Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

Weight gain is associated with improvement in activities of daily living in underweight rehabilitation inpatients: a nationwide survey

European Journal of Clinical Nutrition volume 73, pages 1601–1604 (2019)Cite this article

Subjects

Abstract

We retrospectively analysed large-scale, nationwide data from the Kaifukuki (convalescent) Rehabilitation Ward (KRW) survey of 2015. Patients were classified into two groups based on changes in body mass index (BMI) during their KRW stay: increased BMI and non-increased BMI. The primary outcome was motor functional independence measure (FIM) score at discharge, and the secondary outcomes were motor FIM gain and full oral intake at discharge. We analysed 4605 patients (64% women; mean age, 79.3 years). Of these patients, 1128 and 3477 were classified into the increased and non-increased groups, respectively. Multivariate analysis showed that BMI increases were independently associated with motor FIM scores at discharge (partial regression coefficient = 1.165; 95% confidence interval, 0.671–1.659) and motor FIM gains, although BMI increase was not associated with full oral intake. Thus, increasing body weight might lead to activities of daily life improvement in underweight patients undergoing post-acute rehabilitation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58:1734–8.

    Article  Google Scholar 

  2. Marshall S, Bauer J, Isenring E. The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults. J Hum Nutr Diet. 2014;27:133–41.

    Article  CAS  Google Scholar 

  3. Sakai K, Kinoshita S, Tsuboi M, Fukui R, Momosaki R, Wakabayashi H, et al. Effects of nutrition therapy in older stroke patients undergoing rehabilitation: a systematic review and meta-analysis. J Nutr Health Aging. 2019;23:21–26.

    Article  CAS  Google Scholar 

  4. Avenell A, Smith TO, Curtain JP, Mak JC, Myint PK. Nutritional supplementation for hip fracture aftercare in the older people. Cochrane Database Syst Rev. 2016;11:CD001880.

    PubMed  Google Scholar 

  5. Nishioka S, Wakabayashi H, Momosaki R. Nutritional Status changes and activities of daily living after hip fracture in convalescent rehabilitation units: a retrospective observational cohort study from the Japan Rehabilitation Nutrition Database. J Acad Nutr Diet. 2018;118:1270–6.

    Article  Google Scholar 

  6. Miyai I, Sonoda S, Nagai S, Takayama Y, Inoue Y, Kakehi A, et al. Results of new policies for inpatient rehabilitation coverage in Japan. Neurorehabil Neural Repair. 2011;25:540–7.

    Article  Google Scholar 

  7. Wouters EF. Minimal clinically important differences in COPD: body mass index and muscle strength. COPD. 2005;2:149–55.

    Article  CAS  Google Scholar 

  8. Kalm LM, Semba RD. They starved so that others be better fed: remembering Ancel Keys and the Minnesota experiment. J Nutr. 2005;135:1347–52.

    Article  CAS  Google Scholar 

  9. Jain NB, Al-Adawi S, Dorvlo AS, Burke DT. Association between body mass index and functional independence measure in patients with deconditioning. Am J Phys Med Rehabil. 2008;87:21–25.

    Article  Google Scholar 

  10. Yoshimura Y, Bise T, Shimazu S, Tanoue M, Tomioka Y, Araki M, et al. Effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia: A randomized controlled trial. Nutrition. 2018; https://doi.org/10.1016/j.nut.2018.05.028.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to Maki Urushihara, RD, Yumiko Kiriya, RD, Misuzu Watanabe, RD, Keiko Shintani, RD, Hiromi Nakagomi, RD, Noriko Kageyama, RD and the directors of the KRW Association for their advice and expertise regarding this study and to all participating facilities that responded to the annual survey.

Author information

Authors and Affiliations

  1. Nutrition Committee, Kaifukuki Rehabilitation Ward Association, Tokyo, Japan

    Yoji Kokura, Shinta Nishioka & Masako Takayama

  2. Department of Clinical Nutrition, Keiju Medical Center, Nanao City, Ishikawa, Japan

    Yoji Kokura

  3. Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan

    Shinta Nishioka

  4. Annual Survey Committee, Kaifukuki Rehabilitation Ward Association, Tokyo, Japan

    Takatsugu Okamoto & Ichiro Miyai

  5. Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan

    Takatsugu Okamoto

  6. Department of Nutrition, Kumamoto Kinoh Hospital, Kumamoto, Japan

    Masako Takayama

  7. Neurorehabilitation Research Institute, Morinomiya Hospital, Osaka, Japan

    Ichiro Miyai

Authors
  1. Yoji Kokura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shinta Nishioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takatsugu Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masako Takayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ichiro Miyai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YK was responsible for designing the study protocol, analysis and interpretation of data, and drafting of the article. SN, TO, MT were responsible for designing the study protocol, acquisition of data and revising the paper critically for important intellectual content. IM conducted the acquisition, analysis and interpretation of data, and revising the paper critically for important intellectual content. All authors approved final version of the manuscript.

Corresponding author

Correspondence to Yoji Kokura.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kokura, Y., Nishioka, S., Okamoto, T. et al. Weight gain is associated with improvement in activities of daily living in underweight rehabilitation inpatients: a nationwide survey. Eur J Clin Nutr 73, 1601–1604 (2019). https://doi.org/10.1038/s41430-019-0450-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-019-0450-9

Search

Advanced search

Quick links