title: Nutritional Improvement and Energy Intake Are Associated with Functional Recovery in Patients after Cerebrovascular Disorders.
abstract: BACKGROUND
  Malnutrition affects the activities of daily living (ADLs) in convalescent patients with cerebrovascular disorders. We investigated the relationship between nutritional improvement, energy intake at admission, and recovery of ADLs.
  
  
  METHODS
  We evaluated 67 patients with cerebrovascular disorders admitted to our rehabilitation hospital between April 2013 and April 2015. These patients received interventions from the rehabilitation nutritional support team according to the following criteria: weight loss of 2 kg or more and body mass index of 19 kg/m(2) or lower. Exclusion criteria included a body mass index of 25 kg/m(2) or higher, duration of intervention of less than 14 days, or transfer to an acute care hospital because of clinical deterioration. We assessed nutritional status using the Geriatric Nutritional Risk Index (GNRI) and ADL using the Functional Independence Measure (FIM) score, FIM gain, and FIM efficiency.
  
  
  RESULTS
  The mean age of the patients was 78.7 ± 8.0 years. The numbers of patients in each category of cerebrovascular disorder were 39 with cerebral infarction, 16 with intracerebral hemorrhage, 8 with subarachnoid hemorrhage, and 4 others. Compared with the counterpart group, the group with an improvement in GNRI had a greater gain in FIM (median 17 and 20, respectively; P = .036) and a higher FIM efficiency (.14 and .22, respectively; P = .020). Multivariate stepwise regression analysis showed that an improvement in GNRI, increasing energy intake at admission, and intracerebral hemorrhage were associated independently with greater FIM efficiency.
  
  
  CONCLUSIONS
  This study suggested that nutritional improvement and energy intake at admission are associated with recovery of ADL after cerebrovascular disorders.
authors.affiliation: Department of Nutrition and Food Service, Sakurakai Medical Corporation, Sakurakai Hospital, Japan.
authors.forename: Maria
authors.initials: M
authors.lastname: Nii
authors.affiliation: Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Japan. Electronic address: maeda4work@tng.bbiq.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Rehabilitation Medicine, Yokohama City University Medical Center, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Wakabayashi
authors.affiliation: Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Japan.
authors.forename: Shinta
authors.initials: S
authors.lastname: Nishioka
authors.affiliation: Department of Internal Medicine and Rehabilitation Medicine, Sakurakai Medical Corporation, Sakurakai Hospital, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tanaka
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002561:Cerebrovascular Disorders / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000517:prevention & control*; D009752:Nutritional Status; D018529:Nutritional Support; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013851:Thinness / Q000453:epidemiology; D015431:Weight Loss
keywords: Nutritional status; activities of daily living; cerebrovascular disorders; energy intake; rehabilitation nutrition team