Effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia: A randomized controlled trial

Yoshimura, Yoshihiro; Bise, Takahiro; Shimazu, Sayuri; Tanoue, Maiko; Tomioka, Yuko; Araki, Mai; Nishino, Takafumi; Kuzuhara, Aomi; Takatsuki, Fumihiko

doi:10.1016/j.nut.2018.05.028

Cited by 153 publications

(101 citation statements)

References 38 publications

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“…In fact, previous studies have encouragingly shown that an 8-week program featuring both leucine-enriched amino acid supplementation and low-intensity resistance training were able to increase muscle mass, strength and physical function in post-stroke patients with sarcopenia. 25 More generally, a recent meta-analysis found some positive 26 On the basis of the current results, it would be beneficial to further examine the effect of a combination of nutritional intervention and rehabilitation for "definite sarcopenia" patients, especially for those who are men. The present study did have several limitations.…”

Section: Discussionmentioning

confidence: 70%

“…Nutritional intervention studies addressing older adults with sarcopenia have been increasing. In fact, previous studies have encouragingly shown that an 8‐week program featuring both leucine‐enriched amino acid supplementation and low‐intensity resistance training were able to increase muscle mass, strength and physical function in post‐stroke patients with sarcopenia . More generally, a recent meta‐analysis found some positive effects from exercise and nutritional interventions in treating sarcopenia in older people who have not had a stroke .…”

Section: Discussionmentioning

confidence: 99%

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Sarcopenia as a predictor of activities of daily living capability in stroke patients undergoing rehabilitation

Matsushita¹,

Nishioka²,

Taguchi³

et al. 2019

Geriatrics Gerontology Int

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Aim The aim of the present study was to clarify the relationship between sarcopenia, as defined by the European Working Group on Sarcopenia in Older People, and the recovery of the capability to carry out activities of daily living in convalescent stroke patients who completed a rehabilitation program. Methods This retrospective study included consecutive stroke patients admitted to convalescent rehabilitation wards. To determine which patients had sarcopenia, we used the European Working Group on Sarcopenia in Older People criteria. At admission, participants were classified by either the presence or absence of sarcopenia. Baseline characteristics, including the Functional Independence Measure–motor domain score (FIM‐M), were retrospectively analyzed. The primary outcome to be explained was the FIM‐M at discharge. A multiple linear regression analysis was used to examine how well a sarcopenia diagnosis and various baseline characteristics could predict the FIM‐M score at discharge. Results In total, 267 participants (117 women) were included in this study. Of these, 129 (48.3%) were classified as definitely having sarcopenia. Participants with sarcopenia showed lower FIM‐M at discharge than those without this condition (median 72 vs 89, P < 0.001). Multiple linear regression analyses exploring determinants of the FIM‐M scores showed that a diagnosis of sarcopenia independently predicted them at discharge for men (B −4.957, 95% confidence interval −9.902–−0.012), but not for women. Conclusions Stroke‐related sarcopenia appears to be a predictor of how well male patients can engage in activities of daily living after rehabilitation. Geriatr Gerontol Int 2019; 19: 1124–1128.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Sarcopenia as a predictor of activities of daily living capability in stroke patients undergoing rehabilitation

Matsushita¹,

Nishioka²,

Taguchi³

et al. 2019

Geriatrics Gerontology Int

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“…Therefore, it is possible that greater BMI gain will be required to improve the ADL of underweight patients. However, the potential effect of nutritional intervention in persons with disabilities is evident, as several nutritional intervention trials show that oral nutritional supplementation with specific nutrients (e.g., branched amino acid) increase muscle mass, strength, or functions in patients with functional limitations, undernutrition, or sarcopenia (24)(25)(26)(27)(28). Since this survey did not include data on muscle mass, future intervention trials are needed to focus on the effect of clinical nutrition practice on the rehabilitation outcomes of patients with malnutrition or sarcopenia and muscle mass gain.…”

Section: Discussionmentioning

confidence: 99%

Assignment of Registered Dietitians and Other Healthcare Professionals Positively Affects Weight Change of Underweight Patients in Convalescent (<i>Kaifukuki</i>) Rehabilitation Wards: A Secondary Analysis of a Nationwide Survey

