High Chair Model 03-628-sng Replacement Cover

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High Chair Model 03-628-sng Replacement Cover – Use of diagnostic criteria defined by ESPEN and EASO for sarcopenic obesity after stroke in Japanese patients: prevalence and association with outcome.

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High Chair Model 03-628-sng Replacement Cover

High Chair Model 03-628-sng Replacement Cover

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By Yoshihiro Yoshimura 1 , * , Hidetaka Wakabayashi 2 , Fumihiko Nagano 1 , Takahiro Bise 1 , Sayuri Shimazu 1 , Ai Shiraishi 1 , Yoshifumi Kido 1 and Ayaka Matsumoto 1

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Received: December 16, 2021 / Revised: January 13, 2022 / Accepted: January 19, 2022 / Published: January 20, 2022

Currently, there is a lack of evidence demonstrating that exercise therapy improves sarcopenia in elderly patients in clinical practice. Therefore, we conducted a retrospective cohort study to elucidate the effect of chair-standing exercise on improving sarcopenia in patients with a diagnosis of sarcopenia undergoing post-stroke rehabilitation. According to the latest Asian criteria, sarcopenia was diagnosed when skeletal muscle mass index (SMI) and handgrip strength (HGS) were low. Patients are asked to perform repetitive chair position exercises as a total resistance training, in addition to the rehabilitation program. Outcomes included incidence of sarcopenia, severe mental illness, HGS, and physical activity at hospital discharge. Multivariate analyzes were used to examine whether frequency of daily sedentary activity was independently associated with outcomes after adjustment for potential confounders. After enrollment, 302 patients with sarcopenia were diagnosed (mean age: 78.6 years; 46.4% men). Overall, there was a 21.9% reduction in the incidence of sarcopenia, from 100% at admission to 78.1%. Multivariate analysis showed that exercise frequency was significantly associated with the presence of sarcoma (odds ratio: 0.986, p = 0.010), SMI (β = 0.181, p < 0.001) and HGS (β = 0.101, p = 0.032) in this series. Chair-standing exercises were effective in improving sarcopenia in these patients.

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Activities of daily living; hand strength; musculoskeletal resistance exercise; disruption of the activities of the elderly in daily life; hand strength; musculoskeletal resistance exercise; poor old man

High Chair Model 03-628-sng Replacement Cover

Sarcopenia is common in older adults undergoing rehabilitation, and treatment is mainly based on exercise and nutritional therapy. The prevalence of sarcopenia in patients undergoing rehabilitation is approximately 50% [1, 2], which is higher than the approximately 10% in both sexes among older adults in the community [3, 4]. The global prevalence of sarcophagia is estimated to be around 10%, and the prevalence of sarcophagia is higher in countries outside of Asia than in Asia [5, 6, 7]. Furthermore, sarcopenia is associated with a poor prognosis, including reduced physical activity, dysphagia, urinary incontinence, longer hospital stays, and lower discharge rates, in these patients [ 8 , 9 , 10 , 11 ]. Total hospital costs for patients with sarcopenia are estimated at $40.4 billion, with an average cost per patient of $260 [12]; Therefore, early diagnosis and timely treatment of sarcopenia is essential to maximize progress in functional rehabilitation.

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Exercise and nutritional therapy are the main treatments for sarcopenia. Current guidelines recommend resistance exercise as exercise therapy and high protein intake and essential amino acid supplementation as nutritional therapy; However, there is little evidence for each of these treatments [13, 14, 15]. In addition, branched-chain amino acids and leucine are effective in improving muscle-related indicators in rehabilitation patients [16].

Stroke is the leading cause of death in many countries, and as a direct consequence many survivors experience persistent difficulties in activities of daily living (ADL) [17]. In fact, more than two-thirds of stroke survivors recover after hospitalization [18]. In addition, approximately 50% of stroke patients undergoing rehabilitation have sarcopenia, and sarcophagia interferes with the ability to perform ADL after stroke [ 19 , 20 , 21 ]; Therefore, it is important to combat sarcopenia with exercise and nutritional therapy during stroke rehabilitation [22].

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However, there is a lack of evidence that exercise therapy improves sarcopenia in elderly patients undergoing rehabilitation. A recently published systematic umbrella review suggested that combined resistance and exercise improves muscle mass, muscle strength and physical performance in community-dwelling older adults, with moderate to high-quality evidence [23]. Multimodal training includes a combination of resistance training, cardio, running and balance training. Although rehabilitation itself has beneficial effects in preventing muscle weakness and exercise-related complications in hospitalized rehabilitation patients [24], there is little evidence for specific types of exercise therapy that can improve sarcopenia in patients. This is done. , which involves slow, repetitive low-intensity movements, can improve ADL in stroke and dialysis patients [ 25 , 26 ]. Theoretically, exercise is expected to improve sarcopenia as well as traditional rehabilitation programs; However, the evidence is currently scarce.

Therefore, this cross-sectional study aimed to elucidate the effect of chair exercises on improving sarcopenia among stroke patients diagnosed with sarcopenia undergoing rehabilitation.

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A retrospective cohort study was conducted to identify stroke patients in a community rehabilitation hospital between 2016 and 2020. The hospital has a total of 135 beds, including three rehabilitation units (45 beds each).

All patients who were admitted to rehabilitation units and diagnosed with sarcopenia were included in the study. Of these, there were patients who received permission from their physicians to perform the chair position exercise described below. Exclusion criteria included patients who refused to participate, had missing data, had a pacemaker, or had impaired consciousness on the three-digit Japanese coma scale. The observation period of the study was the length of hospital stay (from admission to discharge).

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The rehabilitation program (up to 3 h per day) was adapted to the physical activity and disability of each patient [27]. Physical therapy included, for example, assistance with paralyzed limbs, movement training, basic training, movement training, resistance training and ADL training [10].

High Chair Model 03-628-sng Replacement Cover

Nutritional management during hospital stay was individualized according to the nutritional and functional status of patients under the guidance of a registered nutritionist and nutrition support team, including energy-dense, high-protein foods and supplements for malnourished patients, and providing and providing adequate protein and calorie restriction for obese patients to maintain muscle mass [28].

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Oral management during hospitalization includes oral screening, assessment, patient education, counseling, oral and swallowing rehabilitation, oral hygiene, dentistry and multidisciplinary work [29].

Medicines are managed during the hospital stay by multidisciplinary teams, including pharmacists. Medications are one of the factors that affect physical activity and nutrition in older adults. Polypharmacy and inappropriate medications were corrected after screening, and medications that could affect physical activity and nutrition were appropriately administered [ 30 ].

In addition to an individualized rehabilitation program, patients perform “chair position exercises”, a group of repetitions of a chair-to-sit-to-sit task in two sessions per day [ 16 , 25 ]. The chair position exercise was a stand-alone program that was clearly separate from the rehabilitation program. With a standard chair, platform or wheelchair, the height of the chair was adjusted to the patient’s body, approximately 40-50 cm. Patients were able to use parallel bars and handrails when needed, and rehabilitation therapists helped patients stand on their own two feet. Each session lasted 20 minutes and participants were asked to sit and stand continuously for up to 120 times, once every 8 seconds. Patients were asked to count all movements while standing on tall chairs, which created a fun and cozy group atmosphere. On the first day, several repetitive movements were performed on the chair, but as muscle strength and endurance improved, the number of repetitions increased day by day. The frequency and progression of chair position exercises depends on the ability and tolerance of each patient (Figure 1).

The chair stand exercise was performed as part of daily clinical practice, not for research and clinical purposes

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