Resting energy expenditure in patients with stroke during the subacute phases - Relationships with stroke types, location, severity of paresis, and activities of daily living

Michiyuki Kawakami, Meigen Liu, Ayako Wada, Tomoyoshi Otsuka, Atsuko Nishimura

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The energy demands in patients with stroke during the subacute phases are unclear. However, this information is essential for appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) during the subacute phases, examine its relationships with stroke types, location, severity of hemiparesis, and activities of daily living (ADL), and evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a 'stress factor' to capture possible additional REE imposed by stroke. Methods: We measured REE in 95 patients with subacute stroke (53.5 ± 16.6 days post-stroke) with indirect calorimetry, and compared it with predicted values of energy expenditure estimated from the HB (expressed as percentage). Patients were admitted for rehabilitation of their first ischemic or nonsurgical hemorrhagic stroke. The severity of hemiparesis was assessed with the motor items of the Stroke Impairment Assessment Set (SIAS). The ADL was assessed with the Functional Independence Measure (FIM). We compared REE and %HB of the two groups divided by hemiparesis severity and ADL limitation using the Student's t-test, and those of the five groups divided by stroke location. The correlations between REE and the motor items of the SIAS and the FIM score were assessed with the Spearman rank correlation test. A multiple regression analysis for REE was conducted. Results: The average body weight (BW) was 57.1 ± 11.3 kg. The average body mass index (BMI) was 22.5 ± 4.0. The mean REE (%HB) was 1,271 ± 284 kcal/day (106.0 ± 17.3%). REE and %HB of the low ADL group was less than that of the high ADL group (p < 0.05). The REE had a positive correlation with the FIM score (rs = 0.51, p < 0.01). The motor items of the SIAS were not significantly correlated with REE. BW, FIM, and stroke location were independent predictors of REE. Conclusions: Analysis of energy expenditure suggests that stroke patients are not hypermetabolic during the subacute phase. The 'stress factor' in stroke patients during the subacute phase was 1.0-1.1. This finding provides important information for improving nutritional management during the subacute phase in patients with stroke.

Original languageEnglish
Pages (from-to)170-175
Number of pages6
JournalCerebrovascular Diseases
Volume39
Issue number3-4
DOIs
Publication statusPublished - 2015 May 6

Fingerprint

Paresis
Activities of Daily Living
Energy Metabolism
Stroke
Body Weight
Indirect Calorimetry
Body Mass Index
Rehabilitation

Keywords

  • Activities of daily living
  • Diet
  • Energy metabolism
  • Rehabilitation
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Resting energy expenditure in patients with stroke during the subacute phases - Relationships with stroke types, location, severity of paresis, and activities of daily living. / Kawakami, Michiyuki; Liu, Meigen; Wada, Ayako; Otsuka, Tomoyoshi; Nishimura, Atsuko.

In: Cerebrovascular Diseases, Vol. 39, No. 3-4, 06.05.2015, p. 170-175.

Research output: Contribution to journalArticle

@article{3400f694158847628d827894340d7cf7,
title = "Resting energy expenditure in patients with stroke during the subacute phases - Relationships with stroke types, location, severity of paresis, and activities of daily living",
abstract = "Background: The energy demands in patients with stroke during the subacute phases are unclear. However, this information is essential for appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) during the subacute phases, examine its relationships with stroke types, location, severity of hemiparesis, and activities of daily living (ADL), and evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a 'stress factor' to capture possible additional REE imposed by stroke. Methods: We measured REE in 95 patients with subacute stroke (53.5 ± 16.6 days post-stroke) with indirect calorimetry, and compared it with predicted values of energy expenditure estimated from the HB (expressed as percentage). Patients were admitted for rehabilitation of their first ischemic or nonsurgical hemorrhagic stroke. The severity of hemiparesis was assessed with the motor items of the Stroke Impairment Assessment Set (SIAS). The ADL was assessed with the Functional Independence Measure (FIM). We compared REE and {\%}HB of the two groups divided by hemiparesis severity and ADL limitation using the Student's t-test, and those of the five groups divided by stroke location. The correlations between REE and the motor items of the SIAS and the FIM score were assessed with the Spearman rank correlation test. A multiple regression analysis for REE was conducted. Results: The average body weight (BW) was 57.1 ± 11.3 kg. The average body mass index (BMI) was 22.5 ± 4.0. The mean REE ({\%}HB) was 1,271 ± 284 kcal/day (106.0 ± 17.3{\%}). REE and {\%}HB of the low ADL group was less than that of the high ADL group (p < 0.05). The REE had a positive correlation with the FIM score (rs = 0.51, p < 0.01). The motor items of the SIAS were not significantly correlated with REE. BW, FIM, and stroke location were independent predictors of REE. Conclusions: Analysis of energy expenditure suggests that stroke patients are not hypermetabolic during the subacute phase. The 'stress factor' in stroke patients during the subacute phase was 1.0-1.1. This finding provides important information for improving nutritional management during the subacute phase in patients with stroke.",
keywords = "Activities of daily living, Diet, Energy metabolism, Rehabilitation, Stroke",
author = "Michiyuki Kawakami and Meigen Liu and Ayako Wada and Tomoyoshi Otsuka and Atsuko Nishimura",
year = "2015",
month = "5",
day = "6",
doi = "10.1159/000375155",
language = "English",
volume = "39",
pages = "170--175",
journal = "Cerebrovascular Diseases",
issn = "1015-9770",
publisher = "S. Karger AG",
number = "3-4",