Nishioka

Kokura

Okamoto

et al. 2019

J Nutr Sci Vitaminol

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This study aimed to verify the relationship between assignment of professional registered dietitians (RDs) and other healthcare professionals and body weight or functional outcome in underweight patients. This was a secondary analysis of the nationwide survey data from Kaifukuki (convalescent) rehabilitation wards (KRWs). Data of patients aged $20 y with disabilities and body mass index (BMI) ,18.5 kg/m 2 and who were discharged from 1,099 KRWs were analyzed. The primary outcome was BMI at discharge. Secondary outcomes were Functional Independence Measure (FIM) at discharge and returning to home. Patients were divided into two groups: those in KRWs with $1 or ,1 dedicated RD per ward (KRW/RD1 and KRW/RD2, respectively). Of 5,843 eligible participants (female, 63%; median age, 82 y; hip/vertebral/knee fracture, 47%; stroke, 34%; disuse syndrome secondary to acute illness, 11%; others, 8%), 1,288 and 4,555 were from the KRW/RD1 and KRW/RD2 groups, respectively. At discharge, KRW/RD1 patients had higher FIM (93 vs. 90) and BMI (17.1 vs. 17.0 kg/m 2) than did KRW/RD2 patients. Multivariable analysis showed that assignment of dedicated RDs (B50.213, 95% confidence interval [CI], 0.036-0.389), number of nurses (B50.023, 95% CI, 0.003-0.043), and daily rehabilitation dose were significantly associated with changes in body weight. Furthermore, these factors positively affected BMI at discharge. Number of nurses and rehabilitation dose correlated with FIM, but assignment of RDs did not correlate with FIM. In conclusion, assignment of RDs, nurses, and sufficient rehabilitation dose may contribute to BMI gain. Nurses and daily rehabilitation dose may positively affect functional recovery.

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“…Other than sarcopenia prevention, amino acid supplementation may also be a potential therapy for treating sarcopenia. In this context, in elderly (>65 years of age) stroke patients with sarcopenia, an 8 week leucine supplementation was able to further enhance the increase in muscle mass and strength when administered together with low‐intensity resistance training in addition to post‐stroke rehabilitation . This suggests that amino acid supplementation may provide additive effects for post‐stroke rehabilitation when coupled with resistance exercise.…”

Section: Interventionsmentioning

confidence: 96%

Sarcopenia: Tilting the Balance of Protein Homeostasis

2019

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Sarcopenia, defined as age‐associated decline of muscle mass and function, is a risk factor for mortality and disability, and comorbid with several chronic diseases such as type II diabetes and cardiovascular diseases. Clinical trials showed that nutritional supplements had positive effects on muscle mass, but not on muscle function and strength, demonstrating our limited understanding of the molecular events involved in the ageing muscle. Protein homeostasis, the equilibrium between protein synthesis and degradation, is proposed as the major mechanism underlying the development of sarcopenia. As the key central regulator of protein homeostasis, the mammalian target of rapamycin (mTOR) is proposed to be essential for muscle hypertrophy. Paradoxically, sustained activation of mTOR complex 1 (mTORC1) is associated with a loss of sensitivity to extracellular signaling in the elderly. It is not understood why sustained mTORC1 activity, which should induce muscle hypertrophy, instead results in muscle atrophy. Here, recent findings on the implications of disrupting protein homeostasis on muscle physiology and sarcopenia development in the context of mTOR/protein kinase B (AKT) signaling are reviewed. Understanding the role of these molecular mechanisms during the ageing process will contribute towards the development of targeted therapies that will improve protein metabolism and reduce sarcopenia.

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Effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia: A randomized controlled trial

Cited by 153 publications

References 38 publications

Sarcopenia as a predictor of activities of daily living capability in stroke patients undergoing rehabilitation

Sarcopenia as a predictor of activities of daily living capability in stroke patients undergoing rehabilitation

Assignment of Registered Dietitians and Other Healthcare Professionals Positively Affects Weight Change of Underweight Patients in Convalescent (<i>Kaifukuki</i>) Rehabilitation Wards: A Secondary Analysis of a Nationwide Survey

Sarcopenia: Tilting the Balance of Protein Homeostasis

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