The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Atrophy and Intramuscular Fat in Specific Muscles of the Thigh: Associated Weakness and Hyperinsulinemia in Stroke Survivors
Open accessAbstract
PURPOSE: Sarcopenia and increased fat infiltration in muscle may play a role in the functional impairment and high risk for diabetes in stroke. Our purpose was to compare muscle volume and muscle attenuation across 6 muscles of the paretic and nonparetic thigh and examine the relationships between intramuscular fat and insulin resistance and between muscle volume and strength in stroke patients. METHODS: Stroke participants (70; 39 men, 31 women) aged 40 to 84 years, BMI = 16 to 45 kg/m(2) underwent multiple thigh CT scans, total body scan by DXA (dual-energy X-ray absorptiometry), peak oxygen intake (VO(2peak)) graded treadmill test, 6-minute walk, fasting blood draws, and isokinetic strength testing. RESULTS: Muscle volume is 24% lower and subcutaneous fat volume is 5% higher in the paretic versus nonparetic thigh. Muscle attenuation (index of amount of fat infiltration in muscle) is 17% higher in the nonparetic midthigh than the paretic. The semitendinosis/semimembranosis, biceps femoris, sartorius, vastus (medialis/lateralis), and rectus femoris have lower (between 9% and 19%) muscle areas on the paretic than the nonparetic thigh. Muscle attenuation is 15% to 25% higher on the nonparetic than the paretic side for 5 of 6 muscles. The nonparetic midthigh muscle attenuation is negatively associated with insulin. Eccentric peak torque of the nonparetic leg and paretic leg are associated with the corresponding muscle volume. CONCLUSIONS: The skeletal muscle atrophy, increased fat around and within muscle, and ensuing muscular weakness observed in chronic stroke patients relates to diabetes risk and may impair functional mobility and independence.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Evidence shows that women have greater myosteatosis than men, independent of differences in body mass index (BMI) or total body fat (Goodpaster et al., 2001a; Hicks et al., 2005; Ryan et al., 2011; Anderson et al., 2013; Therkelsen et al., 2013; Xiao et al., 2018).”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Ryan et al., 2011
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282
Goodpaster, B. H., Leland Thaete, F., Simoneau, J.-A., & Kelley, D. E. (1997) · Diabetes · doi:10.2337/diacare.46.10.1579 · Cited by 1,012
Broderick, J., Brott, T., Kothari, R., Miller, R., Khoury, J., Pancioli, A., Gebel, J., Mills, D., Minneci, L., & Shukla, R. (1998) · Stroke · doi:10.1161/01.str.29.2.415 · Cited by 798
Folsom, A. R., Rasmussen, M. L., Chambless, L. E., Howard, G., Cooper, L. S., Schmidt, M. I., & HEISS, G. M. (1999) · Diabetes Care · doi:10.2337/diacare.22.7.1077 · Cited by 356
Determinants of Walking Function After Stroke: Differences by Deficit Severity
Patterson, S. L., Forrester, L. W., Rodgers, M. M., Ryan, A. S., Ivey, F. M., Sorkin, J. D., & Macko, R. F. (2007) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2006.10.025 · Cited by 356
Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients
Ryan, A. S., Dobrovolny, C. L., Smith, G. V., Silver, K. H. C., & Macko, R. F. (2002) · Archives of Physical Medicine and Rehabilitation · doi:10.1053/apmr.2002.36399 · Cited by 325
Macko, R. F., DeSouza, C. A., Tretter, L. D., Silver, K. H. C., Smith, G. V., Anderson, P. A., Tomoyasu, N., Gorman, P. H., & Dengel, D. R. (1997) · Stroke · doi:10.1161/01.str.28.2.326 · Cited by 276
Skeletal muscle lipid accumulation in obesity, insulin resistance, and type 2 diabetes
Goodpaster, B. H., & Wolf, D. L. (2004) · Pediatric Diabetes · doi:10.1111/j.1399-543x.2004.00071.x · Cited by 214
Ryan, A. S., & Nicklas, B. (1999) · International Journal of Obesity · doi:10.1038/sj.ijo.0800777 · Cited by 199
Susceptibility and precipitating factors in depression: Sex differences and similarities.
