Wakabayashi Hidetaka
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Review article
Language English
Peer review Peer reviewed
Title Clinical practice guidelines for rehabilitation nutrition in cerebrovascular disease, hip fracture, cancer, and acute illness: 2020 update.
Journal Formal name:Clinical nutrition ESPEN
Abbreviation:Clin Nutr ESPEN
ISSN code:24054577/24054577
Domestic / ForeginForegin
Volume, Issue, Page 43,pp.90-103
Author and coauthor Nishioka Shinta, Aragane Hideki, Suzuki Norio, Yoshimura Yoshihiro, Fujiwara Dai, Mori Takashi, Kanehisa Yayoi, Iida Yuki, Higashi Keiichiro, Yoshimura-Yokoi Yuri, Sato Chiaki, Toyota Miwa, Tanaka Mai, Ishii Yoshimasa, Kosaka Shintaro, Kumagae Naoko, Fujimoto Atsushi, Omura Kenji, Yoshida Sadao, Wakabayashi Hidetaka, Momosaki Ryo,
Publication date 2021/06
Summary BACKGROUND:Individuals undergoing rehabilitation often experience nutritional problems such as malnutrition, but there are no clinical practice guidelines (CPGs) specifically tailored to the combination of rehabilitation and nutritional care for these patients. The Japanese Association for Rehabilitation Nutrition aimed to develop CPGs for rehabilitation nutrition to support clinical decision making in daily practice.METHODS:A CPG committee and development process based on the Grading of Recommendations Assessment, Development and Evaluation system and the Minds Handbook for Clinical Practice Guideline Development 2014 was established. Four clinical questions were defined for patients undergoing rehabilitation for cerebrovascular disease, hip fracture, cancer, and acute illness. Literatures of randomised control trials (RCTs) up to April 2020 were searched for using the MEDLINE, EMBASE, CENTRAL, and Ichushi-web databases. After screening, full-text papers were assessed for eligibility for analysis. Subsequently, studies included in the systematic review were examined regarding their risk of bias, and underwent meta-analyses. A CPG development committee drafted the guidelines based on the systematic review report. Final recommendations were determined by the panel members.RESULTS:Four recommendations were made based on 4 to 9 RCTs for each disease/condition. The certainty of the evidence ranged from very low to low. Overall, the enhanced nutritional care was weakly recommended for rehabilitation patients with cerebrovascular disease, hip fracture, cancer, and acute illnesses.CONCLUSIONS:This CPG provides tentative recommendations for nutritional care of individuals undergoing rehabilitation. Due to low certainty of evidence and small sample sizes of the included studies, more high-quality and larger RCTs are needed to develop more practical CPGs.
DOI 10.1016/j.clnesp.2021.02.018
PMID 34024570