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ORIJINAL ARAŞTIRMA

Subakut ve Erken Kronik Dönem İnmeli Hastalarda Nütrisyonel Durumun Yaşam Kalitesine Etkisi: Ön Çalışma
The Effect of Nutritional Status on Quality of Life in Patients with Subacute and Early Chronic Stroke: A Pilot Study
Received Date : 14 Apr 2022
Accepted Date : 08 Sep 2022
Available Online : 14 Sep 2022
Doi: 10.31609/jpmrs.2022-90519 - Makale Dili: EN
J PMR Sci. 2023;26(1):55-64
ÖZET
Amaç: Bu pilot çalışmanın amacı, subakut ve erken kronik dönem inmeli hastaların nütrisyonel durumlarını klinik, biyokimyasal, antropometrik ve ultrasonografi (USG) gibi çok boyutlu yöntemlerle değerlendirmek ve bu parametrelerin yaşam kalitesi ve işlevsellik ile ilişkisini incelemektir. Gereç ve Yöntemler: Bu kesitsel çalışmaya Ocak 2016 ve Ocak 2018 tarihlerinde inme rehabilitasyonu amacı ile hospitalize edilen 33 hasta dâhil edildi. Hastaların nütrisyonel durumu biyokimyasal testler, antropometrik ölçümler (beden kitle indeksi, kol çevresi, triseps cilt kalınlığı, bacak çevresi) ve USG ile değerlendirildi. İnme Etki Ölçeği [Stroke Impact Scale (SIS)] ile biyokimyasal test, antropometrik ve USG ölçüm sonuçları arasındaki ilişkiler analiz edildi. Bulgular: Nonhemiparetik rektus femoris (RF) kalınlığı ve sağlıklı RF alanının USG ölçümleri toplam SIS skoru ile ilişkili bulundu (sırasıyla r=0,399, p=0,013; r=0,476, p=0,027). SIS-iletişim alt grubu ile triseps cilt kalınlığı ve toplam protein, albumin ve kreatinin seviyeleri SIS’nin spesifik alt alanları ile ilişkili bulundu (p<0,05). Nonhemiparetik RF kalınlığı ve alanı toplam SIS skoru için bağımsız risk faktörleriydi, serum albumin seviyesi mobilite için bağımsız bir faktördü ve serum kreatinin seviyesi el fonksiyonu ve katılım için bağımsız bir faktördü (p<0,05). Sonuç: İnmeli hastaların nütrisyonel durumu yaşam kalitesi ve fonksiyonelliği etkileyebilir. Bu nedenle yaşam kalitesi ve fonksiyonelliği iyileştirebilmek için subakut ve kronik inmeli hastaların klinik ve biyokimyasal testler, antropometrik ve USG ölçümleri gibi çok boyutlu yöntemlerle malnütrisyon açısından değerlendirilmesi gerekmektedir.
ABSTRACT
Objective: The aim of this pilot study was to evaluate the nutritional status of patients with subacute and early chronic stroke, using multidimensional methods such as clinical, biochemical, anthropometric, and ultrasonography (USG) and to determine whether these parameters are related to the quality of life (QoL), and functionality. Material and Methods: This cross-sectional study included 33 patients who were hospitalized for stroke rehabilitation between January 2016 and January 2018. The patients were evaluated in respect of nutritional level using biochemical tests, anthropometric measurements [body mass index, arm circumference, triceps skinfold (TSF), leg circumference], and USG. The relationships between the Stroke Impact Scale (SIS) and the biochemical test, anthropometric, and USG measurement results were analyzed. Results: The USG measurements of healthy rectus femoris (RF) thickness and healthy RF area were found to be related to the total SIS score (r=0.399, p=0.013; r=0.476, p=0.027 respectively). Anthropometrically, only TSF was associated with the communication subdomain, and total protein, albumin, and creatinine levels were associated with some specific subdomains (p<0.05). Non-hemiparetic RF thickness and area were independent risk factors for total SIS score, serum albumin level was an independent factor for mobility, and serum creatinine level was an independent factor for hand function, and participation (p<0.05). Conclusion: The nutritional status of patients with stroke may have an effect on QoL and functionality. Therefore, to be able to improve QoL and functionality, subacute and chronic stroke patients should be evaluated in respect of malnutrition using multidimensional methods such as clinical and biochemical tests, and anthropometric and USG measurements.
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