Nutritional intake is associated with activities of daily living and complications in older inpatients with stroke

Kokura, Yoji; Wakabayashi, Hidetaka; Nishioka, Shinta; Maeda, Keisuke

doi:10.1111/ggi.13467

Cited by 33 publications

(21 citation statements)

References 29 publications

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“…Recently, combined intervention has been viewed with keen interest; the effects of combined intervention on improving muscle strength or mass has gained a certain consensus [ 1 , 2 , 3 , 4 , 5 , 6 , 17 , 18 ], and the range of its use is expanding. Previous studies were done in patients with stroke [ 10 ], hip fracture [ 19 ], and artificial joint replacement [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Statistical analysis was conducted by a co-investigator (AK) who was independent of the recruitment, intervention, and data collection. Based on a study by Yoshimura [ 10 ], the minimal sample size was calculated using two-way repeated measures analysis of variance to examine significant differences between the groups (α = 0.05, power = 0.8, effect size = 0.5); 23 participants per group were required. The two groups were created by random assignment of the time of supplementation, including a breakfast group ( n = 23) and post-exercise group ( n = 23).…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, Foley et al [ 9 ] reported that energy and protein intake were 10–20% below the required amounts of patients after strokes. Kokura et al [ 10 ] and Nishijima et al [ 11 ] reported that this deficiency affects the ability to improve functional independence measure (FIM) scores. Furthermore, Yoshimura et al [ 12 ] showed that BCAA supplementation immediately after exercise led to improved FIM scores, grip strength, and skeletal muscle mass in stroke patients.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Timing of a Leucine-Enriched Amino Acid Supplement on Body Composition and Physical Function in Stroke Patients: A Randomized Controlled Trial

et al. 2020

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The combination of exercise and nutritional intervention is widely used for stroke patients, as well as frail or sarcopenic older persons. As previously shown, supplemental branched chain amino acids (BCAAs) or protein to gain muscle mass has usually been given just after exercise. This study investigated the effect of the timing of supplemental BCAAs with exercise intervention on physical function in stroke patients. The participants were randomly assigned to two groups based on the timing of supplementation: breakfast (n = 23) and post-exercise (n = 23). The supplement in the breakfast group was provided at 08:00 with breakfast, and in the post-exercise group it was provided just after the exercise session in the afternoon at 14:00–18:00. In both groups, the exercise intervention was performed with two sessions a day for two months. The main effects were observed in body fat mass (p = 0.02, confidence interval (CI): 13.2–17.7), leg press strength (p = 0.04, CI: 94.5–124.5), and Berg balance scale (p = 0.03, CI: 41.6–52.6), but no interaction with intake timing was observed. Although the effect of the timing of supplementation on skeletal muscle mass was similar in both groups, BCAA intake with breakfast was effective for improving physical performance and decreasing body fat mass. The results suggest that a combination of BCAA intake with breakfast and an exercise program was effective for promoting rehabilitation of post-stroke patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effects of Timing of a Leucine-Enriched Amino Acid Supplement on Body Composition and Physical Function in Stroke Patients: A Randomized Controlled Trial

et al. 2020

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“…However, one of the studies was excluded because it had been retracted by the editors because of concerns about data integrity and scientific misconduct [22,23]. From the nine remaining studies, see Table 1, four were multicenter studies [24,25,26,27]. Two interventions were commenced in the acute stroke phase [25,28] while others were including chronic stroke patients either during rehabilitation as inpatients [29,30] or outpatients [24].…”

Section: Resultsmentioning

confidence: 99%

How to Prevent Loss of Muscle Mass and Strength among Older People in Neuro-Rehabilitation?

Lathuilière

Mareschal

2019

Nutrients

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Stroke is the second leading cause of death worldwide but also of disability. Stroke induces certain alterations of muscle metabolism associated with gross muscle atrophy and a decrease in muscle function, leading to sarcopenia. The vast majority of stroke cases occur in adults over 65 years of age, and the prevalence is expected to massively increase in the coming years in this population. Sarcopenia is associated with higher mortality and functional decline. Therefore, the identification of interventions that prevent muscle alterations after stroke is of great interest. The purpose of this review is to carry out a systematic literature review to identify evidence for nutritional and pharmacological interventions, which may prevent loss of muscle mass in the elderly after stroke. The search was performed on Medline in December 2018. Randomized controlled studies, observational studies and case reports conducted in the last 20 years on post-stroke patients aged 65 or older were included. In total, 684 studies were screened, and eight randomized control trials and two cohort studies were finally included and examined. This review reveals that interventions such as amino acid supplementation or anabolic steroid administration are efficient to prevent muscle mass. Little evidence is reported on nutritional aspects specifically in sarcopenia prevention after stroke. It pinpoints the need for future studies in this particular population.

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“…13 In a retrospective study, Kokura et al reported that energy intake affected the improvements in the ADL of older stroke patients. 14 These reports implied the importance of intensive nutritional support for acute stroke patients with malnutrition risk. In contrast, Pellicane et al reported that improvement in the ADL was not associated with energy intake.…”

Section: Introductionmentioning

confidence: 99%

Individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement: A randomized controlled trial

Otsuki

Himuro

Tatsumi

et al. 2019

Geriatrics Gerontology Int

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Aim The aim of the present study was to investigate the effects of individualized nutritional treatment on the activities of daily living of acute stroke patients. Methods This was a randomized controlled study. The eligibility criteria were acute stroke, age >65 years and the presence of malnutrition risk. Between September 2016 and December 2017, 128 patients were assigned to either the standard or intensive group (individualized nutritional treatment). The intensive group received energy that was calculated using the Harris–Benedict equation. The main outcome measures were the total functional independence measurement gain from the time of assignment to the time of discharge from the recovery hospital or at 3 months after the stroke onset, and motor and cognitive functional independence measurement gains. Results Compared with the standard group, the intensive group had significantly higher median energy intake (P < 0.001); significantly greater functional independence measurement gains in the total score (42 vs. 22; P = 0.02) and motor subscore (P = 0.01), but similar cognitive subscore. Conclusion Individualized nutritional treatment improved the activities of daily living of older acute stroke patients with malnutrition risk. Geriatr Gerontol Int 2019; ••: ••–••.

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Nutritional intake is associated with activities of daily living and complications in older inpatients with stroke

Abstract: Energy intake during the first week after admission affected improvement of ADL and onset of complications during hospitalization in geriatric stroke inpatients. Geriatr Gerontol Int 2018; 18: 1334-1339.

Cited by 33 publications

References 29 publications

The Effects of Timing of a Leucine-Enriched Amino Acid Supplement on Body Composition and Physical Function in Stroke Patients: A Randomized Controlled Trial

The Effects of Timing of a Leucine-Enriched Amino Acid Supplement on Body Composition and Physical Function in Stroke Patients: A Randomized Controlled Trial

How to Prevent Loss of Muscle Mass and Strength among Older People in Neuro-Rehabilitation?

Individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement: A randomized controlled trial

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