Nutritional risk linked to lower functional independence in 60 patients with subacute to chronic stroke undergoing rehabilitationNutritional risk linked to lower independence scores in stroke rehab patients

Frontiers in Medicine Published April 28, 2026 DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Note that nutritional risk associates with lower functional independence in stroke rehab patients.

This prospective observational study included 60 patients with subacute to chronic stroke admitted to an inpatient rehabilitation program. The primary exposure was nutritional status, screened using the Mini Nutritional Assessment-Short Form (MNA-SF), alongside abdominal muscle thickness measured by ultrasonography. The comparator was normal nutritional status versus nutritional risk. The primary outcome was functional independence at discharge, assessed by the Barthel Index. Secondary outcomes included motor recovery, mobility, cognitive outcomes (MMSE), and mobility outcomes (FAC and mRS). The follow-up duration was a 4-week rehabilitation program.

Regarding main results, significant within-group improvements in motor recovery and mobility were observed in both groups following rehabilitation, with p < 0.05. However, abdominal muscle thickness did not change significantly after rehabilitation (p > 0.05). Crucially, nutritional risk was independently associated with lower discharge Barthel Index scores, with an effect size of B = -2.99 and a 95% CI of -5.65 to -0.33 (p = 0.028). Conversely, nutritional risk was not independently associated with discharge cognitive outcomes (MMSE) or discharge mobility outcomes (FAC and mRS); specific p-values and confidence intervals for these secondary outcomes were not reported.

Safety and tolerability data were not reported, as adverse events, serious adverse events, discontinuations, and general tolerability were not assessed or disclosed. Key limitations include the observational study design, which precludes causal conclusions, and the absence of reported absolute numbers for outcomes. Funding sources and conflicts of interest were not reported. The study underscores the importance of early nutritional screening and comprehensive evaluation during stroke rehabilitation.

This prospective observational study looked at 60 patients admitted to an inpatient rehabilitation program for subacute to chronic stroke. Researchers evaluated nutritional status using the MNA-SF screening tool and measured abdominal muscle thickness with ultrasonography. The main goal was to see how these factors affected functional independence when patients left the program.

The study found that patients facing nutritional risk had significantly lower discharge scores on the Barthel Index, a measure of daily living skills. This link remained even after accounting for other factors. However, the team did not find a connection between nutritional risk and outcomes for mobility, motor recovery, or cognitive function. Abdominal muscle thickness also did not change significantly during the four-week rehabilitation period.

While the study did not report safety concerns or adverse events, the findings highlight a specific concern: nutritional risk is tied to poorer functional outcomes at discharge. Because this was a small observational study, it shows an association rather than proving that nutrition directly caused the difference. The main takeaway is the importance of early nutritional screening and comprehensive evaluation for all stroke patients in rehabilitation settings.

What this means for you:

Nutritional risk was linked to lower functional independence scores at discharge in stroke rehabilitation patients.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

BackgroundNutritional status is an important determinant of rehabilitation outcomes after stroke; however, its relationship with abdominal muscle morphology remains unclear. Given the role of abdominal muscles in trunk stability, postural control, and functional mobility, this study aimed to evaluate the association between nutritional status, abdominal muscle thickness, and functional recovery in patients with subacute to chronic stroke.MethodsIn this prospective observational study, patients with subacute to chronic stroke who were admitted to an inpatient rehabilitation program were evaluated at baseline and after a 4-week rehabilitation program. Nutritional status was assessed using the Mini Nutritional Assessment–Short Form (MNA-SF), reflecting screening-defined nutritional risk. Abdominal muscle thicknesses of the external oblique, internal oblique, and transversus abdominis were measured by ultrasonography on the non-paretic side. Clinical, functional, cognitive, and biochemical parameters were recorded at baseline and discharge. The primary outcome was functional independence at discharge, assessed by the Barthel Index.ResultsSixty patients were included, of whom 38 had normal nutritional status and 22 were classified as having nutritional risk based on the MNA-SF. Significant within-group improvements in motor recovery and mobility were observed in both groups following rehabilitation (p  0.05) and did not change significantly after rehabilitation (p > 0.05). Multivariable analysis showed that nutritional risk was independently associated with lower discharge Barthel Index scores (B = −2.99, 95% CI −5.65 to −0.33, p = 0.028), after adjustment for prespecified covariates. In contrast, nutritional risk was not independently associated with discharge cognitive outcomes (MMSE) or mobility outcomes (FAC and mRS).ConclusionIn patients with subacute to chronic stroke, functional recovery during rehabilitation appears to be associated with nutritional risk, whereas no significant association was observed with abdominal muscle thickness. Although muscle thickness remained unchanged, screening-defined nutritional risk was independently associated with functional independence at discharge. These findings underscore the importance of early nutritional screening and comprehensive evaluation during stroke rehabilitation.

Nutritional risk linked to lower functional independence in 60 patients with subacute to chronic stroke undergoing rehabilitationNutritional risk linked to lower independence scores in stroke rehab patients

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Nutritional risk linked to lower functional independence in 60 patients with subacute to chronic stroke undergoing rehabilitationNutritional risk linked to lower independence scores in stroke rehab patients

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