强化营养支持对亚急性卒中患者功能恢复的影响：一项随机、多中心、单盲试验

IF 4.6 3区医学 Q1 REHABILITATION

Annals of Physical and Rehabilitation Medicine Pub Date : 2025-04-17 DOI:10.1016/j.rehab.2025.101976

Dae Hyun Kim , Min Kyun Sohn , Jongmin Lee , Deog Young Kim , Yong-Il Shin , Gyung-Jae Oh , Yang-Soo Lee , Min Cheol Joo , So Young Lee , Min-Keun Song , Junhee Han , Jeonghoon Ahn , Ho Seok Lee , Young-Taek Kim , Yun-Hee Kim , Won Hyuk Chang

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引用次数: 0

摘要

背景：脑卒中亚急性期的营养可能是脑卒中后功能恢复和死亡率的关键因素。然而，亚急性中风患者的强化营养支持问题仍未得到充分探讨。目的研究首次中风患者亚急性期康复期间强化营养支持对功能恢复的影响。这项随机、单盲、平行设计的研究是韩国卒中功能和康复队列研究的一部分，该研究对卒中参与者进行了10年的长期随访。从5家医院招募91例首次卒中患者，随机分为强化营养（IN）组（n = 43）和常规营养（CN）组（n = 48）。所有参与者都接受了相同的全面住院中风康复治疗。在为期三周的干预期间，IN组每天额外接受500千卡静脉营养输注，而两组均接受常规营养。在基线、干预后和中风发作后6个月对功能评估和营养状况进行评估。意向-治疗分析采用重复测量方差分析和事后分析。结果两组间基线特征无显著性差异。in组的辍学率（20%）明显高于CN组（2%）。重复测量方差分析显示，时间与干预之间存在显著的交互作用，改良Barthel指数（P = 0.02, η²= 0.05，小）和2002年营养风险筛查（P = 0.03, η²= 0.03，小），表明in组有显著改善。修改后的Barthel指数、2002年营养风险筛查和功能活动类别显示，在不同时间点之间，in组的变化明显高于CN组。结论综合康复期间强化营养支持可进一步改善亚急性脑卒中患者的功能。然而，应该探索强化营养的替代方法，因为静脉营养输注对一些参与者不是很耐受。临床试验注册号及网站eurl: https://www.clinicaltrials.gov；唯一标识符：NCT04259307。

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Effect of intensive nutritional support on functional recovery in subacute stroke: A randomized, multicenter, single-blinded trial

Background

Nutrition in the subacute phase of stroke may be a critical factor in functional recovery and post-stroke mortality. Nevertheless, the issue of intensive nutritional support for people with subacute stroke remains insufficiently explored.

Objectives

This study investigated the effects of intensive nutritional support during rehabilitation on functional recovery in the subacute phase of participants with a first-ever stroke.

Methods

This randomized, single-blinded, parallel-designed study is part of the Korean Stroke Cohort for Functioning and Rehabilitation, a 10-year long-term follow-up of stroke participants. A total of 91 first-ever stroke participants were recruited from 5 hospitals and randomly allocated to the intensive nutrition (IN) group (n = 43) or the conventional nutrition (CN) group (n = 48). All participants received the same comprehensive inpatient stroke rehabilitation. During the three-week intervention period, the IN group received an additional 500 kcal daily by intravenous nutritional infusion, while both groups received usual nutrition. Functional assessments and nutritional status were evaluated at baseline, post-intervention, and 6 months after stroke onset. Repeated measures ANOVA and post-hoc analyses were used for intention-to-treat analysis.

Results

Baseline characteristics were not significantly different between the groups. The dropout rate was significantly higher in the IN group (20 %) than in the CN group (2 %). A repeated measures ANOVA demonstrated significant interactions between time and intervention for the modified Barthel index (P = 0.02, η² = 0.05, small) and nutrition risk screening 2002 (P = 0.03, η² = 0.03, small), indicating significant improvements in the IN group. The modified Barthel Index, Nutrition Risk Screening 2002, and Functional Ambulation Category demonstrated significantly higher changes in the IN group compared to the CN group between time points.

Conclusions

Intensive nutritional support during comprehensive rehabilitation could provide additional functional improvement in subacute stroke participants. However, alternative methods of intensive nutrition should be explored, as intravenous nutritional infusions were not well-tolerated by some participants.

Clinical Trial Registry number and website

URL: https://www.clinicaltrials.gov; Unique identifier: NCT04259307.

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来源期刊

Annals of Physical and Rehabilitation Medicine Medicine-Rehabilitation

CiteScore

7.80

自引率

4.30%

发文量

136

审稿时长

34 days

期刊介绍： Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.