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Nutrients
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Nutrition in Post-stroke Subjects during Rehabilitation
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Nutrition in Post-stroke Subjects during Rehabilitation

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (30 December 2022) | Viewed by 27440

Special Issue Editor

Dr. Mariacristina Siotto

E-Mail Website
Guest Editor
IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
Interests: post-stroke recovery; rehabilitation; diet; nutrition; nutrients
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The clinical picture after stroke can be heterogeneous and its evolution and response to the rehabilitation can be very different despite similar clinical status at the onset. Individual factors can modulate the clinical picture and response to the rehabilitation treatment. Nutrition plays an important role in the recovery of patients; however, there are few studies in this field right now. Given the prevalence of malnutrition after a stroke insult and the fact that proper and integrated nutrition can have a significant impact on physical and cognitive function, the scientific community should devote more efforts to this field. The aim of this Special Issue is to examine the current state of diet and nutrition research in post-stroke subjects admitted to rehabilitation centres. Original papers, narrative and systematic reviews, and meta-analyses are welcomed.

Dr. Mariacristina Siotto
Guest Editor

Manuscript Submission Information

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Keywords

  • stroke
  • post-stroke
  • sarcopenia
  • dysphagia
  • diet
  • nutrition
  • malnutrition
  • rehabilitation
  • nutritional supplements

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Published Papers (7 papers)

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Editorial

Jump to: Research, Review

3 pages, 187 KiB  
Editorial
Nutrition in Post-Stroke Subjects during Rehabilitation
by Mariacristina Siotto and Irene Aprile
Nutrients 2023, 15(9), 2056; https://doi.org/10.3390/nu15092056 - 25 Apr 2023
Cited by 1 | Viewed by 2223
Abstract
Correct and appropriate nutrition after a stroke insult appears to exert an essential influence on, and play a key role in, the recovery of patients [...] Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)

Research

Jump to: Editorial, Review

11 pages, 520 KiB  
Article
Nutritional Biomarkers as Predictors of Dysphonia Severity in Patients with Ischemic Stroke
by Ji Min Kim, Seung Don Yoo and Eo Jin Park
Nutrients 2023, 15(3), 652; https://doi.org/10.3390/nu15030652 - 27 Jan 2023
Cited by 5 | Viewed by 1990
Abstract
Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index (DSI) and maximum phonation time (MPT). This study aimed to investigate whether the nutritional biomarkers transferrin, albumin, and prealbumin [...] Read more.
Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index (DSI) and maximum phonation time (MPT). This study aimed to investigate whether the nutritional biomarkers transferrin, albumin, and prealbumin could be predictors of dysphonia severity. A retrospective analysis was conducted between January 2018 and October 2022. A total of 180 patients who had suffered an ischemic stroke were included. Serum transferrin, albumin, and prealbumin levels were significantly correlated with DSI and MPT levels. In a multiple regression analysis, prealbumin and transferrin were significant predictors of DSI, whereas only prealbumin was a significant predictor of MPT. Serum transferrin, albumin, and prealbumin levels in patients who have suffered an ischemic stroke may correlate with dysphonia severity as assessed using DSI and MPT. These results may provide objective evidence that nutritional biomarkers affect dysphonia severity. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
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10 pages, 260 KiB  
Article
Nutritional Biomarkers and Heart Rate Variability in Patients with Subacute Stroke
by Eo Jin Park and Seung Don Yoo
Nutrients 2022, 14(24), 5320; https://doi.org/10.3390/nu14245320 - 15 Dec 2022
Cited by 5 | Viewed by 2677
Abstract
Malnutrition and autonomic dysfunction are associated with poor outcomes, mortality, and psychological problems after stroke. Relevant laboratory biomarkers include serum albumin, prealbumin, and transferrin. Heart rate variability (HRV), a noninvasive measurement, can objectively measure autonomic nervous system (ANS) function. The relationship between HRV [...] Read more.
Malnutrition and autonomic dysfunction are associated with poor outcomes, mortality, and psychological problems after stroke. Relevant laboratory biomarkers include serum albumin, prealbumin, and transferrin. Heart rate variability (HRV), a noninvasive measurement, can objectively measure autonomic nervous system (ANS) function. The relationship between HRV and nutritional biomarkers in stroke patients has not been studied. This study aimed to examine the relationship between nutritional biomarkers and HRV parameters in stroke patients. We retrospectively recruited 426 patients with subacute stroke who were examined for nutritional biomarkers, such as serum albumin, prealbumin, and transferrin, and underwent 24 h ambulatory Holter electrocardiography. Patients were divided into groups according to their nutritional biomarker status. Differences in HRV parameters between nutritional biomarker-deficient and normal groups were assessed. Pearson’s correlation and multiple regression analyses were used to verify the relationship between HRV parameters and nutritional biomarkers. HRV parameters were significantly lower in the nutritional biomarker-deficient groups. In addition, there was a significant association between HRV parameters and nutritional biomarkers. Serum albumin, prealbumin, and transferrin levels were associated with ANS function, as measured by HRV, and their deficiency may be a predictive factor for the severity of ANS dysfunction in stroke patients. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
12 pages, 949 KiB  
Article
Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data
by Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara and Irene Aprile
Nutrients 2022, 14(22), 4825; https://doi.org/10.3390/nu14224825 - 15 Nov 2022
Cited by 16 | Viewed by 3064
Abstract
After a stroke, patients can suffer from sarcopenia, which can affect recovery. This could be closely related to an impairment in nutritional status. In this preliminary analysis of a longitudinal prospective study, we screened 110 subjects admitted to our rehabilitation center after a [...] Read more.
After a stroke, patients can suffer from sarcopenia, which can affect recovery. This could be closely related to an impairment in nutritional status. In this preliminary analysis of a longitudinal prospective study, we screened 110 subjects admitted to our rehabilitation center after a stroke. We then enrolled 61 patients, who underwent a 6-week course of rehabilitation treatment. We identified a group of 18 sarcopenic patients (SG), according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), by evaluating muscle strength with the handgrip test, and muscle mass with bioelectrical impedance analysis (BIA). With respect to the non-sarcopenic group (NSG), the SG at admission (T0) had worse muscle quality, according to the BIA-derived phase angle, and a lower score of MNA®-SF. In contrast to the NSG, the SG also exhibited lower values for both BMI and the Geriatric Nutritional Risk Index (GNRI) at T0 and T1. Moreover, 33% of the SG had a major risk of nutrition-related complications (GNRI at T0 < 92) and discarded on average more food during the six weeks of rehabilitation (about one-third of the average daily plate waste). Of note is the fact that the Barthel Index’s change from baseline indicated that the SG had a worse functional recovery than the NGS. These results suggest that an accurate diagnosis of sarcopenia, along with a proper evaluation of the nutritional status on admission to rehabilitation centers, appears strictly necessary to design individual, targeted physical and nutritional intervention for post-stroke patients, to improve their ability outcomes. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
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Review

