Effects of intervention with back-lying exercises with bent knees pointing upwards to prevent disuse muscle atrophy in patients with post-stroke hemiplegia

The present study measured lower extremity muscle mass using DXA （Dual energy X-ray Absorptiometry） in order to verify the effectiveness of intervention with a series of movements, including lying hip raise exercise with bent knees pointing upwards, among bedridden patients with post-stroke hemiplegia in the acute post-stroke period. Subjects in the intervention group were required to perform １０ repetitions of a series of back-lying exercises once a day with researchers, in addition to the exercises performed by those in a control group. The first measurement of muscle mass was conducted at three to five days after onset, and the second measurement was conducted seven days after the first. Muscle mass in the lower extremities was reduced by approximately ６００g （decrease rate ： ９％）on the paralyzed side and by ２８０g on the non-paralyzed side（decrease rate： ５％）in one week in the Brunnstrom stage ≤ II subgroup（site of measurement : lower extremities） （n＝８） of the control group （n＝２３）. The decrease in muscle mass in the Brunnstrom stage ≤ II subgroup （n＝４） of the intervention group （n＝１５） was approximately ２６０g on the paralyzed side （decrease rate ： ５％） and approximately ２８０g （decrease rate ： ５％）on the non-paralyzed side. Thus, muscle mass decreased on both sides, and this occurred regardless of degree of paralysis. Comparison of the Brunnstrom stage ≥ III subgroups between the control and intervention groups also confirmed that the decease in muscle mass was smaller in the latter group. Thus, it was confirmed that back-lying exercises combining lower extremity movements, including hip raises with bent knees pointing upwards, prevented the decrease in lower extremity muscle mass on the paralyzed side in post-stroke patients. The present study also suggests that these exercise movements can be applied to preventive care for bedridden patients with other severe diseases.