6th ISPRMとリハ栄養

私は一昨日から6th ISPRM（第6回国際リハ医学会）のために、プエルトリコに来ています。

http://www.isprm2011.org/

そのためブログの更新頻度がしばらく少なくなることをご了承ください。

抄録集は下記のJournal of REHABILITATION MEDICINE Supplement No. 49 July 2011

http://www.isprm2011.org/JRM_ISPRM2011_Puerto_Rico.pdf

で見ることができます。実は、ブログを書くのに学会HPにアクセスして、今抄録集が学会HPで見れることを知りました（笑）。ちなみに私の手元には抄録集はありません…。抄録集を配布しない学会も初めてです…。余談ですが、こんなに事前と当日の準備がいい加減な学会は、日本ではありえません。これもラテン系といえばそれまでかもしれませんが…。その代わりパーティー類には大変、気合いが入っています（笑）。

私の発表演題、Frequency and cause of malnutrition in disuse syndromeはNo32で、14-15ページに掲載されています。

今回、リハ栄養関連の発表はレクチャーや一般演題の口演にはなく、ポスター発表で私の演題以外に3つのみありました。

Comparing of Characteristic of Body Composition of Different event excellent Athletes.

Relationship between sarcopenia ad physical performance: is it the same in older adults with weak muscle strength?

Disability and diabetes: The National Health and Nutrition Survey 2006 (Mexico

私が一通りプログラムを読んで気付いたのは、この3演題のみです。つまり、国際的にもリハの世界では栄養はまだまだニッチということです。国内的にも十分ニッチですが…。私としてはまずは国内でのリハ栄養の考え方の普及を目指します。

最後に私の発表の抄録を掲載しておきます。

Objective: The purpose of this study is to determine the frequency
and cause of malnutrition in disuse syndrome. Method: A crossstional
study was performed in 127 patients admitted to university
medical center and diagnosed disuse syndrome by physiatrists
between April and November 2010. All patients were prescribed
physical therapy at bedside or gymnasium. Nutrition status at referral
was assessed by Mini Nutritional Assessment Short Form (MNASF).
Cause of malnutrition was classified starvation (less energy
intake than basal energy expenditure), invasion, and pre-cachexia
(underlying chronic disease, unintentional weight loss more than
5% of usual body weight during the last 6 months, chronic systemic
inflammatory response, anorexia). Feeding route, body mass index,
hemoglobin, serum albumin, total lymphocyte count (TLC), Onodera’s
prognostic nutritional index (PNI; serum albumin x 10 + TLC
x 0.005), and difference in nutrition status by setting of physical
therapy were assessed. Results: There were 79 men and 48 women
with a mean age 72.6 years. Mean duration between admission and
referral was 22 days. Seventy-three patients were prescribed physical
therapy at bedside, 54 were at gymnasium. Based on MNA-SF, no
patient was evaluated for normal nutritional status, 20 were at risk
of malnutrition, and 107 were malnourished. Invasion was the most
frequent cause of malnutrition and at risk (107), then starvation (57)
and pre-cachexia (37) (overlapping). Seventy-eight patients were
oral intake, 30 were enteral feeding, and 80 were parenteral feeding
(overlapping). Mean BMI was 20.7. Mean hemoglobin (9.52
g/dl), mean serum albumin (2.61 g/dl), mean TLC (935), and mean
PNI (30.7) were below the lower normal. There was no significant
difference in nutrition status between bedside and gymnasium. Implications/
Impact on Rehabilitation: Most of patients with disuse
syndrome are malnourished because of invasion. Nutrition assessment
is necessary for patients with disuse syndrome regardless of
setting of physical therapy.