Department of Rehabilitation Medicine, Dokkyo Medical University, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi 3210293, Japan.
Department of Rehabilitation Medicine, Setagaya Memorial Hospital, 2-30-10, Noge, Setagaya, Tokyo 1580092, Japan.
Nutrients. 2020 Jun 29;12(7):1923. doi: 10.3390/nu12071923.
Previous studies have suggested that the nutritional status after stroke is independently associated with long-term outcomes and that sarcopenia delays poststroke rehabilitation and worsens the prognosis. However, many stroke patients have a deteriorated nutritional status and a decreased muscle mass in the acute phase. This prospective study included 179 patients who were admitted to the stroke rehabilitation unit. We performed bioelectrical impedance analysis and determined the Geriatric Nutritional Risk Index (GNRI) to assess muscle mass and the nutritional status on admission. Furthermore, we analyzed the activities of daily living using the Functional Independence Measure (FIM) at the time of admission and four weeks later. Furthermore, we evaluated the change in motor FIM items and examined the relationship with the data. Multiple regression analysis revealed that a high muscle rate (skeletal muscle mass/body weight) (odds ratio OR = 2.43), high phase angle (OR = 3.32), and high GNRI (OR = 2.57) were significantly associated with motor FIM items at four weeks in male and female patients. Muscle mass maintenance through nutritional management and early rehabilitation in the acute period of stroke is essential for functional recovery in stroke patients.
先前的研究表明,卒中后患者的营养状况与长期预后独立相关,肌少症会延迟卒中后康复并使预后恶化。然而,许多卒中患者在急性期会出现营养状况恶化和肌肉量减少。本前瞻性研究纳入了 179 名入住卒中康复病房的患者。我们进行了生物电阻抗分析,并测定了入院时的老年营养风险指数(GNRI),以评估肌肉量和营养状况。此外,我们在入院时和四周后使用功能独立性测量(FIM)分析日常生活活动。此外,我们评估了运动 FIM 项目的变化,并检查了与数据的关系。多元回归分析显示,高肌肉率(骨骼肌质量/体重)(比值比 OR=2.43)、高相位角(OR=3.32)和高 GNRI(OR=2.57)与男性和女性患者四周时的运动 FIM 项目显著相关。通过营养管理和急性卒中期的早期康复维持肌肉量对卒中患者的功能恢复至关重要。