# Medication Reduction is Associated with Improved Activities of Daily Living and Muscle Strength in Post-Stroke Patients with Polypharmacy

## TL;DR

Reducing medications in post-stroke patients with many drugs is linked to better daily living skills and muscle strength, though it may lower muscle mass.

## Contribution

This study is the first to show that medication reduction in polypharmacy post-stroke patients is associated with improved functional outcomes and muscle strength.

## Key findings

- Medication reduction was linked to higher motor FIM scores and greater handgrip strength.
- Medication reduction was negatively associated with skeletal muscle mass index.
- Optimizing medications may support functional recovery in post-stroke patients.

## Abstract

Polypharmacy is common among hospitalized post-stroke patients and is associated with adverse outcomes, such as decreased physical function and increased risk of drug-related complications. However, the association with functional outcomes, such as activities of daily living (ADLs) and muscle health remains unclear in this population. This study aimed to investigates whether reducing the number of medications during hospitalization is associated with improved ADL and muscle health in post-stroke patients.

We conducted a retrospective observational study of post-stroke patients with polypharmacy (≥5 medications) undergoing inpatient rehabilitation. Patients were categorized based on whether the number of medications decreased during hospitalization. Outcomes at discharge included the motor domain of the functional independence measure (FIM), handgrip strength, and skeletal muscle mass index (SMI), assessed by bioelectrical impedance analysis. Propensity score (PS) matching and multivariate linear regression was performed to examine associations between medication reduction and each outcome, adjusting for clinically relevant confounders.

A total of 419 patients (mean age 75.9 years; 55.8% male) were included. Medication reduction occurred in 32.5% of patients, with a median decrease of two drugs. After PS matching, the cohort included 212 patients. In the multivariate analysis of this cohort, medication reduction was independently associated with higher FIM-motor scores (β = 0.105, p = 0.006) and greater handgrip strength (β = 0.073, p = 0.043), but were negatively associated with SMI (β = −0.158, p = 0.017).

Medication reduction during hospitalization was associated with improved ADL and muscle strength, but were negatively associated with muscle mass, in post-stroke patients with polypharmacy. Medication optimization may support functional recovery in this population.