Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence

Objective: To investigate the prevalence of malnutrition and sarcopenia in different disciplines of inpatient rehabilitation and the course of nutritional status parameters. Design: Multi-centre cross-sectional prevalence study and longitudinal observational study. Subjects/Patients: Inpatients (&...

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Main Authors: Undine Lehmann, Katja Uhlmann, André Meichtry, Marc Spielmanns, Sabine Spielmanns, Ramin Khatami, Laura Marty, Susanne Rüegsegger, Reto W. Kressig, Caroline M. Kiss, Clare Maguire, Andrea Zurfluh, Thimo Marcin
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Language:English
Published: Medical Journals Sweden 2025-02-01
Series:Journal of Rehabilitation Medicine
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Online Access:https://medicaljournalssweden.se/jrm/article/view/42215
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author Undine Lehmann
Katja Uhlmann
André Meichtry
Marc Spielmanns
Sabine Spielmanns
Ramin Khatami
Laura Marty
Susanne Rüegsegger
Reto W. Kressig
Caroline M. Kiss
Clare Maguire
Andrea Zurfluh
Thimo Marcin
author_facet Undine Lehmann
Katja Uhlmann
André Meichtry
Marc Spielmanns
Sabine Spielmanns
Ramin Khatami
Laura Marty
Susanne Rüegsegger
Reto W. Kressig
Caroline M. Kiss
Clare Maguire
Andrea Zurfluh
Thimo Marcin
author_sort Undine Lehmann
collection DOAJ
description Objective: To investigate the prevalence of malnutrition and sarcopenia in different disciplines of inpatient rehabilitation and the course of nutritional status parameters. Design: Multi-centre cross-sectional prevalence study and longitudinal observational study. Subjects/Patients: Inpatients (> 18 years) in geriatric, pulmonary, cardiovascular, internal medicine/oncological, musculoskeletal, or neurological rehabilitation in 5 rehabilitation centres were included. Methods: Malnutrition was assessed according to the Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People criteria. Bodyweight, hand grip strength (HGS), and functional independence measure (FIM) were assessed within 3 days of admission and after 21 days of rehabilitation and analysed using linear mixed models with time*diagnosis interaction. Results: The study included 558 patients (51.8% male, median age 73.0 years). The overall prevalence of malnutrition and sarcopenia was 35.5% (95% CI 31.5, 39.6%) and 32.7% (95% CI 28.8, 36.8%), respectively. Patients with risk of malnutrition lost on average 1.14 kg (95% CI –1.64, –0.63) during rehabilitation. Patients slightly increased their HGS and FIM, irrespective of risk or diagnosis of malnutrition or sarcopenia. However, at the end of the rehabilitation, malnourished or sarcopenic patients had still a significantly lower bodyweight, HGS, and FIM than patients without (p < 0.01). Some 37.3% of patients at risk of and 35.4% with diagnosed -malnutrition did not receive group or individual nutritional -counselling. Conclusion: Malnutrition and sarcopenia are highly prevalent during inpatient rehabilitation. Nevertheless, dietitians are often not involved in the therapy. While nutritional parameters and functional independence improve, patients with malnutrition and sarcopenia remain on a lower level after 3 weeks of rehabilitation. Long-term follow-up after rehabilitation is recommended to prevent nutritional and muscular decline and related negative health outcomes.