Radloff, L. S., & Rae, D. S. (1979) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.88.2.174 · Cited by 178
Research works printed but not linked: 1
- American Heart Association (AHA), 2010, Heart and Stroke Facts
Cited by
Sorted by citations
Items 101–154 of 154
Resistive Training and Molecular Regulators of Vascular-Metabolic Risk in Chronic Stroke
Ryan, A. S., Li, G., Hafer‐Macko, C. E., & Ivey, F. M. (2016) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2016.11.003 · Cited by 8
de Souza, J. T., Minicucci, M. F., Ferreira, N. C., Polegato, B. F., Okoshi, M. P., Módolo, G. P., Leal-Pereira, F. W., Phillips, B. E., Atherton, P. J., Smith, K., et al. (2024) · Nutrients · doi:10.3390/nu16234148 · Cited by 9
Pu, Y., Wang, Y., Wang, H., Liu, H., Dou, X., Xu, J., & Li, X. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1438575 · Cited by 7
Intermuscular adipose tissue and muscle function in patients on maintenance hemodialysis
Dilaver, R. G., Demirci, M., Crescenzi, R. L., Pridmore, M. D., Ertuğlu, L. A., Guide, A., Greevy, R. A., Roshanravan, B., Ikizler, T. A., & Gamboa, J. L. (2025) · Physiological Reports · doi:10.14814/phy2.70363 · Cited by 7
Mosteiro-Muñoz, F., & Domínguez, R. (2017) · Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte · doi:10.15366/rimcafd2017.68.011 · Cited by 7
Akazawa, N., Kishi, M., Hino, T., Tsuji, R., Tamura, K., Hioka, A., & Moriyama, H. (2021) · Nutrition · doi:10.1016/j.nut.2021.111277 · Cited by 7
Predictive Equations Overestimate Resting Metabolic Rate in Survivors of Chronic Stroke
Ryan, A. S., Novitskaya, M., & Treuth, A. L. (2022) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.01.155 · Cited by 7
Kokura, Y., Kato, M., Kimoto, K., Okada, Y., & Habu, D. (2021) · Medical Principles and Practice · doi:10.1159/000517950 · Cited by 8
Chen, R., Liu, Z., Liao, R., Liang, H., Hu, C., Zhang, X., Chen, J., Xiao, H., Ye, J., Guo, J., et al. (2025) · BMC Neurology · doi:10.1186/s12883-025-04136-1 · Cited by 11
Isokinetic testing of muscle strength of older individuals post-stroke: An integrative review
Bohannon, R. W. (2020) · Isokinetics and Exercise Science · doi:10.3233/ies-201146 · Cited by 6
Huang, M., Miller, T., Fu, S. N., Ying, M. T. C., & Pang, M. Y. C. (2022) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2022.105672 · Cited by 7
Gusdon, A., Savarraj, J. P. J., Feng, D., Starkman, A., Li, G., Bodanapally, U. K., Zimmerman, W., Ryan, A. S., Choi, H., & Badjatia, N. (2024) · Scientific Reports · doi:10.1038/s41598-024-64666-5 · Cited by 7
Arnal‐Gómez, A., Cortés‐Amador, S., Ruescas-Nicolau, M.-A., Carrasco, J. J., Pérez‐Alenda, S., Santamaría-Balfagón, A., & Sánchez-Sánchez, M. L. (2023) · Biomedicines · doi:10.3390/biomedicines11102601 · Cited by 5
Yasuda, T., Honda, S., Matsunaga, K., Hashimura, T., Tsukamoto, Y., Ota, S., Fujita, S., & Onishi, E. (2021) · Journal of Orthopaedic Science · doi:10.1016/j.jos.2021.10.001 · Cited by 5
Muscle architecture and clinical parameters in stroke patients: An ultrasonographic study
Onat, Ş. Ş., Polat, C. S., Gürçay, E., Özcan, D. S., & Orhan, A. (2022) · Journal of Clinical Ultrasound · doi:10.1002/jcu.23202 · Cited by 5
Yoon, J. W., & Jang, H. C. (2016) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2016.40.3.250 · Cited by 5
Targeting the muscle-brain axis to improve post-stroke cognition via the FNDC5/irisin/BDNF pathway
Wei, J., Cai, Y., Jiang, Z., Xie, J., Xie, D., Ouyang, F., Li, J., Xiong, Z., Long, X., Yang, M., et al. (2025) · Journal of Advanced Research · doi:10.1016/j.jare.2025.10.027 · Cited by 4
