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

Abstract

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.

Impact of rehabilitation dose on body mass index change in older acute patients with stroke: a retrospective observational study

“…Additionally, the proportion of patients experiencing weight gain during acute stroke treatment was reported as 10.4% ( 37 ). While literature specific to the acute stroke unit has been scarce, studies focusing on rehabilitation outcomes in the subacute phase have indicated limitations imposed by malnutrition, as indicated by a decreased BMI ( 38 , 39 ).…”

Current trends and future perspectives of stroke management through integrating health care team and nanodrug delivery strategy

“…Nutritionists or dietitians may also guide dietary modifications to prevent future strokes and manage underlying medical conditions, such as diabetes or high blood pressure. For example, Kishimoto et al (2022) figured out that maintaining or gaining weight could be helpful during this stage in patients with a BMI lower than 30. Therefore, nutritional modifications have been extensively advised to inhibit immediate weight loss and observe better functional recovery.…”

The Importance of Nutrition in Neurological Disorders and Nutrition Assessment Methods

“…Recent weight change is more clinically important than the percentage of the ideal body weight. Kishimoto et al [ 16 ] found that, among 293 patients hospitalized for rehabilitation after stroke, the FIM score showed a tendency to improve in patients who maintained or increased their weight compared to those who lost over 5% of their weight in 6 months, and a positive correlation was identified between weight maintenance and higher intake compared to patients’ energy requirements [ 16 ]. In general, if an adult loses more than 5% of his or her weight within a month or 10% or more in 6 months, an overall assessment of nutritional status is required.…”