Initial phase angle was independently associated with failure to achieve full independence at 6 months after stroke, while sarcopenia showed only a non-significant tendency toward association with the outcome.
Key Findings
Results
Phase angle (PhA) measured during the acute phase was independently associated with failure to achieve full independence at 6 months after stroke onset.
Odds ratio for PhA: 0.43 (95% CI, 0.22–0.83; p = 0.012), indicating that higher PhA was associated with lower odds of failing to achieve full independence
Association remained significant after adjusting for age, sex, and NIHSS score
Full independence was defined as a Barthel Index (BI) score of 100 at 6 months post-stroke
Analysis used multivariate logistic regression models
Results
Sarcopenia showed a tendency toward association with failure to achieve full independence at 6 months but did not reach statistical significance.
Odds ratio for sarcopenia: 2.66 (95% CI, 0.95–7.46; p = 0.063)
Sarcopenia prevalence in the study population was 34.1%
Association was evaluated after adjusting for age, sex, and NIHSS score
The non-significant trend suggests sarcopenia may still be a clinically relevant factor warranting further investigation
Results
The incidence of failure to achieve full functional independence at 6 months after stroke was 27.1% in this study population.
129 patients were included in the observational study
Median age was 74 years; 32.6% were female
Patients were admitted to the stroke unit of a tertiary care hospital between June 2022 and May 2023
Functional independence was measured using the Barthel Index (BI), with full independence defined as BI = 100
Results
Mean phase angle values during the acute phase differed by sex, with males having a higher mean PhA than females.
Mean PhA was 5.7° (SD 1.0°) in males
Mean PhA was 5.1° (SD 0.9°) in females
PhA was assessed using bioelectrical impedance analysis during the acute phase of stroke
PhA reflects cell membrane integrity and is considered a marker of overall cellular health and nutritional status
Methods
Sarcopenia and phase angle were both evaluated during the acute phase of stroke as potential predictors of longer-term functional outcomes.
Sarcopenia was diagnosed according to established criteria during the acute phase of hospitalization
PhA was obtained via bioelectrical impedance analysis in the acute setting
The Barthel Index was used to assess functional status at the 6-month follow-up point
Study design was observational, conducted in a tertiary care stroke unit
What This Means
This research suggests that a measurement called 'phase angle,' obtained through a simple body composition test (bioelectrical impedance analysis) shortly after a stroke, can predict whether a patient will fully recover their functional independence six months later. Phase angle reflects the health and integrity of cells throughout the body and is considered a marker of overall nutritional and physical status. In this study of 129 stroke patients with a median age of 74, those with a higher phase angle in the acute phase of their stroke were more likely to achieve full independence (defined as a perfect score on the Barthel Index, a standard measure of daily activities) at six months.
The study also examined whether sarcopenia — the age-related loss of muscle mass and strength, which affected about one in three patients in this study — predicted functional recovery. While there was a trend suggesting sarcopenia might be associated with worse outcomes, this association did not reach statistical significance. In contrast, phase angle remained a significant predictor even after accounting for important factors like age, sex, and initial stroke severity.
This research suggests that measuring phase angle early after stroke could help clinicians identify patients at risk of not fully recovering their independence, potentially allowing for earlier or more targeted rehabilitation interventions. Because phase angle is a quick and non-invasive measurement, it may be a practical tool for use in acute stroke care settings. Further research with larger samples would help clarify the role of sarcopenia in stroke recovery and whether interventions targeting body composition can improve outcomes.
Ishiyama D, Aoyagi Y, Ohashi M, Iwasawa T, Saito T, Sakamoto Y, et al.. (2026). Initial Phase Angle Is Independently Associated With Functional Independence at 6 Months After Stroke.. Geriatrics & gerontology international. https://doi.org/10.1111/ggi.70837