Effect of individual nutritional therapy during inpatient pulmonary rehabilitation in patients at risk for malnutrition and sarcopenia - a randomized controlled trial
Abstract
Background Malnutrition and sarcopenia are common in inpatient rehabilitation, however individual nutritional therapy (iNT) is often underutilized. This study aimed to assess the effect of iNT on nutrition and muscular health. Method Patients with chronic obstructive pulmonary disease (COPD) or post-pneumonia at risk for malnutrition and sarcopenia undergoing inpatient rehabilitation were enrolled. The control group received usual care including enriched food and educational group sessions on nutrition. The intervention group received additional counselling by a dietician twice a week. Both groups received individualized physiotherapy and self-management coaching, endurance exercise sessions on 5 days and strength training sessions on 2–3 days per week as part of the clinical routine. Primary outcomes were changes in energy and protein intake, assessed via menu consumption and macronutrient analysis. Secondary outcomes included handgrip strength, muscle mass by bioimpedance analysis, and physical performance measured by the timed-up-and-go test. Results Twenty-six patients per group (median age of 72 years, 60% men, 52% COPD) were included. Energy and protein intake increased significantly more in the intervention group with a 309 kcal and 16 g compared to −53 kcal and −1 g in the control group (p = 0.001 for group differences). Handgrip improved more in the intervention group by a median of 1 kg (p = 0.007), without group differences in muscle mass or physical performance.…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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