• Sze Chin Jong, Jovic Aguipo Fuentes, Angie En Qin Seow, Chien Joo Lim, Gobinathan Chandran, and ChuaKaren Sui GeokKSG0000-0001-9809-3425Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore..
• Division of Rehabilitation Medicine, University Medicine Cluster, National University Hospital, Singapore.
• Singap Med J. 2021 Oct 31.

IntroductionWe examined the association between admission body mass index (BMI) and discharge rehabilitation functional outcome using the Functional Independence Measure (FIM) in an East-Asian cohort of stroke patients during inpatient rehabilitation.MethodsA prospective observational cohort study of stroke patients admitted to a single inpatient rehabilitation unit was conducted. Using the World Health Organisation Asian standards, BMI was classified as underweight (< 18.5 kg/m2), normal (18.5-22.9 kg/m2) and overweight (≥ 23 kg/m2). The primary outcome measure was discharge FIM, and secondary outcomes included FIM gain, FIM efficiency and FIM effectiveness.Results247 stroke subjects were enrolled (mean age 59.48 [SD 12.35] years, 64.4% [159] male, 52.6% [130] ischaemic stroke). The distributions of underweight, normal and overweight BMI were 10.9% (27), 33.2% (82), and 55.9% (138) respectively on admission and 11.7% (29), 38.1% (94), and 50.2% (124) respectively on discharge. Significant small decreases in BMI from admission (median [IQR]: 23.58 [23.40, 24.70]) to discharge (median [IQR]: 23.12 [22.99, 24.21]) (p < 0.001) were found. Similarly, clinically significant FIM gains (mean FIM 26.71 [95% CI: 24.73, 28.69], p < 0.001) were noted after 36 days of median length of stay. No significant relationships were found between BMI and discharge FIM (p = 0.600), FIM gain (p = 0.254), FIM efficiency (p = 0.412) nor FIM effectiveness (p = 0.796).ConclusionFindings from this study unequivocally support the benefits of acute inpatient stroke rehabilitation. Patients in the obese BMI range tended to normalise during rehabilitation. BMI, whether underweight, normal, or overweight was not correlated with discharge FIM.

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