Correlations between aerobic exercise time during physiotherapy and characteristics of patients with subacute stroke: A pilot cross-sectional study.

BACKGROUND: The amount of aerobic exercise time (AET) is an important factor for improving physical function in patients with stroke. However, there is a lack of evidence regarding the factors for AET during physiotherapy, particularly in stroke patients. OBJECTIVE: To investigate the correlation between AET during physiotherapy and characteristics of patients with subacute stroke. METHODS: In this cross-sectional study, 61 hospitalized subacute stroke patients (age = 72 (11) years, (median (interquartile range)) were enrolled and their exercise intensity was measured by wearable sensors (Mio Alpha 2) worn during physiotherapy sessions. All patients were divided into two groups, non-ambulatory group (functional ambulation classification (FAC); 0-2) and ambulatory group (FAC; 3-5). The correlations between AET and patient characteristics were assessed in each group. RESULTS: There was no significant difference in AET between the ambulatory and non-ambulatory groups (9 (12) min vs 5 (10) min, p = .27, respectively). There was a significant correlation between AET and the functional independent measures (FIM) motor score in the ambulatory group (r = 0.52, p = .005), and between AET and the FIM cognitive score in the non-ambulatory group (r = 0.44, p = .008). CONCLUSION: Correlations between AET and patient characteristics were different according to ambulation capacity in patients with subacute stroke.

Cachexia criteria in chronic illness associated with acute weight loss in patients with stroke.

OBJECTIVES: Weight loss after a stroke is associated with poor outcomes. However, the causes of weight loss in the acute phase of a stroke are not fully understood. The purpose of this study was to investigate the relationship between acute weight changes and cachexia criteria in patients with an acute stroke. METHODS: In this prospective-cohort study, we assessed patients' body weight change during hospitalization, and investigated the five cachexia criteria (muscle strength, fatigue, anorexia, skeletal muscle mass, and abnormal biochemistry) at time of discharge in patients with an acute stroke. A patient was defined as being cachectic if ≥3 cachexia criteria were met. A multivariate analysis was performed to investigate the relationship between weight changes and cachexia criteria. RESULTS: A total of 155 patients with an acute stroke were enrolled in this study, and 30 patients (19%) were found to have weight loss (≥5% weight loss). A univariate regression analysis found that the cachexia criteria were significantly associated with weight changes (ß = -0.338; P < 0.001). The multivariate analyses after adjusting for energy intake, age, sex, body mass index at time of admission, National Institutes of Health stroke scale score, inflammatory disease, length of hospital stay, length of bed rest, and swallowing function showed that the cachexia criteria were significantly associated with weight changes (ß = -0.154; P = 0.043). CONCLUSIONS: The cachexia criteria were independently associated with acute weight loss in patients with a stroke.

Prevalence of Malnutrition Diagnosed with GLIM Criteria and Association with Activities of Daily Living in Patients with Acute Stroke.

BACKGROUND: Malnutrition is associated with a poor functional outcome in patients with stroke. However, the prevalence of malnutrition diagnosed with the Global Leadership Initiative on Malnutrition (GLIM) criteria or its association with activity of daily living (ADL) in patients with acute stroke have not been reported. OBJECTIVE: To investigate the prevalence of the malnutrition diagnosed with the GLIM criteria and its association with ADL or discharge destination in patients with acute stroke. MATERIALS AND METHODS: In this cross-sectional study, we diagnosed malnutrition with the GLIM criteria and the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria and assessed ADL by functional independence measure motor domain (FIM-M) score in patients with acute stroke. Multivariate regression analysis was used to investigate the relationship between FIM-M score or home discharge and malnutrition defined with GLIM or ESPEN criteria. RESULTS: A total of 115 acute stroke patients (39 females; median age: 72 years) were enrolled in this study. The prevalence of malnutrition according to GLIM-criteria and ESPEN-criteria was 28.7% and 16.5%, respectively. Multivariate analyses for FIM-M score after adjusting for potential confounders showed that GLIM criteria and ESPEN criteria were independently associated with FIM-M score (ß = -0.238, p < 0.001; ß = -0118, p = 0.040, respectively). A multivariate analysis for discharge destination found that only malnutrition from the GLIM criteria was significantly associated with home discharge (OR = 0.08, 95% confidential interval = 0.01-0.69, p = 0.02). CONCLUSIONS: Malnutrition with the GLIM criteria is negatively associated with ADL and is also associated with discharge destination in patients with acute stroke.