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Nitrogen balance in patients with hemiparetic stroke during the subacute rehabilitation phase
Author(s) -
Wada A.,
Kawakami M.,
Otsuka T.,
Aoki H.,
Anzai A.,
Yamada Y.,
Liu F.,
Otaka E.,
Akaboshi K.,
Liu M.
Publication year - 2017
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12457
Subject(s) - medicine , nitrogen balance , balance (ability) , stroke (engine) , rehabilitation , hemiparesis , dysphagia , physical therapy , surgery , nitrogen , mechanical engineering , physics , quantum mechanics , angiography , engineering
Background In highly invasive diseases, metabolism commonly changes. Hypercatabolism is frequent in acute stroke, and nitrogen balance tends to be negative. However, there has been no study describing nitrogen balance in subacute and chronic stroke patients. The present study aimed to examine nitrogen balance in the subacute and chronic phases and to identify the factors related to it. Methods Nitrogen balance was calculated from the collected urine of 56 patients with subacute stroke [mean (SD) 53.8 (18.4) days post‐stroke] who were admitted for rehabilitation for their first‐ever ischaemic or nonsurgical haemorrhagic stroke. In the first experiment, their nitrogen balance was measured during the rehabilitation phase, and factors (type, severity of hemiparesis, activities of daily living, dysphagia and malnutrition status) related to it were evaluated. The second experiment was performed to describe the time course of nitrogen balance in 31 consecutive patients, with assessments made at admission and at discharge. Results Nitrogen balance was positive in all patients in the subacute phase. A significant difference was seen in nitrogen balance between high and low fat‐free mass in male patients. In the chronic phase, nitrogen balance was positive in 96% of the patients. There was no significant difference in nitrogen balance between discharge and admission. Conclusions In the subacute and chronic phases of stroke, it was confirmed that hypercatabolism had resolved and that intensive rehabilitation is possible in the convalescent period of stroke.