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Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
接受康复的人经常会遇到营养问题，如营养不良，但是没有专门针对这些患者的康复和营养护理相结合的临床实践指南（CPG）。日本康复营养协会旨在开发用于康复营养的CPG，以支持日常实践中的临床决策。
基于建议评估等级的CPG委员会和开发流程，开发和评估系统和《2014年临床实践指南开发思想手册》已建立。为接受脑血管疾病康复的患者定义了四个临床问题，髋部骨折,癌症,和急性疾病。使用MEDLINE搜索截至2020年4月的随机对照试验(RCT)文献，EMBASE,中部,和Ichushi-web数据库。筛选后,对全文论文进行了分析资格评估.随后，纳入系统评价的研究检查了它们的偏倚风险，并进行了荟萃分析。CPG发展委员会根据系统审查报告起草了指南。小组成员确定了最终建议。
针对每种疾病/状况，基于4至9个RCTs提出了四项建议。证据的确定性从很低到很低。总的来说,加强营养护理对于脑血管病康复患者的建议较弱，髋部骨折,癌症,和急性疾病。
本CPG为接受康复的个体提供了初步的营养护理建议。由于证据确定性低，纳入研究样本量小，需要更多高质量和更大的RCT来开发更实用的CPG。
基于建议评估等级的CPG委员会和开发流程，开发和评估系统和《2014年临床实践指南开发思想手册》已建立。为接受脑血管疾病康复的患者定义了四个临床问题，髋部骨折,癌症,和急性疾病。使用MEDLINE搜索截至2020年4月的随机对照试验(RCT)文献，EMBASE,中部,和Ichushi-web数据库。筛选后,对全文论文进行了分析资格评估.随后，纳入系统评价的研究检查了它们的偏倚风险，并进行了荟萃分析。CPG发展委员会根据系统审查报告起草了指南。小组成员确定了最终建议。
针对每种疾病/状况，基于4至9个RCTs提出了四项建议。证据的确定性从很低到很低。总的来说,加强营养护理对于脑血管病康复患者的建议较弱，髋部骨折,癌症,和急性疾病。
本CPG为接受康复的个体提供了初步的营养护理建议。由于证据确定性低，纳入研究样本量小，需要更多高质量和更大的RCT来开发更实用的CPG。
