ArticleFrontiers in medicine2026
Association of preoperative ankle reflex with skeletal muscle loss and poorer physical performance 6 months after gastrectomy in elderly patients with gastric cancer.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Neuromuscular dysfunction may contribute to postoperative skeletal muscle loss in elderly patients with gastric cancer. However, the association between preoperative ankle reflex and postoperative muscle-related outcomes remains unclear. This study investigated whether reduced or absent preoperative ankle reflexes were associated with appendicular skeletal muscle index (ASMI) and impaired physical performance 6 months after gastrectomy. Methods: A total of 507 elderly patients with gastric cancer were enrolled. Ankle reflex was assessed within 1 week before surgery and graded from 0 to 4. Reflex status was classified as reduced or absent (grades 0-1), normal (grade 2), or brisk/hyperreflexic (grades 3-4). ASMI was measured before surgery and at 6 months after surgery using bioelectrical impedance analysis. Dominant hand grip strength, 6-m walking speed, and Short Physical Performance Battery (SPPB) scores were assessed 6 months after surgery. The primary outcome was the change in ASMI between the preoperative and 6-month postoperative assessments. The secondary outcomes included ASMI, dominant-hand grip strength, 6-m walking speed, and SPPB score at 6 months after surgery. Five self-reported muscle-related symptoms during follow-up were listed as exploratory outcomes. Multivariable linear and logistic regression models were adjusted for prespecified baseline confounders, and inverse probability weighting (IPTW) was employed as a sensitivity analysis. Results: Patients with ankle reflex grades 0-1 experienced greater ASMI change during the first 6 months after surgery than patients with normal reflexes (adjusted β = 0.311, 95% CI: 0.278-0.344, Conclusion: Reduced or absent preoperative ankle reflexes were associated with greater skeletal muscle loss, as well as poorer muscle strength and physical performance, 6 months after gastrectomy in elderly patients with gastric cancer.
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