The journal of nutrition, health & aging

, Volume 23, Issue 1, pp 21–26 | Cite as

Effects of Nutrition Therapy in Older Stroke Patients Undergoing Rehabilitation: A Systematic Review and Meta-Analysis

  • Kotomi Sakai
  • S. Kinoshita
  • M. Tsuboi
  • R. Fukui
  • R. Momosaki
  • H. Wakabayashi



To systematically review evidence on the effects of nutrition therapy in older stroke patients undergoing rehabilitation and identify its effectiveness using meta-analysis.


PubMed (MEDLINE), EMBASE (via Dialog), Cochrane Central Register of Controlled Trial, World Health Organization International Clinical Trials Registry Platform and Ichu-shi Web were searched for relevant articles. Randomized controlled trials investigating the effects of nutrition therapy compared to control interventions in older stroke patients undergoing rehabilitation were considered eligible. The primary outcome was activities of daily living (ADL), and secondary outcomes were all-cause mortality, infections, pneumonia incidence, disability level, walking ability, fall, stroke recurrence, and quality of life. The risk of bias of each trial was assessed using the Cochrane Collaboration Tool, and the quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.


Eight randomized controlled trials with a total of 5484 participants were included in the meta-analysis. The meta-analysis for ADL showed no significant effects (mean difference, 4.16; 95% confidence interval [CI], -0.88 to 9.20; I2=53%, low-quality evidence). The meta-analyses for secondary outcomes revealed a significant effect of reduced infections (risk ratio, 0.65; 95% CI, 0.51 to 0.84; I2=0%; low-quality evidence), with no significant effects on the other outcomes.


Nutrition therapy had no statistically significant effect on ADL. However, it reduced the incidence of infections. More high-quality trials are warranted to clarify the effects of nutrition therapy in older stroke patients undergoing rehabilitation.

Key words

Nutrition therapy malnutrition stroke rehabilitation activities of daily living 

Supplementary material

12603_2018_1095_MOESM1_ESM.docx (1.1 mb)
Appendix: Supplementary data


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Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Kotomi Sakai
    • 1
    • 2
  • S. Kinoshita
    • 3
  • M. Tsuboi
    • 3
  • R. Fukui
    • 3
  • R. Momosaki
    • 4
  • H. Wakabayashi
    • 5
  1. 1.Department of Rehabilitation MedicineSetagaya Memorial HospitalTokyoJapan
  2. 2.Graduate School of Public HealthSt. Luke’s International UniversityTokyoJapan
  3. 3.Department of Rehabilitation MedicineThe Jikei University School of MedicineTokyoJapan
  4. 4.Department of Rehabilitation MedicineTeikyo University School of Medicine, HospitalMizonokuchi, KawasakiJapan
  5. 5.Department of Rehabilitation MedicineYokohama City University Medical CenterYokohamaJapan

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