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
Ersin KAVAZNTAMATIa, Şükran GÜZELb, Damla CANKURTARANa, Ebru UMAYa
aDepartment of Physical Medicine and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
bDepartment of Physical Medicine and Rehabilitation, Başkent University Faculty of Medicine, Ankara, Türkiye
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.
Anahtar Kelimeler: Hemipleji; malnütrisyon; yaşam kalitesi; inme; ultrasonografi
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.
Keywords: Hemiplegia; malnutrition; quality of life; stroke; ultrasonography
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