Effect of Branched Chain Amino Acid Supplementation on Prevention of Sarcopenia after Stroke

Abstract

<h3>Research Objectives</h3> To investigate the effect of branched chain amino acid (BCAA) supplement on prevention of sarcopenia after stoke. We also evaluate the BCAA effect on functional improvement during intensive rehabilitation period after stroke. <h3>Design</h3> Age, stroke-lesion matching study. <h3>Setting</h3> Rehabilitation Center in University Hospital. <h3>Participants</h3> Subacute stroke patients who had stroke-related disabilities and need to undergo intensive rehabilitation intervention were prospectively enrolled. Age, stroke lesion matched control group were enrolled retrospectively medical record review. <h3>Interventions</h3> Patients with study group were administered dietary supplement containing 6g of BCAA twice a day for 1 month. Control group received only conventional rehabilitation therapy. <h3>Main Outcome Measures</h3> Functional status relating stroke were evaluated using the Modified Barthel index, berg balance scale, functional ambulatory category, manual function test, and videoflouroscopic swallowing study. Sarcopenia status were evaluated by using grip strength, and dual energy X-ray absorptiometry (DEXA). Skeletal muscle index (SMI) was defined as appendicular lean mass, assessed by DEXA divided by height in meter squared. All evaluations were measured every 1 month. <h3>Results</h3> Study group showed significantly increased SMI after BCAA supplementation and intensive rehabilitation therapy compared with control group. Both group exhibited functional improvement over time, but the improvement in the study group was more significant than the improvement in control group. 56% of patients who were unable to walk due to stroke, able to walk again with assist after treatment in study group. Univariate analysis revealed that patients with osteoporosis and lower functional status showed decreased SMI after stroke rehabilitation therapy despite of BCAA supplementation. <h3>Conclusions</h3> Our results presented positive effect of BCAA supplement on prevention of sarcopenia after stroke. We also found that nutritional support helps functional improvement on neurologic recovery. Stroke leads to complex systemic metabolic changes, thus loss of muscle mass and malnutrition frequently occurs after stroke. These results suggest that comprehensive rehabilitation intervention with BCAA supplement could be a helpful option during the critical period for post-stroke neurologic recovery. <h3>Author(s) Disclosures</h3> The author reports no conflicts of interest in this work.