Evaluation Of The Relationship Between The Conut Score And Balance And Functional Status In Patients With Chronic Stroke

Stroke is a clinical syndrome characterized by rapidly developing neurological deficits resulting from the sudden interruption or reduction of cerebral blood flow and remains one of the leading causes of mortality and long-term disability among adults worldwide. Following the acute phase, a substantial proportion of patients transition to the chronic stage, during which persistent functional impairments such as motor deficits, balance disorders, gait limitations, and dependence in activities of daily living frequently occur.

During the post-stroke period, the risk of malnutrition increases due to factors such as dysphagia, immobility, reduced oral intake, increased catabolism, and muscle loss, all of which may negatively affect functional recovery and rehabilitation outcomes. In particular, deterioration of nutritional status in patients with chronic stroke has been reported to be associated with reduced muscle strength, impaired postural control, and increased dependence in activities of daily living.

Balance disorders in patients with chronic stroke are closely associated with reduced postural control, decreased muscle strength, and impaired sensorimotor integration. Impaired balance increases the risk of falls during the chronic phase of stroke, reduces walking speed, and limits functional independence. In addition, malnutrition characterized by decreased muscle mass and muscle function has been reported to have adverse effects on postural stability and balance performance. Therefore, evaluating the relationship between nutritional status and balance performance in patients with chronic stroke is of considerable importance for clinical management and rehabilitation strategies.

In the assessment of nutritional status, anthropometric measurements, in addition to biochemical markers, provide valuable information regarding muscle and fat tissue reserves. Mid-upper arm circumference is a simple and reliable anthropometric parameter reflecting muscle mass and peripheral tissue reserves, and it has been shown to be associated with nutritional status and functional outcomes in chronic diseases. Considering muscle loss related to immobility and asymmetric loading in stroke patients, the use of mid-upper arm circumference as a complementary indicator in evaluating the relationship between nutritional status and balance and functional status is clinically meaningful.

The Controlling Nutritional Status (CONUT) score, used to assess nutritional status, is an objective nutritional assessment index based on serum albumin level, total lymphocyte count, and total cholesterol concentration, reflecting not only nutritional status but also immunological and metabolic conditions. Although the CONUT score was initially developed for hospitalized patients, it has been shown to be associated with functional outcomes and mortality in patients with stroke. Evidence suggests that nutritional status may deteriorate from the acute phase through the chronic stage and remains clinically relevant even during the chronic phase of stroke.