Prevalence and factors associated with sarcopenia in individuals with stroke undergoing rehabilitation: A cross-sectional study
- 1SARAH Network of Rehabilitation Hospitals, Fortaleza, Ceará, Brazil.
- 2Graduate Program in Physiotherapy, Federal University of Ceará, Fortaleza, Ceará, Brazil.
- 3Graduate Program in Public Health, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Abstract
Objective: To determine the prevalence of sarcopenia and identify clinical and functional factors independently associated with confirmed sarcopenia in individuals with stroke undergoing rehabilitation. Methods: This cross-sectional study enrolled 209 adults with stroke admitted for neurological rehabilitation. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm, using SARC-CalF, handgrip strength, five-times sit-to-stand test, physical performance measures and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry (DXA). Bivariate analyses and multivariable logistic regression were performed to identify factors independently associated with confirmed sarcopenia. Results: Confirmed sarcopenia was identified in 55 of 209 participants (26.3%; 95% CI: 20.6% to 32.8%). Participants with sarcopenia were older and had lower body mass index (BMI), poorer physical performance, and greater motor impairment than those without sarcopenia. In the multivariable model, lower BMI (OR = 0.70; 95% CI: 0.59 to 0.83), positive SARC-CalF screening (OR = 6.37; 95% CI: 2.03 to 20.05), and lower Short Physical Performance Battery (SPPB) scores (OR = 0.83; 95% CI: 0.69 to 0.99) remained independently associated with sarcopenia. Motor impairment severity, assessed using Fugl-Meyer motor categories, was also independently associated with sarcopenia. Conclusion: DXA-confirmed post-stroke sarcopenia affected approximately one in four individuals undergoing rehabilitation and was independently associated with lower BMI, poorer physical performance, and greater motor impairment. These findings indicate that sarcopenia is closely linked to functional impairment after stroke and reinforce the importance of integrating muscle health and functional assessment during rehabilitation. Early identification of individuals at risk may support more individualized rehabilitation strategies and improve clinical decision-making.
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BibTeX
@article{ida2026prevalence,
title = {{Prevalence and factors associated with sarcopenia in individuals with stroke undergoing rehabilitation: A cross-sectional study}},
author = {Fernando Shizuo Ida and Esther Joyce De Monte Castello E Silva and Gabriela De Souza Martins Brasil and Leandro Moreira Peregrino and Cruiff Emerson Pinto Da Silva and Pedro Ykaro Fialho Silva},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0361113},
url = {https://doi.org/10.1371/journal.pone.0361113},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prevalence and factors associated with sarcopenia in individuals with stroke undergoing rehabilitation: A cross-sectional study
AU - Fernando Shizuo Ida
AU - Esther Joyce De Monte Castello E Silva
AU - Gabriela De Souza Martins Brasil
AU - Leandro Moreira Peregrino
AU - Cruiff Emerson Pinto Da Silva
AU - Pedro Ykaro Fialho Silva
PY - 2026
DA - 2026/10/26
JO - PLOS One
DO - 10.1371/journal.pone.0361113
UR - https://doi.org/10.1371/journal.pone.0361113
AB - Objective: To determine the prevalence of sarcopenia and identify clinical and functional factors independently associated with confirmed sarcopenia in individuals with stroke undergoing rehabilitation. Methods: This cross-sectional study enrolled 209 adults with stroke admitted for neurological rehabilitation. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm, using SARC-CalF, handgrip strength, five-times sit-to-stand test, physical performance measures and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry (DXA). Bivariate analyses and multivariable logistic regression were performed to identify factors independently associated with confirmed sarcopenia. Results: Confirmed sarcopenia was identified in 55 of 209 participants (26.3%; 95% CI: 20.6% to 32.8%). Participants with sarcopenia were older and had lower body mass index (BMI), poorer physical performance, and greater motor impairment than those without sarcopenia. In the multivariable model, lower BMI (OR = 0.70; 95% CI: 0.59 to 0.83), positive SARC-CalF screening (OR = 6.37; 95% CI: 2.03 to 20.05), and lower Short Physical Performance Battery (SPPB) scores (OR = 0.83; 95% CI: 0.69 to 0.99) remained independently associated with sarcopenia. Motor impairment severity, assessed using Fugl-Meyer motor categories, was also independently associated with sarcopenia. Conclusion: DXA-confirmed post-stroke sarcopenia affected approximately one in four individuals undergoing rehabilitation and was independently associated with lower BMI, poorer physical performance, and greater motor impairment. These findings indicate that sarcopenia is closely linked to functional impairment after stroke and reinforce the importance of integrating muscle health and functional assessment during rehabilitation. Early identification of individuals at risk may support more individualized rehabilitation strategies and improve clinical decision-making.
SN - 1932-6203
ER -