Nitrogen balance in patients with hemiparetic stroke during the subacute rehabilitation phase.
In highly invasive diseases, metabolism commonly changes. Hypercatabolism is frequent in acute stroke, and nitrogen balance tends to be negative. However, there has been no study describing nitrogen balance in subacute and chronic stroke patients. The present study aimed to examine nitrogen balance in the subacute and chronic phases and to identify the factors related to it.



Nitrogen balance was calculated from the collected urine of 56 patients with subacute stroke [mean (SD) 53.8 (18.4) days post-stroke] who were admitted for rehabilitation for their first-ever ischaemic or nonsurgical haemorrhagic stroke. In the first experiment, their nitrogen balance was measured during the rehabilitation phase, and factors (type, severity of hemiparesis, activities of daily living, dysphagia and malnutrition status) related to it were evaluated. The second experiment was performed to describe the time course of nitrogen balance in 31 consecutive patients, with assessments made at admission and at discharge.



Nitrogen balance was positive in all patients in the subacute phase. A significant difference was seen in nitrogen balance between high and low fat-free mass in male patients. In the chronic phase, nitrogen balance was positive in 96% of the patients. There was no significant difference in nitrogen balance between discharge and admission.



In the subacute and chronic phases of stroke, it was confirmed that hypercatabolism had resolved and that intensive rehabilitation is possible in the convalescent period of stroke.
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Japan.
A
A
Wada
Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
M
0000-0001-6459-3325
M
Kawakami
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Japan.
T
T
Otsuka
Nutrition Management Office, National Higashisaitama Hospital, Hasuda, Japan.
H
H
Aoki
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Japan.
A
A
Anzai
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Japan.
Y
Y
Yamada
Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
F
F
Liu
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Japan.
E
E
Otaka
Department of Rehabilitation Medicine, Ichikawa City Rehabilitation Hospital, Ichikawa, Japan.
K
K
Akaboshi
Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
M
M
Liu
D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000175:diagnosis*; D004734:Energy Metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D009584:Nitrogen / Q000652:urine*; D010291:Paresis / Q000175:diagnosis*; D010351:Patient Discharge; D011446:Prospective Studies; D012146:Rest; D020521:Stroke / Q000628:therapy / Q000652:urine*; D000071939:Stroke Rehabilitation
D009584:Nitrogen
energy metabolism; nitrogen balance; rehabilitation