Clinical practice guidelines for rehabilitation nutrition in cerebrovascular disease, hip fracture, cancer, and acute illness: 2020 update. (June 2021)

• Record Type: Journal Article
• Authors: Nishioka, Shinta; Aragane, Hideki; Suzuki, Norio; Yoshimura, Yoshihiro; Fujiwara, Dai; Mori, Takashi; Kanehisa, Yayoi; Iida, Yuki; Higashi, Keiichiro; Yoshimura-Yokoi, Yuri; Sato, Chiaki; Toyota, Miwa; Tanaka, Mai; Ishii, Yoshimasa; Kosaka, Shintaro; Kumagae, Naoko; Fujimoto, Atsushi; Omura, Kenji; Yoshida, Sadao; Wakabayashi, Hidetaka; Momosaki, Ryo
• Is Part Of: Clinical nutrition ESPEN. Volume 43(2021)
• Page Start: 90
• Page End: 103
• Publication Date: 2021-06
• Subjects: Acute illness -- Cancer -- Cerebrovascular disease -- Clinical practice guideline -- Hip fracture -- Rehabilitation nutrition; ADL activities of daily living -- AGREE II Appraisal of Guidelines for Research and Evaluation II -- CPGs clinical practice guidelines -- CQs Clinical questions -- EAA essential amino acid -- FIM Functional Independence Measure -- GRADE Grading of Recommendations Assessment -- Development and Evaluation ICF -- International Classification of Functioning Disability and Health -- MCIDs minimal clinically important differences -- ONS oral nutritional supplements -- QoL quality of life -- RCTs randomised control trials -- SRs systematic reviews -- 6MWT six-minutes-walk-test score; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2021.02.018
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background: Individuals undergoing rehabilitation often experience nutritional problems such as malnutrition, but there are no clinical practice guidelines (CPGs) specifically tailored to the combination of rehabilitation and nutritional care for these patients. The Japanese Association for Rehabilitation Nutrition aimed to develop CPGs for rehabilitation nutrition to support clinical decision making in daily practice. Methods: A CPG committee and development process based on the Grading of Recommendations Assessment, Development and Evaluation system and the Minds Handbook for Clinical Practice Guideline Development 2014 was established. Four clinical questions were defined for patients undergoing rehabilitation for cerebrovascular disease, hip fracture, cancer, and acute illness. Literatures of randomised control trials (RCTs) up to April 2020 were searched for using the MEDLINE, EMBASE, CENTRAL, and Ichushi-web databases. After screening, full-text papers were assessed for eligibility for analysis. Subsequently, studies included in the systematic review were examined regarding their risk of bias, and underwent meta-analyses. A CPG development committee drafted the guidelines based on the systematic review report. Final recommendations were determined by the panel members. Results: Four recommendations were made based on 4 to 9 RCTs for each disease/condition. The certainty of the evidence ranged from very low to low. Overall, the enhanced nutritional care was weakly recommended for rehabilitation patients with cerebrovascular disease, hip fracture, cancer, and acute illnesses. Conclusions: This CPG provides tentative recommendations for nutritional care of individuals undergoing rehabilitation. Due to low certainty of evidence and small sample sizes of the included studies, more high-quality and larger RCTs are needed to develop more practical CPGs.