Nishioka S, Sugawara H, Takayama M, Urushihara M, Watanabe M, Kiriya Y, Shintani K, Nakagomi H, Kageyama N, Okamoto T, Sumita S, Fujita M, Hashimoto S, Ishikawa M, Tsushima E, Ogawa A. Relationship between weight gain, functional recovery and nutrition monitoring in underweight tube-fed stroke patients. Jpn J Compr Rehabil Sci 2018; 9: 3-10.
Objective: To investigate the relationship between the frequency of nutritional monitoring, and both weight gain and functional recovery in underweight, tube-fed stroke patients.
Methods: Data for tube-fed stroke patients aged ≥40 with an (age-dependent) body mass index (BMI) of either <18.5, <20.0, or <21.5 kg/m2 were extracted from two studies included in the “Algorithm for Post-stroke Patients to improve oral intake Level (APPLE)” study, conducted at five Kaifukuki (convalescent) rehabilitation wards in Japan. The outcome measurements were compared between the wards participating in either weekly (WM), or monthly (MM) nutritional monitoring protocols by dietitians. Primary outcomes were a change in BMI, and functional independence measure (FIM) at discharge.
Results: There were 37 WM patients (18 women; mean age, 77 years) and 29 MM patients (19 women; mean age, 78 years) with no differences in stroke subtype, BMI, functional independence measure (FIM) and swallowing function. At discharge, WM patients showed a significantly higher BMI gain compared to MM patients (+0.2 kg/m2 vs. -0.5 kg/m2, p=0.009). A greater proportion of WM patients than that of MM patients achieved full oral intake (81.1% vs. 44.8%, p=0.002). WM was independently correlated with BMI change and discharge FIM on multivariable analyses.
Conclusions: Nutritional monitoring and planning recommendation at least once a week by dietitians may correlate with positive BMI change and better functions in tube-fed stroke patients.
