Nutritional improvement is associated with better functional outcome in stroke rehabilitation: A cross-sectional study using controlling nutritional status

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

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.

Nutritional status and activities of daily living in patients with Parkinson's disease

Patients with Parkinson's disease are often frail and likely to be malnourished. Several studies have reported the adverse effects of malnutrition on functional outcomes; however, the association between nutritional status and activities of daily living is unclear among patients with Parkinson's disease. This study aimed to investigate the relationship between nutritional status and activities of daily living in patients with Parkinson's disease. We conducted a retrospective cohort study with the data of 124 patients who were consecutively admitted to a rehabilitation hospital in Japan, among whom the data of 61 patients were included in the analyses. The Controlling Nutritional Status score was used to measure the nutritional status of the participants, and the motor subdomain of the Functional Independence Measure was used to assess the activities of daily living. Piecewise linear mixed-effects models were fitted to the data after adjusting for confounding factors. A poor nutritional status (i.e., Controlling Nutritional Status score >3) was significantly associated with a poor Functional Independence Measure gain, which was defined as difference in the score values of the Functional Independence Measures between discharge and admission. Our findings could aid in developing nutritional intervention programs for patients with Parkinson's disease by employing the Controlling Nutritional Status score to improve their activities of daily living.