}

TY - JOUR

T1 - Resting energy expenditure in patients with stroke during the subacute phases - Relationships with stroke types, location, severity of paresis, and activities of daily living

AU - Kawakami, Michiyuki

AU - Liu, Meigen

AU - Wada, Ayako

AU - Otsuka, Tomoyoshi

AU - Nishimura, Atsuko

PY - 2015/5/6

Y1 - 2015/5/6

N2 - Background: The energy demands in patients with stroke during the subacute phases are unclear. However, this information is essential for appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) during the subacute phases, examine its relationships with stroke types, location, severity of hemiparesis, and activities of daily living (ADL), and evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a 'stress factor' to capture possible additional REE imposed by stroke. Methods: We measured REE in 95 patients with subacute stroke (53.5 ± 16.6 days post-stroke) with indirect calorimetry, and compared it with predicted values of energy expenditure estimated from the HB (expressed as percentage). Patients were admitted for rehabilitation of their first ischemic or nonsurgical hemorrhagic stroke. The severity of hemiparesis was assessed with the motor items of the Stroke Impairment Assessment Set (SIAS). The ADL was assessed with the Functional Independence Measure (FIM). We compared REE and %HB of the two groups divided by hemiparesis severity and ADL limitation using the Student's t-test, and those of the five groups divided by stroke location. The correlations between REE and the motor items of the SIAS and the FIM score were assessed with the Spearman rank correlation test. A multiple regression analysis for REE was conducted. Results: The average body weight (BW) was 57.1 ± 11.3 kg. The average body mass index (BMI) was 22.5 ± 4.0. The mean REE (%HB) was 1,271 ± 284 kcal/day (106.0 ± 17.3%). REE and %HB of the low ADL group was less than that of the high ADL group (p < 0.05). The REE had a positive correlation with the FIM score (rs = 0.51, p < 0.01). The motor items of the SIAS were not significantly correlated with REE. BW, FIM, and stroke location were independent predictors of REE. Conclusions: Analysis of energy expenditure suggests that stroke patients are not hypermetabolic during the subacute phase. The 'stress factor' in stroke patients during the subacute phase was 1.0-1.1. This finding provides important information for improving nutritional management during the subacute phase in patients with stroke.

AB - Background: The energy demands in patients with stroke during the subacute phases are unclear. However, this information is essential for appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) during the subacute phases, examine its relationships with stroke types, location, severity of hemiparesis, and activities of daily living (ADL), and evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a 'stress factor' to capture possible additional REE imposed by stroke. Methods: We measured REE in 95 patients with subacute stroke (53.5 ± 16.6 days post-stroke) with indirect calorimetry, and compared it with predicted values of energy expenditure estimated from the HB (expressed as percentage). Patients were admitted for rehabilitation of their first ischemic or nonsurgical hemorrhagic stroke. The severity of hemiparesis was assessed with the motor items of the Stroke Impairment Assessment Set (SIAS). The ADL was assessed with the Functional Independence Measure (FIM). We compared REE and %HB of the two groups divided by hemiparesis severity and ADL limitation using the Student's t-test, and those of the five groups divided by stroke location. The correlations between REE and the motor items of the SIAS and the FIM score were assessed with the Spearman rank correlation test. A multiple regression analysis for REE was conducted. Results: The average body weight (BW) was 57.1 ± 11.3 kg. The average body mass index (BMI) was 22.5 ± 4.0. The mean REE (%HB) was 1,271 ± 284 kcal/day (106.0 ± 17.3%). REE and %HB of the low ADL group was less than that of the high ADL group (p < 0.05). The REE had a positive correlation with the FIM score (rs = 0.51, p < 0.01). The motor items of the SIAS were not significantly correlated with REE. BW, FIM, and stroke location were independent predictors of REE. Conclusions: Analysis of energy expenditure suggests that stroke patients are not hypermetabolic during the subacute phase. The 'stress factor' in stroke patients during the subacute phase was 1.0-1.1. This finding provides important information for improving nutritional management during the subacute phase in patients with stroke.

KW - Activities of daily living

KW - Diet

KW - Energy metabolism

KW - Rehabilitation

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=84924123391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924123391&partnerID=8YFLogxK

U2 - 10.1159/000375155

DO - 10.1159/000375155

M3 - Article

C2 - 25720382

AN - SCOPUS:84924123391

VL - 39

SP - 170

EP - 175

JO - Cerebrovascular Diseases

JF - Cerebrovascular Diseases

SN - 1015-9770

IS - 3-4

ER -