Wohlfarth, V., Kway, Y., Sood, A., Jeon, Y., Chong, L. R., Marx, U. C., Tay, J., Eriksson, J., Bendahan, D., Michel, C. P., et al. (2025) · MAGMA · doi:10.1007/s10334-025-01308-5 · Cited by 3
Prevalence of Stroke‐Related Sarcopenia: A Systematic Review and Meta‐Analysis
Santos, L., Staico, B. M., Vaz, A. B., Galvão, A. C. J., de Oliveira, A. L. M., Ferreira, M. C. M., Leopoldino, A. A. O., & Polese, J. C. (2025) · Physiotherapy Research International · doi:10.1002/pri.70134 · Cited by 4
Hatzantonis, C., Satkunam, L. E., Rabey, K. N., Hocking, J. C., & Agur, A. M. R. (2024) · Journal of Anatomy · doi:10.1111/joa.14025 · Cited by 3
Nguyen-Khac, V., Bonnet-Lebrun, A., Linglart, A., Tienda, M. D., Berkenou, J., Mannes, I., Adamsbaum, C., Wicart, P., & Wafa Skalli, E. (2022) · Journal of the Endocrine Society · doi:10.1210/jendso/bvac135 · Cited by 4
Wang, X., Zhang, J., Xu, J., Li, T., & Ye, Q. (2025) · Brain and Behavior · doi:10.1002/brb3.70763 · Cited by 3
Vanzella, L. M., Lawand, R., Shuaib, M., OH, P. I., Corbett, D., & Marzolini, S. (2022) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004287 · Cited by 3
Akazawa, N., Kishi, M., Hino, T., Tsuji, R., Tamura, K., Hioka, A., & Moriyama, H. (2022) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2022.12.018 · Cited by 3
Hyngstrom, A. S., Nguyen, J. N., Murphy, S. A., Raab, S. C., Schmit, B. D., Gutterman, D. D., & Durand, M. J. (2023) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2023.2291902 · Cited by 3
Association of Characteristics between Acute Stroke Patients and Sarcopenia: A Cross-Sectional Study
Kim, S.-Y., Kim, B.-G., & Park, S. (2024) · Exercise Science · doi:10.15857/ksep.2024.00248 · Cited by 3
Friedman, B., Beamer, B. A., Beans, J., Gray, V. L., Alon, G., Ryan, A. S., Katzel, L. I., Sorkin, J. D., & Addison, O. R. (2025) · JMIR Research Protocols · doi:10.2196/68082 · Cited by 3
Johnson, C. A., Farrens, A. J., Biswas, P., Garcia-Fernandez, L., See, J., Dodakian, L., Chan, V., Wang, P. T., Cramer, S. C., Nenadić, Z., et al. (2025) · Sensors · doi:10.3390/s25206405 · Cited by 2
Treadmill training impacts the skeletal muscle molecular clock after ischemia stroke in rats
Mai, L., Yin, Y., & Qin, D. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e27430 · Cited by 2
Protein-energy malnutrition and sarcopenia in acute cerebral insufficiency
Dobrynin, A. S. (2024) · Clinical nutrition and metabolism · doi:10.17816/clinutr643360 · Cited by 2
Irisawa, H., Nakamura, T., Chiba, Y., Hirota, M., Hoshiai, H., & Mizushima, T. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1548796 · Cited by 2
Malnutrition in Neurological Diseases
Güngör, L. (2017) · Springer eBooks · doi:10.1007/978-3-319-53171-7_3 · Cited by 2
Neuromuscular component of muscle quality assessment in older adults
Puš, K., & Šimunič, B. (2024) · Kinesiologia Slovenica scientific journal on sport · doi:10.52165/kinsi.30.1.95-111 · Cited by 1
Miura, M., Owada, S., Ito, O., & Kohzuki, M. (2025) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2025.1559077 · Cited by 2
Sanz, N. D., Trandafir, P. C., Moneo, A. B. B., Serrano, A. M. I., & Ramírez‐Vélez, R. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1641859 · Cited by 1
Chen, G., Liou, I., Sun, S., Li, C.-H., & Tuan, S. (2026) · Life · doi:10.3390/life16071073 · Cited by 1
Identifying sarcopenia among post-stroke older people
Sosiawati, A. F., Irwan, A. M., & Sabriyati, W. O. N. I. (2021) · Enfermería Clínica · doi:10.1016/j.enfcli.2021.10.011 · Cited by 1
