Relationship between nutritional status and improved ADL in individuals with cervical spinal cord injury in a convalescent rehabilitation ward

Spinal Cord. 2019 Jun;57(6):501-508. doi: 10.1038/s41393-019-0245-9. Epub 2019 Jan 30.

Abstract

Study design: Retrospective cohort study.

Objectives: To investigate the relationship of nutritional status with improvement of activities of daily living in individuals with cervical spinal cord injury.

Setting: A convalescent rehabilitation ward at the Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities in Japan.

Methods: This retrospective analysis investigated adults (age ≥20 years) with cervical spinal cord injury who were consecutively admitted to a convalescent rehabilitation ward between 2006 and 2015. Data of 154 patients were analyzed. Nutritional status was evaluated using the Subjective Global Assessment (SGA; 3 groups: well-nourished, suspected of being malnourished or moderately malnourished, severely malnourished) and body mass index (BMI; 3 groups: underweight, standard, and overweight and obese). The main outcome was functional independence measure (FIM) efficiency. Multiple regression analysis was performed to investigate the relationship of SGA and BMI to FIM efficiency.

Results: FIM efficiency was significantly higher in the well-nourished group based on the SGA than in the two groups with malnutrition (P = .007: 0.32 vs. 0.26 vs. 0.10). Multivariate regression analysis revealed that FIM efficiency was similar in the underweight and standard group, but was significantly higher in the overweight and obese group (P = .006: 0.20 vs. 0.21 vs. 0.31).

Conclusions: SGA and BMI on admission may be independently associated with FIM efficiency in patients with cervical spinal cord injury.

MeSH terms

  • Activities of Daily Living* / psychology
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Cervical Vertebrae
  • Cohort Studies
  • Convalescence / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status / physiology*
  • Recovery of Function / physiology*
  • Rehabilitation Centers / trends*
  • Retrospective Studies
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / psychology
  • Spinal Cord Injuries / rehabilitation*