Yamanoi J1, Nishida T1, Kitamura T1, Sako A1
1Aichi Saiseikai Rehabilitation Hospital, Rehabilitation, Nagoya, Japan
Background: Stroke patients in the convalescent stage often have complications due to malnutrition and muscle weakness in the affected and unaffected muscle.
From this, it is necessary to consider the malnutrition of the stroke patients at the convalescent stage. However, there is no report on the relationship between changes in malnutrition and muscle strength during hospitalization for stroke patients at the convalescent stage. Therefore, it is unclear whether malnutrition improvement affects muscle strength recovery of stroke patients at the convalescent stage is unclear.
Purpose: The aim of this study was to investigate the correlation between the malnutrition and unaffected lower limb muscular strength of stroke patients at the convalescent stage in a longitudinal study.
Methods: There were 103 patients aged 65 years or older selected among stroke patients admitted to the convalescent stage. The Mini Nutritional Assessment-Short Form and lower limb muscle strength were measured at admission and discharge.
Nutritional status at admission was classified as Malnutrition (0 to 7) and Malnutrition At risk (8 to 11). Among them, those who recognized improvement of malnutrition at discharge were classified as Malnutrition Improved Group(MI) and Malnutrition At risk Improved Group(MAI)． On the other hand, those who have not improved were classified Malnutrition Non-Improved Group(MNI) and Malnutrition At Risk Non -Improved Group(MANI). Unaffected lower limb muscle strength was measured by Hand Held Dynamometer, which were categorized by Flexion(HF), Extension(HE), Abduction(HAb), Adduction(HAd), External Rotation(HEr), Internal Rotation(HIr) of the hip joint, Flexion(KF), Extension(KE) of the knee joint , Planter Flexion (APF), Dorsiflexion(ADf) of the ankle joint. We conducted a Bonferroni method to compare unaffected lower limb muscle strength among the four group. A P value less than 0.05 was considered statistically significant.
Results: MAI and MANI showed significantly higher muscle strength at admission, discharge and degree of improvement of HF, HE, HAb, HAd, HER, HIR, KF, and ADf than MI and MNI (p 0.05). In addition, MAI was significantly higher muscle strength than the MANI(p 0.05),and the MI was significantly higher muscle strength than the MNI(p 0.05).
MAI and MANI showed significantly higher muscle strengths at the admission, discharge and degree of improvement of KE and APF than MI and MNI (p 0.01). In addition, MAI was significantly higher muscle strength than the MANI(p 0.01), and the MI was significantly higher muscle strength than the MNI(p 0.01).
Conclusion(s): It was revealed that malnutrition at admission and improvement of malnutrition during hospitalization of the stroke patient at the convalescent stage affected muscle weakness and muscle strength improvement of unaffected lower limb muscular strength. In particular, It was revealed that muscle weakness and muscle strength improvement was poor in muscles where disuse muscle atrophy of the lower limbs remarkably occurred due to bed rest.
Therefore, in considering improvement of muscle strength, acute stage and convalescent stage adequate nutrition management for nutritional improvement is necessary.
Implications: We explained the content of the research to the participants or their families verbally through writing and obtained written consent. This survey conforms to the ethical standards of the Declaration of Helsinki.
Keywords: Stroke, Malnutrition, Low limb muscle strength
Funding acknowledgements: Using a protocol that requires no research funds.
From this, it is necessary to consider the malnutrition of the stroke patients at the convalescent stage. However, there is no report on the relationship between changes in malnutrition and muscle strength during hospitalization for stroke patients at the convalescent stage. Therefore, it is unclear whether malnutrition improvement affects muscle strength recovery of stroke patients at the convalescent stage is unclear.
Purpose: The aim of this study was to investigate the correlation between the malnutrition and unaffected lower limb muscular strength of stroke patients at the convalescent stage in a longitudinal study.
Methods: There were 103 patients aged 65 years or older selected among stroke patients admitted to the convalescent stage. The Mini Nutritional Assessment-Short Form and lower limb muscle strength were measured at admission and discharge.
Nutritional status at admission was classified as Malnutrition (0 to 7) and Malnutrition At risk (8 to 11). Among them, those who recognized improvement of malnutrition at discharge were classified as Malnutrition Improved Group(MI) and Malnutrition At risk Improved Group(MAI)． On the other hand, those who have not improved were classified Malnutrition Non-Improved Group(MNI) and Malnutrition At Risk Non -Improved Group(MANI). Unaffected lower limb muscle strength was measured by Hand Held Dynamometer, which were categorized by Flexion(HF), Extension(HE), Abduction(HAb), Adduction(HAd), External Rotation(HEr), Internal Rotation(HIr) of the hip joint, Flexion(KF), Extension(KE) of the knee joint , Planter Flexion (APF), Dorsiflexion(ADf) of the ankle joint. We conducted a Bonferroni method to compare unaffected lower limb muscle strength among the four group. A P value less than 0.05 was considered statistically significant.
Results: MAI and MANI showed significantly higher muscle strength at admission, discharge and degree of improvement of HF, HE, HAb, HAd, HER, HIR, KF, and ADf than MI and MNI (p 0.05). In addition, MAI was significantly higher muscle strength than the MANI(p 0.05),and the MI was significantly higher muscle strength than the MNI(p 0.05).
MAI and MANI showed significantly higher muscle strengths at the admission, discharge and degree of improvement of KE and APF than MI and MNI (p 0.01). In addition, MAI was significantly higher muscle strength than the MANI(p 0.01), and the MI was significantly higher muscle strength than the MNI(p 0.01).
Conclusion(s): It was revealed that malnutrition at admission and improvement of malnutrition during hospitalization of the stroke patient at the convalescent stage affected muscle weakness and muscle strength improvement of unaffected lower limb muscular strength. In particular, It was revealed that muscle weakness and muscle strength improvement was poor in muscles where disuse muscle atrophy of the lower limbs remarkably occurred due to bed rest.
Therefore, in considering improvement of muscle strength, acute stage and convalescent stage adequate nutrition management for nutritional improvement is necessary.
Implications: We explained the content of the research to the participants or their families verbally through writing and obtained written consent. This survey conforms to the ethical standards of the Declaration of Helsinki.
Keywords: Stroke, Malnutrition, Low limb muscle strength
Funding acknowledgements: Using a protocol that requires no research funds.
Topic: Musculoskeletal: lower limb; Neurology: stroke; Older people
Ethics approval required: Yes
Institution: Aichi Saiseikai Rehabilitation Hospital
Ethics committee: Aichi Saiseikai Rehabilitation Hospital Ethics Committee
Ethics number: 201811
All authors, affiliations and abstracts have been published as submitted.
