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The relationship between energy expenditure and physical functions in patients hospitalised for stroke

ABSTRACT: We assessed the relationship between energy expenditure (EE) and Functional Independence Measure motor items (FIM-M) score, Berg Balance Scale (BBS) score, and comfortable walking speed (CWS) in patients hospitalised for stroke. The total EE per day (TEE), EE during rehabilitation (REE), and EE during activities other than rehabilitation (OEE) were measured using a single-axis acceleration sensor in 36 patients hospitalised for the first stroke episode. In addition, the relationships between each type of EE and FIM-M, BBS, and CWS were investigated. In these patients (mean age 66.2 ± 10.6 years), the median values of TEE, REE, and OEE were 41.8 kcal, 18.5 kcal, and 16.6 kcal, respectively. Correlations were observed between each EE type and all physical function indices. Following the stratification of patients into two groups (high and low) based on the level of physical function, a significant correlation between EE type and physical function was observed only in the low BBS group. EE was correlated with overall physical function indices, but the trend differed depending on physical ability. When patients were stratified based on ability, there were several groups with no significant correlation. Therefore, several patients were unable to achieve an appropriate EE for their level of physical function.

SUBMITTER: Hobo K

PROVIDER: S-EPMC8568978 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Total energy expenditure (TEE) data in patients with early-stage cancer are scarce, precluding an understanding of energy requirements. OBJECTIVE:The objective was to cross-sectionally characterize TEE in patients with colorectal cancer (CRC) and to compare measured TEE with energy recommendations. It was hypothesized that TEE would differ according to body mass, body composition, and physical activity level (PAL) and current energy recommendations would have poor individual-level accuracy. METHODS:Patients with newly diagnosed CRC had resting energy expenditure (REE) measured by indirect calorimetry and TEE by doubly labeled water. Hypermetabolism was defined as REE > 110% of that predicted from the Mifflin St.-Jeor equation. Body composition was assessed via DXA. Physical activity was determined as the ratio of TEE to REE (TEE:REE) (PAL) and residual activity energy expenditure (RAEE). TEE was compared with energy recommendations of 25-30 kcal/d and Dietary Reference Intakes (DRIs) using Bland-Altman analyses. Patients were stratified according to median BMI, PAL, and sex-specific ratio of fat mass (FM) to fat-free mass (FFM). RESULTS:Twenty-one patients (M:F 14:7; mean ± SD BMI: 28.3 ± 4.9 kg/m2, age: 57 ± 12 y) were included. Most (n = 20) had stage II-III disease; 1 had stage IV. Approximately half (n = 11) were hypermetabolic; TEE was not different in those with hypermetabolism and REE as a percentage of predicted was not correlated with TEE. Mean ± SD TEE was 2473 ± 499 kcal/d (range: 1562-3622 kcal/d), or 29.7 ± 6.3 kcal/kg body weight (range: 20.4-48.5 kcal/kg body weight). Mean ± SD PAL was 1.43 ± 0.27. The energy recommendation of 25 kcal/kg underestimated TEE (-12.6% ± 16.5%, P = 0.002); all energy recommendations had wide limits of agreement (the smallest was DRI with measured PAL: -21.2% to 29.3%). Patients with higher BMI and FM:FFM had higher bias using kilocalories per kilogram recommendations; bias from several recommendations was frequently lower (i.e. underestimation) in patients with higher PAL and RAEE. CONCLUSIONS:TEE variability was not reflected in energy recommendations and error was related to body weight, body composition, and physical activity. This trial was registered at clinicaltrials.gov as NCT03131921.

Project description:Accurate, nonintrusive, and feasible methods are needed to predict energy expenditure (EE) and physical activity (PA) levels in preschoolers. Herein, we validated cross-sectional time series (CSTS) and multivariate adaptive regression splines (MARS) models based on accelerometry and heart rate (HR) for the prediction of EE using room calorimetry and doubly labeled water (DLW) and established accelerometry cut points for PA levels.Fifty preschoolers, mean ± SD age of 4.5 ± 0.8 yr, participated in room calorimetry for minute-by-minute measurements of EE, accelerometer counts (AC) (Actiheart and ActiGraph GT3X+), and HR (Actiheart). Free-living 105 children, ages 4.6 ± 0.9 yr, completed the 7-d DLW procedure while wearing the devices. AC cut points for PA levels were established using smoothing splines and receiver operating characteristic curves.On the basis of calorimetry, mean percent errors for EE were -2.9% ± 10.8% and -1.1% ± 7.4% for CSTS models and -1.9% ± 9.6% and 1.3% ± 8.1% for MARS models using the Actiheart and ActiGraph+HR devices, respectively. On the basis of DLW, mean percent errors were -0.5% ± 9.7% and 4.1% ± 8.5% for CSTS models and 3.2% ± 10.1% and 7.5% ± 10.0% for MARS models using the Actiheart and ActiGraph+HR devices, respectively. Applying activity EE thresholds, final accelerometer cut points were determined: 41, 449, and 1297 cpm for Actiheart x-axis; 820, 3908, and 6112 cpm for ActiGraph vector magnitude; and 240, 2120, and 4450 cpm for ActiGraph x-axis for sedentary/light, light/moderate, and moderate/vigorous PA (MVPA), respectively. On the basis of confusion matrices, correctly classified rates were 81%-83% for sedentary PA, 58%-64% for light PA, and 62%-73% for MVPA.The lack of bias and acceptable limits of agreement affirms the validity of the CSTS and MARS models for the prediction of EE in preschool-aged children. Accelerometer cut points are satisfactory for the classification of sedentary, light, and moderate/vigorous levels of PA in preschoolers.

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The relationship between energy expenditure and physical functions in patients hospitalised for stroke

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