Does Nutritional Therapy Reduce Disability and Improve Activities of Daily Living After a Stroke? – A Cochrane Review Summary with Commentary

Abstract

Background

Malnutrition can severely impact post-stroke functional recovery, but the effects of nutritional therapy (NT) on disability and activities of daily living (ADL) after stroke are not thoroughly investigated.

Objectives

the aim of the Cochrane Review by Sakai et al. (2023) was to evaluate the effectiveness of NT in reducing disability and improving ADL after stroke. The aim of this Corner is to provide a summary of Sakai et al. with comments from a rehabilitation perspective.

Methods

randomised controlled trials (RCTs) enrolling persons with stroke, investigating NT (defined as the administration of supplemental nutrients), compared with placebo, usual care (UC), or another type of NT were searched. Disability (modified Rankin score-mRS) and activities of daily living (ADL) were the primary outcomes.

Results

The review included 52 trials (11,926 participants) with most studies conducted in the acute phase (36) and 25 types of supplements used. There was no difference in disability nor all-cause mortality, but oral energy and protein supplements may improve ADL. There was a higher risk of diarrohea, hyper- and hypoglycemia in participants receiving NT.

Conclusions

The effects of NT on disability and ADL after stroke is still uncertain, while NT may associate to increased adverse events. Future research should focus on targeted nutritional interventions to improve function after stroke, based on a theoretical rationale.