Association between Undernutrition at Admission and Improvement in Balance Function Post-stroke.

IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL JMA journal Pub Date : 2025-01-15 Epub Date: 2024-11-01 DOI:10.31662/jmaj.2024-0228
Keisuke Sato, Seiji Tanaka, Masaki Koike, Takahiro Ogawa
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Abstract

Introduction: The prognosis for activities of daily living (ADL) ability after stroke is negatively influenced by undernutrition and impaired balance. However, the association between undernutrition and balance improvement has not yet been elucidated. This study aimed to investigate the influence of undernutrition on balance function improvement in patients with stroke.

Methods: This retrospective observational study included patients with cerebral infarction aged ≥65 years. The study period was from May 2018 to May 2022. The patients were divided into undernutrition and intact nutrition groups according to the Global Leadership Initiative on Malnutrition criteria. The primary outcome was the change in the Berg Balance Scale (BBS) score (BBS score at discharge - BBS score at admission).

Results: This study included 304 patients (mean age, 79.2 ± 8.1 years; 173 men and 131 women). These patients were divided into the undernutrition (N = 114) and intact nutrition (N = 190) groups. The undernutrition group demonstrated lower BBS scores at admission (16.0 ± 17.1 vs. 28.3 ± 18.4, p < 0.001) and at discharge (24.2 ± 19.6 vs. 40.0 ± 16.9, p < 0.001) than the intact nutrition group. After adjusting for confounding factors, undernutrition was associated with a smaller change in the BBS score (coefficient = -2.988, 95% confidence interval = -5.481 to -0.495, p = 0.019).

Conclusions: Undernutrition negatively influences balance function recovery in post-stroke patients. A strategy aimed at improving nutritional status could have beneficial effects on patients' balance function.

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入院时营养不良与中风后平衡功能改善之间的关系。
脑卒中后日常生活活动(ADL)能力的预后受到营养不良和平衡受损的负面影响。然而,营养不良和平衡改善之间的关系尚未得到阐明。本研究旨在探讨营养不良对脑卒中患者平衡功能改善的影响。方法:回顾性观察研究纳入年龄≥65岁的脑梗死患者。研究期间为2018年5月至2022年5月。根据全球营养不良领导倡议的标准,将患者分为营养不良组和营养完整组。主要观察指标为Berg平衡量表(BBS)评分的变化(出院时的BBS评分-入院时的BBS评分)。结果:本研究纳入304例患者(平均年龄79.2±8.1岁;173名男性和131名女性)。将患者分为营养不良组(N = 114)和营养完整组(N = 190)。营养不良组入院时的BBS评分(16.0±17.1比28.3±18.4,p < 0.001)和出院时的BBS评分(24.2±19.6比40.0±16.9,p < 0.001)均低于营养完整组。在调整混杂因素后,营养不良与BBS评分的较小变化相关(系数= -2.988,95%可信区间= -5.481至-0.495,p = 0.019)。结论:营养不良对脑卒中后患者平衡功能恢复有负面影响。旨在改善营养状况的策略可能对患者的平衡功能产生有益的影响。
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