理学療法ジャーナル56巻6号

2022年06月発行

特集 医療現場におけるサルコペニア・フレイル

回復期リハビリテーション病棟におけるサルコペニア・フレイル

著者： 井上達朗¹

所属機関： ¹新潟医療福祉大学リハビリテーション学部理学療法学科

ページ範囲：P.683 - P.689

Point

●回復期リハビリテーション病棟入院患者のサルコペニアの有病割合は48〜85％である

●回復期リハビリテーション病棟入院患者のサルコペニアはADL回復や自宅退院を阻害し，医療費を増加させる要因である

●骨格筋量・機能を正確に評価し，全身の運動療法と栄養療法を併用することが現段階で最も効果的なサルコペニアへの介入戦略である

参考文献

1）Yagi T, Inoue T, et al：Sarcopenia affects activities of daily living recovery and hospitalization costs in older adults in convalescent rehabilitation wards. Eur Geriatr Med 2021；12：1237-1245

2）Inoue T, et al：Calf circumference value for sarcopenia screening among older adults with stroke. Arch Gerontol Geriatr 2020；93：104290. doi：10.1016/j.archger.2020.104290

3）Matsushita T, et al：Sarcopenia as a predictor of activities of daily living capability in stroke patients undergoing rehabilitation. Geriatr Gerontol Int 2019；19：1124-1128

4）Yoshimura MD, et al：Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation. Nutrition 2019；61：111-118

5）Kaiser MJ, et al：Frequency of malnutrition in older adults：a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010；58：1734-1738

6）Inoue T, et al：Undernutrition, sarcopenia, and frailty in fragility hip fracture：advanced strategies for improving clinical outcomes. Nutrients 2020；12：3743. doi：10.3390/nu12123743

7）日本老年医学会：フレイルに関する老年医学会からのステートメント．https://jpn-geriat-soc.or.jp/info/topics/pdf/20140513_01_01.pdf（2022年2月22日閲覧）

8）Wahl TS, et al：Association of the modified frailty index with 30-day surgical readmission. JAMA Surg 2017；152：741-757

9）Inoue T, et al：Frailty defined by 19 items as a predictor of short-term functional recovery in patients with hip fracture. Injury 2019；50：2272-2276

10）Yoshimura Y, et al：Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr 2018；37：2022-2028

11）Shiraishi A, et al：Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients：implications for oral sarcopenia. Clin Nutr 2018；37：204-207

12）Matsushita T, et al：Effect of improvement in sarcopenia on functional and discharge outcomes in stroke rehabilitation patients. Nutrients 2021；13. 2192. doi：10.3390/nu13072192

13）Ohtsubo T, et al：Association of sarcopenia and physical activity with functional outcome in older Asian patients hospitalized for rehabilitation. Aging Clin Exp Res 2022；34：391-397

14）Yoshimura Y, et al：Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation. Nutrition 2019；61：111-118

15）Chen LK, et al：Sarcopenia in Asia：consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014；15：95-101

16）Chen LK, et al：Asian Working Group for Sarcopenia：2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020；21：300-307

17）Nishioka S, et al：Validity of calf circumference for estimating skeletal muscle mass for the patients after stroke. Nutrition 2021；82：111028. doi：10.1016/j.nut.2020.111028

18）Nakahara S, et al：Sarcopenia and cachexia evaluation in different healthcare settings：a questionnaire survey of health professionals. Asia Pac J Clin Nutr 2018；27：167-175

19）Yoshimura Y, et al：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. Nutrition 2019；58：1-6

20）Rondanelli M, et al：Improving rehabilitation in sarcopenia：a randomized- controlled trial utilizing a muscle-targeted food for special medical purposes. J Cachexia Sarcopenia Muscle 2020；11：1535-1547

21）Murayama I, et al：Is increased “stay away from bed” time associated with improved clinical rehabilitation outcomes in Japanese rehabilitation hospitals? A prospective observational study and clinical practice. Aging Clin Exp Res 2020；32：913-920

22）Yoshimura Y, et al：Chair-stand exercise improves sarcopenia in rehabilitation patients after stroke. Nutrients 2022：14：461. doi：10.3390/nu14030461

23）Nagano A, et al：Association of sarcopenic dysphagia with underlying sarcopenia following hip fracture surgery in older women. Nutrients 2020；12：1365. doi：10.3390/nu12051365

24）Shimizu A, et al：Delayed dysphagia may be sarcopenic dysphagia in patients after stroke. J Am Med Dir Assoc 2021；22：2527-2533

25）Nagano A, et al：Effects of physical rehabilitation and nutritional intake management on improvement in tongue strength in sarcopenic patients. Nutrients 2020；12：3104. doi：10.3390/nu12103104