Your competent? doctor has already synthesized my 31 posts on vitamin D back to May 2012 to see what other benefits it has and the fall risk danger and supplements vs. natural ways for vitamin D. NO, that hasn't been done? So, you DON'T HAVE A FUNCTIONING STROKE DOCTOR, DO YOU?
Impact of vitamin D supplementation on post-stroke rehabilitation outcomes: A
systematic review and meta-analysis
Received: November 30, 2024 - Accepted: March 27, 2025 - Published online: April 28, 2025
Review Article
narra j
Copyright: © 2025 by the authors.
This is an open access article distributed under
the terms and conditions of the CC BY-NC 4.0.
Review Article
Impact of vitamin D supplementation on
post-stroke rehabilitation outcomes: A
systematic review and meta-analysis
Etisa A. Murbawani1,2, Dodik T. Pramukarso3, Siti F. Muis2, Dwi Pudjonarko3,
Hertanto W. Subagio2*, Kevin C. Tjandra4, Danendra RP. Respati4, Laksmana AK.
Nugraha4, Ghifarie A. Ramadhany4 and Stephano Pranoto4
1Doctoral Program in Medical and Health Science, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia;
2Department of Clinical Nutrition Physician, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia;
3Department of Neurology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia; 4Department of
Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
*Corresponding author: hertantows@lecturer.undip.ac.id
related deaths, with low- and middle-income countries shouldering a disproportionately
high financial burden. Studies have associated vitamin D deficiency with arteriosclerosis,
left ventricular hypertrophy, and vascular dysfunction, contributing to an elevated risk of
stroke. The aim of this study was to evaluate how vitamin D supplementation affects post-
stroke outcomes. A comprehensive literature search was performed across PubMed,
Scopus, the Cochrane Library, ScienceDirect, Springer Link, ProQuest, and
Epistemonikos from April to May 2024. This study focused on comparing the efficacy of
vitamin D supplementation versus no supplementation in stroke patients of all ages.
Outcome measures included the Functional Ambulation Classification (FAC), Brunnstrom
Recovery Stage (BRS), Modified Rankin Scale (mRS), and National Institutes of Health
Stroke Scale (NIHSS). Case reports, reviews, and research on other cardiovascular or
metabolic issues were excluded. Five authors extracted data and analyzed bias separately
using the Risk of Bias Version 2 (RoB V2) algorithms. The results of continuous variables
were pooled into the mean difference (MD) along with 95% confidence intervals (CI) using
random-effect models. Review Manager 5.4 was used to evaluate the data. Out of the
1,152,449 papers evaluated, six met the inclusion criteria, with a sample size ranging from
42 to 123 patients. Vitamin D supplementation was found to yield better outcomes after
stroke. BRS in lower extremities showed better results (MD: 0.59 (95%CI: 0.27–0.91))
and NIHSS improved with an MD of -1.47 (95%CI: -2.03–(-0.90)). Furthermore, there
was also an improvement in mRS, with an MD of -0.91 (95%CI: -1.25–(-0.56)). In
conclusion, vitamin D improved post-stroke outcomes,(But you uselessly didn't give us amounts, or supplements vs. natural!) which supported its
supplementation as a part of stroke rehabilitation.
Keywords: Vitamin D supplementation, stroke outcome, stroke management, functional
recovery, meta-analysis
Review Article
narra j
Copyright: © 2025 by the authors.
This is an open access article distributed under
the terms and conditions of the CC BY-NC 4.0.
Review Article
Impact of vitamin D supplementation on
post-stroke rehabilitation outcomes: A
systematic review and meta-analysis
Etisa A. Murbawani1,2, Dodik T. Pramukarso3, Siti F. Muis2, Dwi Pudjonarko3,
Hertanto W. Subagio2*, Kevin C. Tjandra4, Danendra RP. Respati4, Laksmana AK.
Nugraha4, Ghifarie A. Ramadhany4 and Stephano Pranoto4
1Doctoral Program in Medical and Health Science, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia;
2Department of Clinical Nutrition Physician, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia;
3Department of Neurology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia; 4Department of
Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
*Corresponding author: hertantows@lecturer.undip.ac.id
Abstract
Each year, there are approximately 12.2 million new stroke cases and 6.5 million stroke-related deaths, with low- and middle-income countries shouldering a disproportionately
high financial burden. Studies have associated vitamin D deficiency with arteriosclerosis,
left ventricular hypertrophy, and vascular dysfunction, contributing to an elevated risk of
stroke. The aim of this study was to evaluate how vitamin D supplementation affects post-
stroke outcomes. A comprehensive literature search was performed across PubMed,
Scopus, the Cochrane Library, ScienceDirect, Springer Link, ProQuest, and
Epistemonikos from April to May 2024. This study focused on comparing the efficacy of
vitamin D supplementation versus no supplementation in stroke patients of all ages.
Outcome measures included the Functional Ambulation Classification (FAC), Brunnstrom
Recovery Stage (BRS), Modified Rankin Scale (mRS), and National Institutes of Health
Stroke Scale (NIHSS). Case reports, reviews, and research on other cardiovascular or
metabolic issues were excluded. Five authors extracted data and analyzed bias separately
using the Risk of Bias Version 2 (RoB V2) algorithms. The results of continuous variables
were pooled into the mean difference (MD) along with 95% confidence intervals (CI) using
random-effect models. Review Manager 5.4 was used to evaluate the data. Out of the
1,152,449 papers evaluated, six met the inclusion criteria, with a sample size ranging from
42 to 123 patients. Vitamin D supplementation was found to yield better outcomes after
stroke. BRS in lower extremities showed better results (MD: 0.59 (95%CI: 0.27–0.91))
and NIHSS improved with an MD of -1.47 (95%CI: -2.03–(-0.90)). Furthermore, there
was also an improvement in mRS, with an MD of -0.91 (95%CI: -1.25–(-0.56)). In
conclusion, vitamin D improved post-stroke outcomes,(But you uselessly didn't give us amounts, or supplements vs. natural!) which supported its
supplementation as a part of stroke rehabilitation.
Keywords: Vitamin D supplementation, stroke outcome, stroke management, functional
recovery, meta-analysis
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