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Sarcopenia, Nutritional Status, and the Association Between Rehabilitation Dose and Functional Efficiency After Inpatient Rehabilitation for First-Ever Ischemic Stroke

In brief

30-minute daily therapy boost efficiency; sarcopenia drops it by a quarter

In 1,036 first-ever ischemic stroke patients, each additional 30 minutes of inpatient rehab per day increased functional efficiency, while having sarcopenia decreased efficiency by roughly the same amount. Better nutritional status also modestly improved efficiency, and the benefit of therapy was blunted in sarcopenic patients, highlighting the need to address muscle loss during stroke recovery.

Journal
American journal of physical medicine & rehabilitation (Q1)
Published
7 September 2026
Study design
Retrospective cohort
Evidence level
Level 3, Low (CEBM 3b)
Authors
Eo Jin Park
PMID
42704886
DOI
10.1097/PHM.0000000000003152

Why clinicians should know about it

  • Picked for Rehabilitation (paper of the day, 10 September 2026): Rehab dose, sarcopenia, nutrition linked to functional efficiency after stroke

Abstract

OBJECTIVE: To examine the associations of rehabilitation dose, sarcopenia, and nutritional status with functional efficiency after inpatient rehabilitation for first-ever ischemic stroke. DESIGN: A single-center retrospective cohort included 1,036 adults with first-ever ischemic stroke. The outcome was Modified Barthel Index efficiency, defined as gain divided by inpatient rehabilitation days. Sarcopenia was defined as concurrent low skeletal muscle mass index and low non-paretic hand grip strength. Multivariable linear regression used HC3 robust standard errors. RESULTS: Poor functional efficiency occurred in 419 (40.4%) patients. Rehabilitation dose per 30 min/day was associated with higher efficiency (β=0.17, 95% CI 0.12 to 0.21; P<0.001). Sarcopenia was associated with lower efficiency (β=-0.22, 95% CI -0.28 to -0.15; P<0.001), whereas Geriatric Nutritional Risk Index per 5-point increase was associated with higher efficiency (β=0.05, 95% CI 0.03 to 0.07; P<0.001). The dose × sarcopenia interaction was negative (β=-0.12, 95% CI -0.20 to -0.05; P=0.001), and the dose × Geriatric Nutritional Risk Index interaction was small and positive (β=0.02, 95% CI 0.00 to 0.05; P=0.039). CONCLUSION: Rehabilitation dose, sarcopenia, and nutritional status are associated with functional efficiency after inpatient stroke rehabilitation.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.