Abstract
BACKGROUND CONTEXT
Adequate nutrition is essential to address the surgical stress response and mitigate
loss of muscle mass, strength, and functionality in older adults with lumbar spinal
stenosis (LSS). However, it is unknown whether amino acids and/or vitamin D are beneficial
in older adults following lumbar surgery for LSS.
PURPOSE
To evaluate whether branched-chain amino acids (BCAA) plus vitamin D supplementation
could attenuate the loss of muscle mass and strength, accelerate the return of functional
mobility, and improve clinical outcomes following lumbar surgery for LSS.
STUDY DESIGN/SETTING
A single-center, single-blind randomized controlled trial.
PATIENT SAMPLE
Eighty patients who received lumbar surgery for LSS.
OUTCOME MEASURES
The primary outcome was the Zurich claudication questionnaire (ZCQ), and secondary
outcomes included knee muscle strength, muscle mass measured by bioelectrical impedance
analysis, gait speed and a timed up-and-go test (TUG) at 12 weeks postoperatively.
Follow-up assessment was performed for the ZCQ at 52 weeks postoperatively.
METHODS
Patients ingested the supplementation (BCAA group: BCAA plus vitamin D, Nonamino acid
group: nonamino acid) twice daily for 3 weeks from the day after surgery, and received
two hours of postoperative inpatient rehabilitation 5 times a week.
RESULTS
No significant differences were observed in the mean changes on the ZCQ between the
two groups at 12 weeks and 52 weeks. At 2 weeks postoperatively, the nonamino acid
group showed significant deterioration compared with the BCAA group for strengths
of knee extensor and knee flexor (p < .01). At 12 weeks, the BCAA group showed significant
improvements in knee extensor strength and knee flexor strength compared with the
nonamino acid group (p <.01). There were no significant differences in mean changes
of muscle mass, maximum gait speed, and TUG at 12 weeks between two groups.
CONCLUSIONS
BCAA plus vitamin D supplementation did not improve LSS-related clinical outcomes
after lumbar surgery for LSS, even though muscle strength increased. Future studies
should focus on long-term outcomes for muscle mass and physical function, including
development of sarcopenia and frailty.
Keywords
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Article info
Publication history
Published online: March 18, 2023
Accepted:
March 13,
2023
Received in revised form:
March 1,
2023
Received:
October 15,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: MM: Grant: 2020 Wakayama Medical Award for Young Researchers (B); MK: Nothing to disclose; MT: Nothing to disclose; YE: Nothing to disclose; MN: Nothing to disclose; YY: Nothing to disclose; NS: Nothing to disclose; SM: Nothing to disclose; TN: Nothing to disclose; RN: Nothing to disclose; WN: Nothing to disclose; YN: Nothing to disclose.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
