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应用生物电阻抗分析法评估颅脑损伤和脑卒中康复过程中骨骼肌质量指数和脂肪质量指数的变化。

Changes in skeletal muscle mass index and fat mass index during rehabilitation for traumatic brain injury and stroke measured by bioelectrical impedance analysis.

机构信息

Rehabilitation Department of Brain injuries, Department for Rehabilitation post Stroke, Department of Alimentation and Dietetics, National Institute of Locomotor Diseases and Disabilities/National Institute for Medical Rehabilitation.

Department of Rehabilitation Medicine, Semmelweis University, Budapest.

出版信息

Int J Rehabil Res. 2023 Sep 1;46(3):264-269. doi: 10.1097/MRR.0000000000000587. Epub 2023 Jun 16.

Abstract

Although malnutrition may negatively impact the outcomes of rehabilitation and increase the cost of care, there are still no valid nutritional assessment methods appropriate for specific groups of patients undergoing rehabilitation. This study aimed to determine if a multifrequency bioelectrical impedance is suitable for monitoring the changes in body composition of brain-injured patients for whom individualized nutritional goals were set during rehabilitation. Fat mass index (FMI) and skeletal muscle mass index (SMMI) were examined by Seca mBCA515 or portable Seca mBCA525 device within 48 h of admission and before discharge in 11 traumatic brain injury (TBI) and 11 stroke patients with admission Nutritional Risk Screening 2002 scores ≥2. The changes in outcomes and plausible interactions were examined between the admission values and the values estimated for the 18th day (minimum length of stay in the sample) using a repeated measure mixed-sample analysis of covariance. In patients with low FMI at admission (mainly younger, TBI patients, with longer ICU stay), there was no change over time whereas, in those with high admission FMI (older, stroke patients, with shorter ICU stay), a decrease was observed (significant interaction F(1,19) = 9.224 P  = 0.007 Part. η² = 0.327). The SMMI significantly increased over time (F(1,19) = 5.202 P  = 0.034 Part. η² = 0.215) independently of gender, age, days spent in ICU and cause of brain injury. Our results suggest that bioelectrical impedance analysis is feasible and informative for monitoring the changes in body composition during rehabilitation, which also requires consideration of demographic and pre-rehabilitation characteristics.

摘要

尽管营养不良可能对康复结果产生负面影响,并增加护理成本,但仍没有适用于接受康复治疗的特定患者群体的有效营养评估方法。本研究旨在确定多频生物电阻抗是否适合监测脑损伤患者的身体成分变化,这些患者在康复期间设定了个性化的营养目标。在 11 例创伤性脑损伤(TBI)和 11 例脑卒中患者入院时(入院时营养风险筛查 2002 评分≥2),使用 Seca mBCA515 或便携式 Seca mBCA525 设备在入院后 48 小时内和出院前检查体脂肪指数(FMI)和骨骼肌质量指数(SMMI)。使用重复测量混合样本协方差分析,检查入院值和第 18 天(样本中最短的住院时间)估计值之间的结果变化和合理的相互作用。在入院时 FMI 较低的患者(主要是年轻的 TBI 患者,ICU 住院时间较长)中,没有随时间的变化,而在入院时 FMI 较高的患者(较年长的脑卒中患者,ICU 住院时间较短)中,观察到下降(显著的交互作用 F(1,19)=9.224 P=0.007 部分 η²=0.327)。SMMI 随时间显著增加(F(1,19)=5.202 P=0.034 部分 η²=0.215),与性别、年龄、在 ICU 中度过的天数和脑损伤的原因无关。我们的结果表明,生物电阻抗分析对于监测康复期间身体成分的变化是可行且有信息的,这也需要考虑人口统计学和康复前的特征。

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