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spelling doaj-art-8f41b3b3fb6f4a228d0ee701fef90ab02025-08-20T03:12:16ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-02-015710.2340/jrm.v57.42215Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independenceUndine Lehmann0Katja Uhlmann1André Meichtry2Marc Spielmanns3Sabine Spielmanns4Ramin Khatami5Laura Marty6Susanne Rüegsegger7Reto W. Kressig8Caroline M. Kiss9Clare Maguire10Andrea Zurfluh11Thimo Marcin12Division Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, SwitzerlandDivision Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, SwitzerlandDivision Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, SwitzerlandZürcher RehaZentren | Klinik Wald, Wald, Switzerland; Faculty of Health, Department Pneumology, University of Witten-Herdecke, GermanyZürcher RehaZentren | Klinik Wald, Wald, SwitzerlandKlinik Barmelweid AG, Barmelweid, Switzerland; Department of Neurology, University Hospital Bern, SwitzerlandDivision Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Klinik Barmelweid AG, Barmelweid, SwitzerlandKlinik Barmelweid AG, Barmelweid, SwitzerlandUniversity Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland; University of Basel, Basel, SwitzerlandUniversity Department of Geriatric Medicine FELIX PLATTER, Basel, SwitzerlandREHAB Basel Clinic for Neurorehabilitation and Paraplegiology, Basel, SwitzerlandBerner Reha Zentrum, Rehabilitation & Sports Medicine, Insel Group, University Hospital Bern, Bern, SwitzerlandBerner Reha Zentrum, Rehabilitation & Sports Medicine, Insel Group, University Hospital Bern, Bern, SwitzerlandObjective: To investigate the prevalence of malnutrition and sarcopenia in different disciplines of inpatient rehabilitation and the course of nutritional status parameters. Design: Multi-centre cross-sectional prevalence study and longitudinal observational study. Subjects/Patients: Inpatients (> 18 years) in geriatric, pulmonary, cardiovascular, internal medicine/oncological, musculoskeletal, or neurological rehabilitation in 5 rehabilitation centres were included. Methods: Malnutrition was assessed according to the Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People criteria. Bodyweight, hand grip strength (HGS), and functional independence measure (FIM) were assessed within 3 days of admission and after 21 days of rehabilitation and analysed using linear mixed models with time*diagnosis interaction. Results: The study included 558 patients (51.8% male, median age 73.0 years). The overall prevalence of malnutrition and sarcopenia was 35.5% (95% CI 31.5, 39.6%) and 32.7% (95% CI 28.8, 36.8%), respectively. Patients with risk of malnutrition lost on average 1.14 kg (95% CI –1.64, –0.63) during rehabilitation. Patients slightly increased their HGS and FIM, irrespective of risk or diagnosis of malnutrition or sarcopenia. However, at the end of the rehabilitation, malnourished or sarcopenic patients had still a significantly lower bodyweight, HGS, and FIM than patients without (p < 0.01). Some 37.3% of patients at risk of and 35.4% with diagnosed -malnutrition did not receive group or individual nutritional -counselling. Conclusion: Malnutrition and sarcopenia are highly prevalent during inpatient rehabilitation. Nevertheless, dietitians are often not involved in the therapy. While nutritional parameters and functional independence improve, patients with malnutrition and sarcopenia remain on a lower level after 3 weeks of rehabilitation. Long-term follow-up after rehabilitation is recommended to prevent nutritional and muscular decline and related negative health outcomes. https://medicaljournalssweden.se/jrm/article/view/42215malnutritionmuscle strengthnutrition therapyprevalencerehabilitationsarcopenia
spellingShingle Undine Lehmann
Katja Uhlmann
André Meichtry
Marc Spielmanns
Sabine Spielmanns
Ramin Khatami
Laura Marty
Susanne Rüegsegger
Reto W. Kressig
Caroline M. Kiss
Clare Maguire
Andrea Zurfluh
Thimo Marcin
Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
Journal of Rehabilitation Medicine
malnutrition
muscle strength
nutrition therapy
prevalence
rehabilitation
sarcopenia
title Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
title_full Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
title_fullStr Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
title_full_unstemmed Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
title_short Malnutrition and sarcopenia in inpatient rehabilitation: prevalence and associations with changes in bodyweight, muscle strength, and functional independence
title_sort malnutrition and sarcopenia in inpatient rehabilitation prevalence and associations with changes in bodyweight muscle strength and functional independence
topic malnutrition
muscle strength
nutrition therapy
prevalence
rehabilitation
sarcopenia
url https://medicaljournalssweden.se/jrm/article/view/42215
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