An Exercise Prescription for Patients with Stroke and Sarcopenia Based on the Modified Delphi Study

Overview

Journal Life (Basel)

Specialty Biology

Date 2024 Mar 28

PMID 38541657

Authors

Jae Wan Yoo

Geun-Young Park

Hae-Yeon Park

Yeun Jie Yoo

Mi-Jeong Yoon

Seungyup Song

Kyung Hyun Park

Hooman Lee

Sangui Choi

Sun Im

Seong Hoon Lim

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to develop a consensus on the need for and priorities of exercise to treat preexisting sarcopenia with hemiplegic stroke.

Methods: A modified three-round Delphi study was conducted. The panelists responded to the questionnaire on a 7-point Likert scale. Responses were returned with descriptive statistics in the next round. Consensus was defined as >75% agreement (score of 5-7) with a median > 5. The percentage of strong agreement (score of 6-7) and Kendall's coefficient of concordance were calculated to demonstrate a more refined interpretation of the consensus.

Results: Fifteen panelists contributed to all rounds. The need for exercise was demonstrated. The consensus was reached on 53 of 58 items in the first round and all items in the second and final rounds. The percentage of strong agreement was high for all but eight items.

Conclusions: This study is the first Delphi study to investigate the need for and priorities of exercise for treating preexisting sarcopenia in stroke hemiplegia. We present a standard recommendation including 57 priorities and a strong recommendation including 49 priorities. The eight items that were excluded reflected factors that are less important to hemiplegic patients with poor balance, cognitive decline, or mental vulnerability.

Citing Articles

Wearable Activity Trackers and Physical Activity Levels Among Members of the Athens Medical Association in Greece.

Lampsas S, Marinos G, Lamprinos D, Theofilis P, Zakynthinos G, Gialamas I J Cardiovasc Dev Dis. 2024; 11(10).

PMID: 39452306 PMC: 11509063. DOI: 10.3390/jcdd11100336.

References

Cruz-Jentoft A, Landi F, Schneider S, Zuniga C, Arai H, Boirie Y . Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014; 43(6):748-59. PMC: 4204661. DOI: 10.1093/ageing/afu115. View

Cannataro R, Cione E, Bonilla D, Cerullo G, Angelini F, DAntona G . Strength training in elderly: An useful tool against sarcopenia. Front Sports Act Living. 2022; 4:950949. PMC: 9339797. DOI: 10.3389/fspor.2022.950949. View

Fielding R, Vellas B, Evans W, Bhasin S, Morley J, Newman A . Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011; 12(4):249-56. PMC: 3377163. DOI: 10.1016/j.jamda.2011.01.003. View

Gracia-Sanchez A, Lopez-Pineda A, Chicharro-Luna E, Gil-Guillen V . A Delphi Study Protocol to Identify Recommendations on Physical Activity and Exercise in Patients with Diabetes and Risk of Foot Ulcerations. Int J Environ Res Public Health. 2021; 18(20). PMC: 8536116. DOI: 10.3390/ijerph182010988. View

McKenna H . The Delphi technique: a worthwhile research approach for nursing?. J Adv Nurs. 1994; 19(6):1221-5. DOI: 10.1111/j.1365-2648.1994.tb01207.x. View

Niederberger M, Spranger J . Delphi Technique in Health Sciences: A Map. Front Public Health. 2020; 8:457. PMC: 7536299. DOI: 10.3389/fpubh.2020.00457. View

Cui H, Wang Z, Wu J, Liu Y, Zheng J, Xiao W . Chinese expert consensus on prevention and intervention for elderly with sarcopenia (2023). Aging Med (Milton). 2023; 6(2):104-115. PMC: 10242264. DOI: 10.1002/agm2.12245. View

Feigin V, Forouzanfar M, Krishnamurthi R, Mensah G, Connor M, Bennett D . Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014; 383(9913):245-54. PMC: 4181600. DOI: 10.1016/s0140-6736(13)61953-4. View

Rosenberg I . Sarcopenia: origins and clinical relevance. J Nutr. 1997; 127(5 Suppl):990S-991S. DOI: 10.1093/jn/127.5.990S. View

10.

Labib M, Bohm C, MacRae J, Bennett P, Wilund K, McAdams-DeMarco M . An International Delphi Survey on Exercise Priorities in CKD. Kidney Int Rep. 2021; 6(3):657-668. PMC: 7938076. DOI: 10.1016/j.ekir.2020.12.001. View

11.

Junger S, Payne S, Brine J, Radbruch L, Brearley S . Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med. 2017; 31(8):684-706. DOI: 10.1177/0269216317690685. View

12.

Chen L, Woo J, Assantachai P, Auyeung T, Chou M, Iijima K . Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020; 21(3):300-307.e2. DOI: 10.1016/j.jamda.2019.12.012. View

13.

Landi F, Marzetti E, Martone A, Bernabei R, Onder G . Exercise as a remedy for sarcopenia. Curr Opin Clin Nutr Metab Care. 2013; 17(1):25-31. DOI: 10.1097/MCO.0000000000000018. View

14.

Mas M, Gonzalez J, Frontera W . Stroke and sarcopenia. Curr Phys Med Rehabil Rep. 2021; 8(4):452-460. PMC: 7990034. DOI: 10.1007/s40141-020-00284-2. View

15.

Papadatou M . Sarcopenia in Hemiplegia. J Frailty Sarcopenia Falls. 2020; 5(2):38-41. PMC: 7272773. DOI: 10.22540/JFSF-05-038. View

16.

Izquierdo M, Merchant R, Morley J, Anker S, Aprahamian I, Arai H . International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021; 25(7):824-853. DOI: 10.1007/s12603-021-1665-8. View

17.

Wiangkham T, Duda J, Haque M, Rushton A . Development of an active behavioural physiotherapy intervention (ABPI) for acute whiplash-associated disorder (WAD) II management: a modified Delphi study. BMJ Open. 2016; 6(9):e011764. PMC: 5030579. DOI: 10.1136/bmjopen-2016-011764. View

18.

Yoshimura Y, Wakabayashi H, Bise T, Tanoue M . Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr. 2017; 37(6 Pt A):2022-2028. DOI: 10.1016/j.clnu.2017.09.009. View

19.

Nozoe M, Kanai M, Kubo H, Yamamoto M, Shimada S, Mase K . Prestroke Sarcopenia and Stroke Severity in Elderly Patients with Acute Stroke. J Stroke Cerebrovasc Dis. 2019; 28(8):2228-2231. DOI: 10.1016/j.jstrokecerebrovasdis.2019.05.001. View

20.

Nagano F, Yoshimura Y, Bise T, Shimazu S, Shiraishi A . Muscle mass gain is positively associated with functional recovery in patients with sarcopenia after stroke. J Stroke Cerebrovasc Dis. 2020; 29(9):105017. DOI: 10.1016/j.jstrokecerebrovasdis.2020.105017. View