A systematic review of the impact of obesity on stroke inpatient rehabilitation functional outcomes

MacDonald, Shannon L; Journeay, W. Shane; Uleryk, Elizabeth

doi:10.3233/nre-192979

Cited by 8 publications

(31 citation statements)

References 20 publications

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“…Although it is unknown whether functional outcomes in adults undergoing inpatient stroke rehabilitation are affected by obesity [25], in this study, BMI was significantly positively associated with motor FIM gain in the group of patients with a BMI < 30.…”

Section: Discussionmentioning

confidence: 74%

“…As in the case of frailty, molecular biological analysis has been conducted on stroke patients [22], but many epidemiological studies have also been conducted [23][24][25]. The range of overweight not reaching obesity is also considered to be a risk factor for stroke [24], and it has been shown that there are not a few stroke rehabilitation patients with high BMI [25]. However, the relationship between weight change in CR and improvement of ADL at the time of CR discharge in patients with a wide range of BMI has not been clarified so far.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Two studies reported benefit, whereas the remainder demonstrated either no benefit or a negative association between obesity and functional outcomes. 6 Despite the previously described obesity paradox, one could also hypothesize that individuals with obesity might have worse functional outcomes given that obesity has been associated with disability in the general population. 5 However, our results indicate that all groups achieved similar, clinically meaningful functional improvements regardless of BMI.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review included seven international studies that varied in size (84–897 participants) and reported conflicting results regarding the association of obesity with functional outcomes after inpatient stroke rehabilitation. Two studies reported benefit, whereas the remainder demonstrated either no benefit or a negative association between obesity and functional outcomes 6 . Despite the previously described obesity paradox, one could also hypothesize that individuals with obesity might have worse functional outcomes given that obesity has been associated with disability in the general population 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Research examining the association of obesity with functional outcomes has also yielded inconsistent findings 9,12–16 . A recent systematic review examining the effect of obesity on functional outcomes after inpatient rehabilitation for stroke was unable to draw any definitive conclusions 6 . Furthermore, it has been suggested by some authors that rather than obesity being protective, the more important association is between being underweight and worse outcomes 15 …”

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confidence: 99%

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The Impact of Body Mass Index Classification on Outcomes After Stroke Rehabilitation

Weidman¹,

MacDonald²

2022

Am J Phys Med Rehabil

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With improving stroke mortality rates, more individuals are living with the consequences of stroke. Obesity is a known risk factor for stroke, but its effect on functional outcomes poststroke is less clear. The aim of this study was to determine the association between body mass index classification (underweight, normal weight, overweight, and obese) and functional outcomes, as measured by Functional Independence Measure change, Functional Independence Measure efficiency, and rehabilitation length of stay after inpatient stroke rehabilitation. A retrospective cohort study of individuals with a diagnosis of stroke admitted to a high-intensity inpatient rehabilitation program was performed. Patients were divided into 4 groups based on body mass index category using normal body mass index as the reference. Overall, 34 individuals (4.5%) were classified as underweight, 303 (40.1%) had body mass indices within the normal range, 269 (35.6%) were overweight, and 149 (19.7%) were obese. Ischemic stroke was the most common stroke type across all body mass index categories. Patients in the overweight and obese groups tended to be younger. There were no statistically significant differences in rehabilitation length of stay, Functional Independence Measure change, or Functional Independence Measure efficiency with all groups demonstrating significant functional improvements. Based on these findings, patients admitted for inpatient rehabilitation after stroke can be expected to make similar functional improvements regardless of BMI class.

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Association Between Weight Loss and Activities of Daily Living in Obese and Overweight Patients after Stroke: A Cross-Sectional Study

Kokura

Nishioka²

2021

Journal of Stroke and Cerebrovascular Diseases

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A systematic review of the impact of obesity on stroke inpatient rehabilitation functional outcomes

Cited by 8 publications

References 20 publications

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

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

The Impact of Body Mass Index Classification on Outcomes After Stroke Rehabilitation

Association Between Weight Loss and Activities of Daily Living in Obese and Overweight Patients after Stroke: A Cross-Sectional Study

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