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15 pages, 383 KiB  
Review
The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients
by Olivia Di Vincenzo, Maria Luisa Eliana Luisi, Paola Alicante, Giada Ballarin, Barbara Biffi, Chiara Francesca Gheri and Luca Scalfi
Nutrients 2023, 15(3), 683; https://doi.org/10.3390/nu15030683 - 29 Jan 2023
Cited by 27 | Viewed by 5894
Abstract
Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to [...] Read more.
Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
18 pages, 1340 KiB  
Review
Influence of Oxidative Stress and Inflammation on Nutritional Status and Neural Plasticity: New Perspectives on Post-Stroke Neurorehabilitative Outcome
by Irene Ciancarelli, Giovanni Morone, Marco Iosa, Antonio Cerasa, Rocco Salvatore Calabrò, Giovanni Iolascon, Francesca Gimigliano, Paolo Tonin and Maria Giuliana Tozzi Ciancarelli
Nutrients 2023, 15(1), 108; https://doi.org/10.3390/nu15010108 - 26 Dec 2022
Cited by 22 | Viewed by 3977
Abstract
Beyond brain deficits caused by strokes, the effectiveness of neurorehabilitation is strongly influenced by the baseline clinical features of stroke patients, including a patient’s current nutritional status. Malnutrition, either as a pre-stroke existing condition or occurring because of ischemic injury, predisposes patients to [...] Read more.
Beyond brain deficits caused by strokes, the effectiveness of neurorehabilitation is strongly influenced by the baseline clinical features of stroke patients, including a patient’s current nutritional status. Malnutrition, either as a pre-stroke existing condition or occurring because of ischemic injury, predisposes patients to poor rehabilitation outcomes. On the other hand, a proper nutritional status compliant with the specific needs required by the process of brain recovery plays a key role in post-stroke rehabilitative outcome favoring neuroplasticity mechanisms. Oxidative stress and inflammation play a role in stroke-associated malnutrition, as well as in the cascade of ischemic events in the brain area, where ischemic damage leads to neuronal death and brain infarction, and, via cell-to-cell signaling, the alteration of neuroplasticity processes underlying functional recovery induced by multidisciplinary rehabilitative treatment. Nutrition strategies based on food components with oxidative and anti-inflammatory properties may help to reverse or stop malnutrition and may be a prerequisite for supporting the ability of neuronal plasticity to result in satisfactory rehabilitative outcome in stroke patients. To expand nutritional recommendations for functional rehabilitation recovery, studies considering the evolution of nutritional status changes in post-stroke patients over time are required. The assessment of nutritional status must be included as a routine tool in rehabilitation settings for the integrated care of stroke-patients. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
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18 pages, 807 KiB  
Review
The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review
by Klaudia Marek, Natalia Cichoń, Joanna Saluk-Bijak, Michał Bijak and Elżbieta Miller
Nutrients 2022, 14(13), 2761; https://doi.org/10.3390/nu14132761 - 4 Jul 2022
Cited by 17 | Viewed by 6452
Abstract
Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. [...] Read more.
Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention. Full article
(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)
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