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Aim: To elucidate the effects of whole-body exercise on clinical outcomes, including dysphagia status, between stroke patients with dysphagia who are undergoing convalescent rehabilitation. Methods: This retrospective cohort study included consecutive patients with post-stroke dysphagia in a rehabilitation hospital in Japan between 2016 and 2018. Dysphagia was defined as a Food Intake Level Scale (FILS) score <7. Participants were asked to perform a repeated chair-stand exercise as a whole-body exercise in addition to the convalescence rehabilitation program. Study outcomes included the FILS score and presence of dysphagia at discharge, the Functional Independence Measure-motor (FIM-motor) score and length of stay. Multivariate analyses were used to determine whether the frequency of daily chair-stand exercise was independently associated with study outcomes, after adjusting for potential confounders; P < 0.05 was considered statistically significant. Results: Of the 637 patients admitted, 148 stroke patients with dysphagia (mean age 72.7 years; 48.6% men) were included in the final analysis dataset. The median daily frequency of repeated chair-stand exercise was 36 (12-65). In multivariate analyses, the frequency of chair-stand exercise was independently associated with the FILS score at discharge (β = 0.231, P = 0.015), the presence of dysphagia at discharge (odds ratio: 0.982, P = 0.035), FIM-motor at discharge (β = 0.205, P = 0.008) and its gain (β = 0.237, P = 0.013), and length of hospital stay (β = −0.042, P < 0.001). Conclusions: Chair-stand exercise is associated with preferable clinical outcomes, including dysphagia status, activities of daily living and length of hospital stay, in stroke patients with dysphagia. Post-stroke dysphagia rehabilitation should include whole-body exercises in addition to conventional rehabilitation programs.

Evidence is scarce regarding the polypharmacy in patients with sarcopenia. The aim of this study was to investigate the effect of deprescribing for polypharmacy on the improvement of nutritional intake and sarcopenia in older patients with sarcopenia. A retrospective cohort study was conducted with hospitalized older patients with sarcopenia undergoing rehabilitation after stroke. Study outcomes included energy intake, protein intake, handgrip strength (HG) and skeletal muscle mass index (SMI) at hospital discharge. To consider the effects of deprescribing for polypharmacy, we used multivariate analyses to examine whether the change in the number of medications during hospitalization was associated with outcomes. Of 361 patients after enrollment, 91 (mean age 81.0 years, 48.4% male) presented with sarcopenia and polypharmacy and were eligible for analysis. The change in the number of medications was independently associated with energy intake (β = −0.237, p = 0.009) and protein intake (β = −0.242, p = 0.047) at discharge, and was not statistically significantly associated with HG (β = −0.018, p = 0.768) and SMI (β = 0.083, p = 0.265) at discharge, respectively. Deprescribing was associated with improved nutritional intake in older sarcopenic patients with polypharmacy undergoing stroke rehabilitation.

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