Resources for Physiotherapists

Malnutrition Pathway Primary Care Network Portal

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Physiotherapists working in the community assess, diagnose, treat and manage a range of musculoskeletal conditions affecting physical function. They can play an important role in monitoring the nutritional status of individuals during treatment and rehabilitation as poor nutrition can directly affect function and ability to recover from injury or illness. Optimizing nutritional status also enables individuals to get the most benefit out of exercise or rehabilitation programmes, such as pulmonary rehab.

Physiotherapists might consider observing and building into conversations questions about appetite, unexplained weight loss, dysphagia or fatigue. Further assistance is available via the following resources:

‘Initiating conversations about unintentional (unplanned) weight loss and diet’ - a list of questions to help obtain useful information; assists in selecting the most appropriate course of action and dietary advice resources for the individual. GO TO QUESTION SHEET

‘Subjective indicators of malnutrition risk’ - a list of indicators of unintentional weight loss and/or malnutrition risk to look out for: GO TO RESOURCE SHEET

The British Association for Parenteral and Enteral Nutrition (BAPEN) has a useful ONLINE SCREENING TOOL to be used with individuals who are experiencing unexplained weight loss or are experiencing a loss of appetite/poor appetite and not eating well. It is simple to follow; enter current weight and height and the weight they were 3 – 6 months ago before illness/lost weight. The calculation gives advice on further steps.

Consider referring at risk patients to a GP/Practice Nurse/Practice Pharmacist/Dietitian for further assessment.

In the meantime there are a number of useful leaflets that can be given to patients:

the Malnutrition Pathway Green Leaflet, low malnutrition risk, Eating Well

GREEN: Eating Well for those at low risk of malnutrition; how to eat a balanced diet.

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YELLOW: Your Guide to Making the Most of Your Food for those at medium risk of malnutrition; how to fortify foods.

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RED: Nutrition Drinks (known as oral nutritional supplements) for those at high risk of malnutrition and who have been prescribed oral nutritional supplements. This leaflet gives advice on how best to incorporate oral nutritional supplements into the diet.

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Muscle protein is directly affected by protein intake in the diet and muscle synthesis may be stimulated nutritionally.

Offering patients advice on the importance of eating enough protein and about how to get enough protein into the diet, in combination with physical activity, might be helpful:

the Malnutrition Pathway Protein Leaflets, a series for professionals and patients

The Malnutrition Pathway has produced a leaflet for healthcare professionals and a corresponding leaflet for patients in relation to the role of protein in the diet and foods that are rich in protein.

PROTEIN RESOURCES

There is also information available for Physiotherapists relating to:

SARCOPENIA: fact sheet summarising multiple factors that can contribute to sarcopenia and the potential consequences to health giving practical advice on diagnosis and treatment according to the patient's current nutritional status. Includes advice on optimising nutritional intake in combination with exercise.

the Malnutrition Pathway Sarcopaenia fact sheet, information and factsheets for health professionals

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FALLS: nutritional status is an independent predictor of falls in older people in the community. Improvement in nutritional status is found to reduce falls risk; this fact sheet outlines key actions for implementing nutrition screening and assessment into falls pathways.

the Malnutrition Pathway Falls fact sheet, information and factsheets for health professionals

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