Weight Change during the Early Phase of Convalescent Rehabilitation after Stroke as a Predictor of Functional Recovery: A Retrospective Cohort Study.

Hiroshi Kishimoto,Naoki Kobayashi,Hanako Tanamachi,Kazushi Takahashi,Kiyoshige Ishibashi,Kazunori Koseki,Yuka Nemoto,Takayuki Maezawa,Yutaka Kohno

doi:10.3390/nu14020264

Hiroshi Kishimoto, Naoki Kobayashi + Show 7 more

Open Access

https://doi.org/10.3390/nu14020264

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Journal: Nutrients	Publication Date: Jan 9, 2022
Citations: 5	License type: CC BY 4.0

Affiliation: Ibaraki Prefectural University of Health Sciences

Abstract

It has been reported that weight gain at discharge compared with admission is associated with improved activities of daily living in convalescent rehabilitation (CR) patients with low body mass index. Here, we investigated whether weight maintenance or gain during the early phase of CR after stroke correlates with a better functional recovery in patients with a wide range of BMI values. We conducted this retrospective cohort study in a CR ward of our hospital and included adult stroke patients admitted to the ward from January 2014 to December 2018. After ~1 month of hospitalization, the patients were classified into weight loss and weight maintenance or gain (WMG) groups based on the Global Leadership Initiative on Malnutrition criteria for weight. We adopted the motor functional independence measure (FIM) gain as the primary outcome. The motor FIM gain tended to be greater in the WMG group but without statistical significance. However, multiple regression analysis showed that WMG was significantly and positively associated with motor FIM gain. In conclusion, weight maintenance or gain in patients during the early phase of CR after stroke may be considered as a predictor of their functional recovery, and nutritional management to prevent weight loss immediately after the start of rehabilitation would contribute to this.

Highlights

The aging of the society is a global challenge today, and frailty [1] has become a critical issue
We have previously reported that a group of patients whose nutritional status was maintained at good or even slightly improved from poor during convalescent rehabilitation (CR) had better functional recovery than a group of patients whose nutritional status remained poor or worsened even if their status was good at admission [13]
The motor functional independence measure (FIM) gain as the outcome of the study was greater in the weight maintenance or gain (WMG) group, but it did not reach statistical significance

Summary

Introduction

The aging of the society is a global challenge today, and frailty [1] has become a critical issue. In Japan, the national health insurance system established a convalescent rehabilitation (CR) ward in the year 2000, which has played an important role in the post-acute care of patients with stroke, brain or spinal cord injury, hip fracture, and hospital-associated deconditioning [7]. It has been reported that the prevalence of malnutrition, malnutrition risk status, and sarcopenia is high among patients admitted to the ward [8,9]. Having malnutrition or sarcopenia has been associated with poor recovery of physical function in CR [9,10]. We have previously reported that a group of patients whose nutritional status was maintained at good or even slightly improved from poor during CR had better functional recovery than a group of patients whose nutritional status remained poor or worsened even if their status was good at admission [13]

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