Association Between Body Mass Index and Results of Rehabilitation in Patients After Stroke: A 3-Month Observational Follow-Up Study

Abstract

Background We assessed the relationship between body mass index and results of rehabilitation in stroke patients. Material/Methods The study was carried out at the Clinical Rehabilitation Ward with Early Neurological Rehabilitation Unit at the Clinical Hospital. The examinations were performed 3 times. Based on inclusion and exclusion criteria, 128 subjects were qualified for the first examination, the second examination involved 114 subjects, and 100 stroke patients participated in the third examination. Body mass was examined with an accuracy of 0.1 kg, using a Tanita MC–780 MA body composition analyser. Body mass index (BMI) was calculated for all of the subjects. Effects of rehabilitation were assessed with the Barthel index and Ashworth scale. Results Higher functional status in daily life, measured with the Barthel scale, was found in patients with normal body mass, compared to the overweight and obese subjects (examination I, II, and II). Exam I showed that before rehabilitation the overweight patients obtained significantly higher results in assessment of upper limbs, based on the Ashworth scale (mean=0.35±0.54) compared to the obese patients (mean=0.03±0.32) and those with normal body weight (mean=0.24±0.75). Conclusions Following hospital-based rehabilitation, patients with normal body mass achieved greater functional efficiency. The findings also show a trend towards normalization of BMI. The positive effect of rehabilitation was sustained for 3 months (Exam III), which may contribute to decreased risk of cardiovascular diseases and complications such as stroke.

The relationship between nutritional status at the time of stroke on adverse outcomes: a systematic review and meta-analysis of prospective cohort studies

“…Of the 14 prospective cohort studies examining the relationship between BMI and outcomes, 149 107 participants (46% females) diagnosed with stroke were included. [14][15][16][17][18][19][20][21][22][23][24][25][26][27] Mean age across the studies ranged from 54.2 to 78.0 years. All-cause mortality was determined at three months for three studies 17,21,27 at six months for one study 18 and at 12 months or longer in the remaining ten studies.…”

“…[14][15][16][17][18][19][20][21][22][23][24][25][26][27] Mean age across the studies ranged from 54.2 to 78.0 years. All-cause mortality was determined at three months for three studies 17,21,27 at six months for one study 18 and at 12 months or longer in the remaining ten studies. [14][15][16]19,20,[22][23][24][25][26] Poor functional status was ascertained by the modified Rankin Scale (mRS), Barthel Index (BI) and Functional Independence Measure.…”

“…19 Common strengths were: Clear and focused question (n ¼ 26; 100%), selecting of participants (n ¼ 26; 100%) clearly defining the number of participants in each group (n ¼ 24; 92%), [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][33][34][35][36][37][38][39] distinctly stating outcomes (n ¼ 26; 100%) and reliable exposure assessment (n ¼ 25; 96%). 39 The majority of studies had acceptable drop-out rates (n ¼ 22; 85%), [14][15][16][17][18]20,[22][23][24][25][26][27][29][30][31][32][33][34][35][36][37]39 provided confidence intervals (n ¼ 23; 88%) …”

“…39 The majority of studies had acceptable drop-out rates (n ¼ 22; 85%), [14][15][16][17][18]20,[22][23][24][25][26][27][29][30][31][32][33][34][35][36][37]39 provided confidence intervals (n ¼ 23; 88%) [14][15][16][17][18][20][21][22][23][25][26][27][28][29][30][31][32][33][34][35][37][38][39] or found a clear association between exposure and outcome (n ¼ 23; 88%). [14][15][16][18][19]…”

The Efficiency of Spa Rehabilitation in Chronic Ischemic Stroke Patients—Preliminary Reports

“…However, one should bear in mind that during the first few weeks following a stroke, rehabilitation should not be too intensive [ 1 ]. The purpose of physiotherapy applied post-stroke is to improve the patient’s functional efficiency and restore their self-sufficiency and psychophysical balance as much as possible [ 2 , 3 ].…”