Ryan, A. S., Beamer, B. A., Gruber‐Baldini, A. L., Craik, R. L., Golden, J., Guralnik, J. M., Hochberg, M. C., Mangione, K. K., Orwig, D., Rathbun, A. M., et al. (2024) · The Journals of Gerontology Series A · doi:10.1093/gerona/glae078 · Cited by 1
Ng, S. S. M., Chen, P., Choi, S. H., Lam, T. J., Lau, H. Y., Lau, H. K., Law, H. Y., Lam, D. Y. W., & Lai, C. Y. Y. (2025) · Journal of Rehabilitation Medicine · doi:10.2340/jrm.v57.44075 · Cited by 1
Zhao, S., Zhang, T., Li, B., Wu, Z., & Zhao, J. Y. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105130 · Cited by 1
Insulin Resistance in Skeletal Muscle of Chronic Stroke
Ryan, A. S., Hafer‐Macko, C. E., & Ortmeyer, H. K. (2020) · Brain Sciences · doi:10.3390/brainsci11010020 · Cited by 1
Mattlage, A. E. (2016) · KU ScholarWorks (The University of Kansas)
Ishimoto, T., TOMARI, A., & Akazawa, N. (2019) · Rigakuryoho Kagaku · doi:10.1589/rika.34.135
Strengthening interventions for people after stroke
de Sousa, D. G. (2020) · The Sydney eScholarship Repository (The University of Sydney)
Just, I., & Krššák, M. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-822186-0.00019-5
Wang, J., Yin, X., Mu, M., Zhang, J., & Gao, Y. (2025) · Medicine · doi:10.1097/md.0000000000044404
Tanaka, S., Yamauchi, K., Hayashi, Y., Harayama, E., Shinya, T., & Arakawa, S. (2026) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2026.2675413
Tang, H., Li, J., Chen, J., Zhu, X., Hao, M., Chen, L., Yang, J., & Xue, C. (2026) · BMC Neurology · doi:10.1186/s12883-026-05066-2
Correlation between rectus femoris activity and abdominal muscle thickness in post-stroke hemiplegia
Lee, J., & Kim, J. (2026) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2026.08.011
Ross, S. A., Dorscher, S. N., Leonard, T. R., Seerattan, R. A., Corbett, D., & Herzog, W. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.09.09.750457
Xie, D., Ma, M., & Chen, L. (2026) · Brain and Behavior · doi:10.1002/brb3.71810
Yang, X., Zuo, T., Jiang, W., Li, H., Chen, X., Shen, W., & Zhang, X. (2026) · British Journal Of Nutrition · doi:10.1017/s0007114526108423
Metadata
- Authors
- Ryan, A. S., Buscemi, A., Forrester, L., Hafer-Macko, C. E., & Ivey, F. M.
- Affiliations
- University of Maryland, Baltimore (US)
- Baltimore VA Medical Center, University of Maryland School of Medicine, Baltimore, MD, USA
- ORCID
- Ryan, Alice S.
- Venue
- Neurorehabilitation and neural repair
- Publisher
- SAGE Publications
- Published
- 2011-07-06
- Volume
- 25
- Issue
- 9
- Pages
- 865-872
- ISSN
- 0888-4390 (ISSN-L)
- 1545-9683
- 1552-6844
- PMC
- PMC3546168
- OpenAlex
- W2023729390
- Cited by
- 154
- References
- 20
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 13 · 2023: 6 · 2022: 17 · 2021: 10 · 2020: 24 · 2019: 9 · 2018: 11 · 2017: 8 · 2016: 15 · 2015: 11 · 2014: 3 · 2013: 3 · 2012: 1
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurorehabilitation and neural repair (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (K01AG019242, R29-AG14487, R29AG014487, R01AG19310, R01AG019310, KO1-AG019242, P60AG012583, P60 AG12583, P30AG028747, R01AG030075)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- stroke, sarcopenia, muscle atrophy, intramuscular fat, fatty infiltration, thigh muscle, paretic limb, muscle volume, muscle attenuation, insulin resistance, muscle strength, isokinetic strength, diabetes risk, functional mobility
- MeSH terms
- Adipose Tissue, Adult, Aged, Aged, 80 and over, Female, Humans, Hyperinsulinism, Male, Middle Aged, Muscular Atrophy, Paresis, Radiography, Survivors, Muscle Weakness, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
