Rehabilitation and the Center for Functional Assessment Research: Guide for Use of the Uniform Data Set for Medical Rehabilitation, version 3.1. State University of New York at Buffalo, Buffalo, 1990. – reference: 18) Holden MK, Gill KM, Magliozzi MR, et al.: Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther, 1984, 64: 35-40. – reference: 25) 五十嵐達也，松岡秀典，星野, 涼・他：急性期入院脳卒中者における超音波診断装置を用いた下肢筋厚，筋輝度測定の信頼性と最小可検変化量の検証．理学療法科学，2021, 36: 239-246. – reference: 2) Reimers K, Reimers CD, Wagner S, et al.: Skeletal muscle sonography: a correlative study of echogenicity and morphology. J Ultrasound Med, 1993, 12: 73-77. – reference: 7) Nozoe M, Kanai M, Kubo H, et al.: Changes in quadriceps muscle thickness in acute non-ambulatory stroke survivors. Top Stroke Rehabil, 2016, 23: 8-14. – reference: 4) Fukumoto Y, Ikezoe T, Yamada Y, et al.: Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol, 2012, 112: 1519-1525. – reference: 17) Nozoe M, Kanai M, Kubo H, et al.: Prestroke sarcopenia and functional outcomes in elderly patients who have had an acute stroke: a prospective cohort study. Nutrition, 2019, 66: 44-47. – reference: 9) Ryan AS, Dobrovolny CL, Smith GV, et al.: Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients. Arch Phys Med Rehabil, 2002, 83: 1703-1707. – reference: 20) Bouillanne O, Morineau G, Dupont C, et al.: Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr, 2005, 82: 777-783. – reference: 24) Wilhelm EN, Rech A, Minozzo F, et al.: Relationship between quadriceps femoris echo intensity, muscle power, and functional capacity of older men. Age (Dordr), 2014, 36: 9625. – reference: 27) Fox TA: Dysplasia of the quadriceps mechanism: hypoplasia of the vastus medialis muscle as related to the hypermobile patella syndrome. Surg Clin North Am, 1975, 55: 199-226. – reference: 6) Yamada M, Kimura Y, Ishiyama D, et al.: Differential characteristics of skeletal muscle in community-dwelling older adults. J Am Med Dir Assoc, 2017, 18: 807.e9-807.e16. – reference: 28) Nozoe M, Kubo H, Furuichi A, et al.: Validity of quadriceps muscle thickness measurement in patients with subacute stroke during hospitalization for assessment of muscle wasting and physical function. J Stroke Cerebrovasc Dis, 2017, 26: 438-441. – reference: 22) English CK, Thoirs KA, Fisher L, et al.: Ultrasound is a reliable measure of muscle thickness in acute stroke patients, for some, but not all anatomical sites: a study of the intra-rater reliability of muscle thickness measures in acute stroke patients. Ultrasound Med Biol, 2012, 38: 368-376. – reference: 19) Brunnstrom S: Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther, 1966, 46: 357-375. – reference: 15) Nozoe M, Kanai M, Kubo H, et al.: Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke. J Clin Neurosci, 2020, 74: 141-145. – reference: 26) Domholdt E: Physical Therapy Research: Principles and Applications, 2nd ed. WB Saunders, Philadelphia, 2000, pp347-335. – reference: 16) Kokura Y, Kato M, Taniguchi Y, et al.: Energy intake during the acute phase and changes in femoral muscle thickness in older hemiplegic inpatients with stroke. Nutrition, 2020, 70: 110582. – reference: 23) Pinto RS, Correa CS, Radaelli R, et al.: Short-term strength training improves muscle quality and functional capacity of elderly women. Age (Dordr), 2014, 36: 365-372. – reference: 5) Yuguchi S, Asahi R, Kamo T, et al.: Gastrocnemius thickness by ultrasonography indicates the low skeletal muscle mass in Japanese elderly people. Arch Gerontol Geriatr, 2020, 90: 104093. – reference: 1) Ryan AS, Ivey FM, Prior S, et al.: Skeletal muscle hypertrophy and muscle myostatin reduction after resistive training in stroke survivors. Stroke, 2011, 42: 416-420. – reference: 11) Monjo H, Fukumoto Y, Asai T, et al.: Muscle thickness and echo intensity of the abdominal and lower extremity muscles in stroke survivors. J Clin Neurol, 2018, 14: 549-554. – reference: 13) Ishimoto T, Taniguchi Y, Akazawa N: Longitudinal relationship between intramuscular fat in the quadriceps and gait independence in convalescent stroke patients. J Stroke Cerebrovasc Dis, 2020, 29: 105287. – reference: 3) Pillen S, Tak RO, Zwarts MJ, et al.: Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol, 2009, 35: 443-446. – reference: 14) Nozoe M, Kanai M, Kubo H, et al.: Changes in quadriceps muscle thickness, disease severity, nutritional status, and C-reactive protein after acute stroke. J Stroke Cerebrovasc Dis, 2016, 25: 2470-2474. – reference: 8) Monjo H, Fukumoto Y, Asai T, et al.: Differences in muscle thickness and echo intensity between stroke survivors and age- and sex-matched healthy older adults. Phys Ther Res, 2020, 23: 188-194. – reference: 12) Maeda H, Imada K, Ishida K, et al.: Quadriceps thickness and echo intensity predict gait independence in individuals with severe and mild hemiparetic stroke. Eur Neurol, 2020, 83: 167-173. – reference: 10) Maeda H, Imada K, Ishida K, et al.: Relationship of quadriceps muscle thickness with motor paralysis and muscle echo intensity in post-stroke patients. Eur Neurol, 2019, 81: 56-62. – reference: 29) Rosenberg IH: Summary comments: epidemiological and methodological problem in determining nutritional status of older persons. Am J Clin Nutr, 1989, 50: 1231-1233. |
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| Snippet | ... 「要旨」: 〔目的〕亜急性期脳卒中患者における大腿部骨格筋の筋厚, 筋輝度に関連する要因を検討した. 〔対象と方法〕対象は亜急性期入院脳卒中患者41名とした. 超音波診断装置により大腿直筋と内側広筋の筋厚と筋輝度を測定し, 健患差を比較した. 各筋厚, 筋輝度と年齢, 体格, 罹患期間, 栄養状態, 病前の歩行能力,... |
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| Title | 亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度と関連要因の検討 |
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