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Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 1999 June;35(2):75-81

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prevalence of malnutrition and inadequate food intake in self-feeding rehabilitation patients with stroke

Aquilani R. 1, Galli M. 3, Guarnaschelli C. 2, Fugazza G. 1, Lorenzoni M. 2, Varalda E. 4, Arrigoni N. 2, Achilli M. P. 2, Zelaschi G. P. 2, Crespi M. G. 3, Baiardi P. 5, Mariani P. 3

1 Servizio di Fisiopatologia Metabolico Nutrizionale e Nutrizione Clinica; 2 Divisione di Recupero e Rieducazione Funzionale II, Unità Spinale, Fondazione S. Maugeri, IRCCS, Centro Medico - Montescano; 3 Divisione di Recupero e Rieducazione Funzionale, Fondazione S. Maugeri, IRCCS, Centro Medico - Tradate; 4 Sezione Day Hospital, Divisione di Recupero e Rieducazione Funzionale, Fondazione S. Maugeri, IRCCS, Centro Medico - Montescano; 5 Servizio di Informatica Medica, Fondazione S. Maugeri, IRCCS, Centro Medico - Pavia, Italy


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BACKGROUND: Malnutrition is ­known to ­impair func­tion­al out­come and pro­long the hos­pi­tal ­stay of reha­bil­i­ta­tion ­patients ­with ­stroke. The aim of ­this ­study was to estab­lish the prev­a­lence of mal­nu­tri­tion in ­self-feed­ing ­patients ­with ­stroke and to inves­ti­gate the ade­qua­cy of ­their ­food ­intake.
METHODS: One hun­dred and fif­ty ­self-feed­ing ­patients ­with ­stroke ­were con­sid­ered (85 M + 65 W; 60 ± 11 yrs, 30 ± 10 ­days ­from the ­acute ­event; 45.3% ­with ­right and 54.7% ­with ­left hem­i­ple­gia). Each ­patient under­went the fol­low­ing eval­u­a­tions: a) anthro­pom­e­try to diag­nose the mal­nu­tri­tion; b) rest­ing ener­gy expen­di­ture (REE by indi­rect cal­o­rim­e­try, stan­dard pro­to­col); c) cal­o­rie and mac­ro­nu­tri­ent ­intakes by ­using 3 — day ­food diar­ies; d) 24 hr uri­nary nitro­gen excre­tion to meas­ure nitro­gen bal­ance (NB).
RESULTS: Forty-­five ­patients (=30%) ­were diag­nosed as mal­nour­ished. Inadequacies in cal­o­rie (Kcal-I/REE≤110%), pro­tein (<0.8 g/kg/day) and in car­bo­hy­drate (<140 g/d) ­intake ­were ­found, respec­tive­ly in 60, 50, 38.6% of all the ­patients ­with ­stroke. A neg­a­tive NB was ­observed in ­more ­than 50% of ­patients. Food ­intake inad­e­qua­cy was sig­nif­i­cant­ly great­er in mal­nour­ished ­than in nor­mal­ly nour­ished ­patients.
CONCLUSIONS: The prev­a­lence of mal­nu­tri­tion in ­self feed­ing reha­bil­i­ta­tion ­patients ­with ­stroke is ­high and a ­self-feed­ing stat­us is not syn­on­y­mous ­with nor­mal ­food ­intake. Nutritional eval­u­a­tions ­should be rou­tine­ly ­made in ­patients ­with the seque­lae of cereb­ro­vas­cu­lar acci­dents.

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