Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data

Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara, Irene Aprile, Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara, Irene Aprile

Abstract

After a stroke, patients can suffer from sarcopenia, which can affect recovery. This could be closely related to an impairment in nutritional status. In this preliminary analysis of a longitudinal prospective study, we screened 110 subjects admitted to our rehabilitation center after a stroke. We then enrolled 61 patients, who underwent a 6-week course of rehabilitation treatment. We identified a group of 18 sarcopenic patients (SG), according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), by evaluating muscle strength with the handgrip test, and muscle mass with bioelectrical impedance analysis (BIA). With respect to the non-sarcopenic group (NSG), the SG at admission (T0) had worse muscle quality, according to the BIA-derived phase angle, and a lower score of MNA®-SF. In contrast to the NSG, the SG also exhibited lower values for both BMI and the Geriatric Nutritional Risk Index (GNRI) at T0 and T1. Moreover, 33% of the SG had a major risk of nutrition-related complications (GNRI at T0 < 92) and discarded on average more food during the six weeks of rehabilitation (about one-third of the average daily plate waste). Of note is the fact that the Barthel Index’s change from baseline indicated that the SG had a worse functional recovery than the NGS. These results suggest that an accurate diagnosis of sarcopenia, along with a proper evaluation of the nutritional status on admission to rehabilitation centers, appears strictly necessary to design individual, targeted physical and nutritional intervention for post-stroke patients, to improve their ability outcomes.

Keywords: Geriatric Nutritional Risk Index; bioelectrical impedance analysis; food consumption; functional recovery; malnutrition: nutrition; nutritional intake; plate waste; post-stroke; rehabilitation; sarcopenia.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
EWGSOP2 algorithm for case finding and diagnosis of sarcopenia at baseline in the sample group. Patients enrolled (n = 61) were assessed by handgrip test and the diagnosis in patients with probable sarcopenia (n = 32) was confirmed by muscle-quantity assessment using bioelectrical impedance analysis (BIA), identifying a Sarcopenic Group (SG) of 18 subjects and a Non-Sarcopenic Group (NSG) of 43 subjects.
Figure 2
Figure 2
Distribution of the change from baseline of the modified Barthel Index (ΔBI) after 6 weeks of rehabilitation in Non-Sarcopenic Group (NSG, n = 42) and Sarcopenic Group (SG, n = 16). Mean bars and 95% CI are reported. * Refers to the statistically significant difference (p value = 0.038).

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