Editorial

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2 pages, 171 KiB

Open AccessEditorial

Recent Advances in Clinical Nutrition in Stroke Rehabilitation

by Yoshihiro Yoshimura

Nutrients 2022, 14(6), 1130; https://doi.org/10.3390/nu14061130 - 08 Mar 2022

Cited by 4 | Viewed by 2805

Abstract

Stroke is a common cause of death and disability worldwide [...] Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

Research

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8 pages, 277 KiB

Open AccessArticle

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

by Hiroshi Kishimoto, Yuka Nemoto, Takayuki Maezawa, Kazushi Takahashi, Kazunori Koseki, Kiyoshige Ishibashi, Hanako Tanamachi, Naoki Kobayashi and Yutaka Kohno

Nutrients 2022, 14(2), 264; https://doi.org/10.3390/nu14020264 - 09 Jan 2022

Cited by 5 | Viewed by 2276

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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7 pages, 1233 KiB

Open AccessArticle

Relationships between Pre-Stroke SARC-F Scores, Disability, and Risk of Malnutrition and Functional Outcomes after Stroke—A Prospective Cohort Study

by Masafumi Nozoe, Hiroki Kubo, Masashi Kanai and Miho Yamamoto

Nutrients 2021, 13(10), 3586; https://doi.org/10.3390/nu13103586 - 13 Oct 2021

Cited by 12 | Viewed by 2601

Abstract

SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was [...] Read more.

SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was the modified Rankin Scale (mRS) 3 months after stroke. The relationship between SARC-F scores and poor functional outcomes was examined using a logistic regression analysis. Furthermore, the applicability of SARC-F scores to the assessment of poor functional outcomes was analyzed based on the area under the receiver operating curve (ROC). Eighty-one out of the 324 patients enrolled in the present study (25%) had poor functional outcomes (mRS ≥ 4). The results of the multivariate analysis revealed a correlation between SARC-F scores (OR = 1.29, 95% CI = 1.05–1.59, p = 0.02) and poor functional outcomes. A cut-off SARC-F score ≥ 4 had low-to-moderate sensitivity (47.4%) and high specificity (87.3%). The present results suggest that the measurement of pre-stroke SARC-F scores is useful for predicting the outcomes of stroke patients. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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10 pages, 486 KiB

Open AccessFeature PaperArticle

Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke

by Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ryo Momosaki, Fumihiko Nagano, Takahiro Bise, Sayuri Shimazu and Ai Shiraishi

Nutrients 2021, 13(9), 3274; https://doi.org/10.3390/nu13093274 - 19 Sep 2021

Cited by 13 | Viewed by 5097

Abstract

We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as [...] Read more.

We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as actual BW (kg) × 30 (kcal/day), and the stored energy was defined as the energy intake minus the energy requirement. Body composition was measured by bioelectrical impedance analysis. The study participants gained an average of 1.0 ± 2.6 kg of BW over a mean hospital stay of 100 ± 42 days with a mean stored energy of 96.2 ± 91.4 kcal per day. They also gained an average of 0.2 ± 1.6 kg of SMM and 0.5 ± 2.3 kg of fat mass (FM). This means about 9600 kcal were needed to gain 1 kg of BW. In addition, a 1 kg increase in body weight resulted in a 23.7% increase in SMM and a 45.8% increase in FM. Multivariate regression analyses showed that the stored energy was significantly associated with gains in BW and SMM. Aggressive nutrition therapy is important for improving nutritional status and function in patients with malnutrition and sarcopenia. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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14 pages, 939 KiB

Open AccessArticle

Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

by Lien T. K. Nguyen, Binh N. Do, Dinh N. Vu, Khue M. Pham, Manh-Tan Vu, Hoang C. Nguyen, Tuan V. Tran, Hoang P. Le, Thao T. P. Nguyen, Quan M. Nguyen, Cuong Q. Tran, Kien T. Nguyen, Shwu-Huey Yang, Jane C.-J. Chao and Tuyen Van Duong

Nutrients 2021, 13(5), 1641; https://doi.org/10.3390/nu13051641 - 13 May 2021

Cited by 10 | Viewed by 5104

Abstract

Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke [...] Read more.

Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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20 pages, 3446 KiB

Open AccessArticle

Possible Neuroprotective Effects of l-Carnitine on White-Matter Microstructural Damage and Cognitive Decline in Hemodialysis Patients

by Yuji Ueno, Asami Saito, Junichiro Nakata, Koji Kamagata, Daisuke Taniguchi, Yumiko Motoi, Hiroaki Io, Christina Andica, Atsuhiko Shindo, Kenta Shiina, Nobukazu Miyamoto, Kazuo Yamashiro, Takao Urabe, Yusuke Suzuki, Shigeki Aoki and Nobutaka Hattori

Nutrients 2021, 13(4), 1292; https://doi.org/10.3390/nu13041292 - 14 Apr 2021

Cited by 4 | Viewed by 2870

Abstract

Although l-carnitine alleviated white-matter lesions in an experimental study, the treatment effects of l-carnitine on white-matter microstructural damage and cognitive decline in hemodialysis patients are unknown. Using novel diffusion magnetic resonance imaging (dMRI) techniques, white-matter microstructural changes together with cognitive decline [...] Read more.

