Objective

Whether weight loss during hospitalization is associated with improvement in activities of daily living (ADL) in overweight and obese stroke patients remains unclear. This study investigated the association between decreases in body mass index (BMI), fat-free mass (FFM), and fat mass (FM) and ADL improvement.

Materials and methods

In this cross-sectional study, we analyzed data of patients admitted to acute care hospitals with stroke. Patients were classified into two groups based on their change in BMI during their hospital stay (i.e. decreased or nondecreased group). To control and adjust for patient characteristics and confounders, we created an inverse probability-weighted (IPW) model using propensity scoring, which was used to compare the Functional Independence Measure Motor (FIM-M) efficacy between the two groups. We also compared FFM and FM between admission and discharge in each group.

Results

A total of 556 patients were analyzed, among whom 391 (70.3%) had a decrease in BMI and 165 (29.7%) had a nondecrease. After IPW adjustment, efficiency of FIM-M was significantly higher in the nondecreased group as compared to that in the decreased group (median: 0.44 vs. 0.29, P < 0.001). FFM and FM were significantly decreased from admission to discharge in the decreased group, but there was no significanct difference observed in the nondecreased group. Preserving BMI during hospitalization was associated with a positive improvement in ADL in overweight and obese stroke patients undergoing rehabilitation.

Conclusions

Risks and benefits of weight loss should be balanced in nutritional care and rehabilitation for overweight and obese stroke patients.

中文翻译：

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中风后肥胖和超重患者体重减轻与日常生活活动之间的关系：一项横断面研究

客观的

住院期间体重减轻是否与超重和肥胖卒中患者日常生活活动（ADL）的改善有关仍不清楚。本研究调查了体重指数 (BMI)、无脂肪量 (FFM) 和脂肪量 (FM) 的降低与 ADL 改善之间的关联。

材料和方法

在这项横断面研究中，我们分析了因卒中而入住急诊医院的患者的数据。根据住院期间 BMI 的变化将患者分为两组（即降低组或未降低组）。为了控制和调整患者特征和混杂因素，我们使用倾向评分创建了一个逆概率加权 (IPW) 模型，用于比较两组之间的功能独立性测量运动 (FIM-M) 功效。我们还比较了每组入院和出院之间的 FFM 和 FM。

结果

共分析了 556 名患者，其中 391 名 (70.3%) 的 BMI 下降，165 名 (29.7%) 未下降。IPW 调整后，未减量组 FIM-M 的效率显着高于减量组（中位数：0.44 vs. 0.29，P  < 0.001）。减量组从入院到出院时FFM和FM显着降低，但未减量组无显着差异。在接受康复治疗的超重和肥胖卒中患者中，住院期间保持 BMI 与 ADL 的积极改善相关。

结论

超重和肥胖卒中患者的营养护理和康复治疗应平衡减肥的风险和益处。