Whey protein-enriched high-protein diet combined with sustained musculoskeletal rehabilitation improves muscle and bone mass in central nervous system injury patients

Purpose: Convalescent stroke and traumatic brain injury (TBI) patients have special nutritional needs during rehabilitation training. Here, we investigated the administration of a whey protein-enriched high-protein feeding and rehabilitation program (WHRP) and its correlation with body composition changes in stroke and TBI patients. Methods: Fifty patients with stroke and TBI (mean age: 64.6±15.02 years) were enrolled. Patients received tube feeding and texture-modified diet training, combined with rehabilitation exercise training. Diet in the WHRP was calculated for five daily meals; total daily caloric intake was 29.8±6.1 kcal/kg/day, total protein intake was 1.41±0.18 g/kg/day, and whey protein 15.7±10.9g/day. Medical dietary records were maintained for each participant. Results: Body composition analysis was performed before and after the intervention and showed that muscle mass increased from 42.0±7.40 kg to 42.7±7.05 kg (P=0.029), whereas bone mass increased from 2.37±0.37 kg to 2.41±0.34 kg (P=0.042). Muscle mass associated more strongly with post- vs. pre-intervention protein and whey protein, with r values of 0.705 vs. 0.410 and 0.335 vs. 0.163, respectively, and the strongest effect was observed with post-intervention protein. Bone mass also associated more strongly with protein and whey protein after the WHRP intervention than before, with r of 0.699 vs. 0.291, and 0.463 vs. 0.117, respectively. The highest correlation was similarly observed for protein after the intervention. Conclusion: This WHRP intervention program was beneficial for tube-fed stroke and TBI patients undergoing inpatient rehabilitation. Our study serves as a reference for clinical healthcare workers when incorporating nutritional supplementation into treatment plans for inpatient convalescent stroke and TBI rehabilitation patients.