Although l-carnitine alleviated white-matter lesions in an experimental study, the treatment effects of l-carnitine on white-matter microstructural damage and cognitive decline in hemodialysis patients are unknown. Using novel diffusion magnetic resonance imaging (dMRI) techniques, white-matter microstructural changes together with cognitive decline in hemodialysis patients and the effects of l-carnitine on such disorders were investigated. Fourteen hemodialysis patients underwent dMRI and laboratory and neuropsychological tests, which were compared across seven patients each in two groups according to duration of l-carnitine treatment: (1) no or short-term l-carnitine treatment (NSTLC), and (2) long-term l-carnitine treatment (LTLC). Ten age- and sex-matched controls were enrolled. Compared to controls, microstructural disorders of white matter were widely detected on dMRI of patients. An autopsy study of one patient in the NSTLC group showed rarefaction of myelinated fibers in white matter. With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels. The LTLC group showed better achievement on trail making test A, which was correlated with amelioration of disorders in some white-matter tracts. Novel dMRI tractography detected abnormalities of white-matter tracts after hemodialysis. Long-term treatment with l-carnitine might alleviate white-matter microstructural damage and cognitive impairment in hemodialysis patients. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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9 pages, 840 KiB

Open AccessArticle

Nutrition in the First Week after Stroke Is Associated with Discharge to Home

by Yoichi Sato, Yoshihiro Yoshimura and Takafumi Abe

Nutrients 2021, 13(3), 943; https://doi.org/10.3390/nu13030943 - 15 Mar 2021

Cited by 25 | Viewed by 4853

Abstract

Malnutrition is associated with poor clinical outcomes in stroke patients. The effect of early nutritional intake after admission on home discharge is unclear. We evaluated the impact of energy intake in the first week of hospitalization of acute stroke patients on home discharge [...] Read more.

Malnutrition is associated with poor clinical outcomes in stroke patients. The effect of early nutritional intake after admission on home discharge is unclear. We evaluated the impact of energy intake in the first week of hospitalization of acute stroke patients on home discharge and activities of daily living (ADL). A retrospective cohort study was conducted with 201 stroke patients admitted to an acute care hospital in Japan. The energy and protein intake during the first week were evaluated. Multivariate models were used to estimate variables related to discharge destination and ADL at discharge. The cut-off point of nutritional intake for determining the discharge destination was evaluated using the receiver operating characteristic curve. Out of 163 patients included in the analysis, 89 (54.6%) and 74 (45.4%) were discharged home and elsewhere, respectively. Those discharged home had higher energy and protein intake than those discharged elsewhere. In multiple regression analysis, energy intake was independently associated with ADL at discharge and home discharge (odds ratio 1.146). Those with energy intake >20.7 kcal/kg/day had higher ADL at discharge and more patients discharged home than those with energy intake <20.7 kcal/kg/day. Energy intake during the first week affected home discharge in acute stroke patients. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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Review

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9 pages, 600 KiB

Open AccessReview

Temporal Muscle and Stroke—A Narrative Review on Current Meaning and Clinical Applications of Temporal Muscle Thickness, Area, and Volume

by Masahito Katsuki, Yukinari Kakizawa, Akihiro Nishikawa, Yasunaga Yamamoto, Toshiya Uchiyama, Masahiro Agata, Naomichi Wada, Shin Kawamura and Akihito Koh

Nutrients 2022, 14(3), 687; https://doi.org/10.3390/nu14030687 - 06 Feb 2022

Cited by 18 | Viewed by 2651

Abstract

Background: Evaluating muscle mass and function among stroke patients is important. However, evaluating muscle volume and function is not easy due to the disturbances of consciousness and paresis. Temporal muscle thickness (TMT) has been introduced as a novel surrogate marker for muscle mass, [...] Read more.

Background: Evaluating muscle mass and function among stroke patients is important. However, evaluating muscle volume and function is not easy due to the disturbances of consciousness and paresis. Temporal muscle thickness (TMT) has been introduced as a novel surrogate marker for muscle mass, function, and nutritional status. We herein performed a narrative literature review on temporal muscle and stroke to understand the current meaning of TMT in clinical stroke practice. Methods: The search was performed in PubMed, last updated in October 2021. Reports on temporal muscle morphomics and stroke-related diseases or clinical entities were collected. Results: Four studies reported on TMT and subarachnoid hemorrhage, two studies on intracerebral hemorrhage, two studies on ischemic stroke, two studies on standard TMT values, and two studies on nutritional status. TMT was reported as a prognostic factor for several diseases, a surrogate marker for skeletal muscle mass, and an indicator of nutritional status. Computed tomography, magnetic resonance imaging, and ultrasonography were used to measure TMT. Conclusions: TMT is gradually being used as a prognostic factor for stroke or a surrogate marker for skeletal muscle mass and nutritional status. The establishment of standard methods to measure TMT and large prospective studies to further investigate the relationship between TMT and diseases are needed. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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