Phase angle and nutrition in the acute phase are associated with the subsequent recovery of activities of daily living ability after stroke

Objectives

To examine the factors predicting the recovery of post-stroke activities of daily living during the entire hospitalization period, focusing on skeletal muscle characteristics, nutrition, and physical activity in the acute phase.

Materials and methods

This prospective observational study included 55 stroke patients (72.4 ± 8.9 years). The primary outcome measures were relative functional gain (RFG) and efficiency (RFE) calculated using the Functional Independence Measure motor items. The FIM was assessed upon admission to the acute hospital and on discharge from the acute or convalescent hospital. Phase angle upon admission were evaluated using a bioimpedance analyzer (InBody S10). The energy sufficiency ratio was evaluated using nutritional intake surveys for two weeks from the onset. Metabolic equivalents were measured using a tri-axial accelerometer (ActiGraph wGT3X-BT). Hierarchical multiple regression analyses were performed with RFG and RFE as the dependent variables.

Results

The FIM motor score increased from 34.7 ± 22.1 at admission to 81.5 ± 10.2 at discharge. Multiple regression analysis revealed that phase angle (β = 0.529) was significantly associated with RFG (R² = 0.223). The phase angle (β = 0.314) and the energy sufficiency ratio (β = 0.312) were significantly associated with RFE (R² = 0.319). The interaction between nutrition and physical activity was observed, with energy sufficiency ratio emerging as a significant predictor in participants with low levels of physical activity.

Conclusions

Phase angle and nutritional management during the acute phase are important factors for improving activities of daily living during total hospital stay in stroke patients.