Bioelectrical Impedance Analysis (BIA) of the association of the Japanese Kampo concept "Suidoku" (fluid disturbance) and the body composition of women

Effects of Kampo medicine hangebyakujutsutemmato on persistent postural-perceptual dizziness: A retrospective pilot study

BACKGROUND

Persistent postural-perceptual dizziness (PPPD) is a functional disorder, typically preceded by acute vestibular disorders. It is characterized by a shift in processing spatial orientation information, to favor visual over vestibular and somatosensory inputs, and a failure of higher cortical mechanisms. To date, no therapies for PPPD have been approved. Kampo medicine hangebyakujutsutemmato (HBT) has been reported to alleviate disturbances of equilibrium. We hypothesized that HBT would be a beneficial treatment for PPPD.

AIM

To examine the efficacy of HBT for the treatment of PPPD.

METHODS

Patients with PPPD were enrolled and divided into two groups: The HBT group (n = 24) and the non-HBT group (n = 14). The participants completed questionnaire surveys [Niigata PPPD questionnaire (NPQ), dizziness handicap inventory, hospital anxiety and depression scale (HADS), orthostatic dysregulation questionnaire, pittsburg sleep quality index (PSQI), and motion sickness scores] before and after HBT treatment. Additionally, to identify HBT responders, multivariate regression analysis was performed using the results of the questionnaire surveys and equilibrium tests; including stabilometry, and caloric, vestibular evoked myogenic response, and head-up tilt tests.

RESULTS

Thirty-eight outpatients were included in this study, of which 14 patients (3 men, 11 women; mean age, 63.5 ± 15.9 years) received treatment without HBT, and 24 (1 man, 23 women; mean age, 58.2 ± 18.7 years) received combination treatment with HBT. Following HBT treatment, NPQ scores decreased significantly (baseline 40.1 ± 10.0 vs 2 mo 24.6 ± 17.7, P < 0.001). No statistically significant changes were observed in the NPQ scores in the non-HBT group (baseline 38.6 ± 12.2 vs 2 mo 39.4 ± 14.4, P = 0.92). Multivariable regression analysis revealed that the results of stabilometry (P = 0.02) and the caloric (P = 0.03), and head-up tilt tests (P < 0.001), HADS (P = 0.003), and PSQI (P = 0.01) were associated with HBT responsiveness in PPPD patients.

CONCLUSION

HBT may be an effective adjunct therapy for PPPD. Patients with autonomic dysfunction, unstable balance, semicircular canal paresis, anxiety, and poor sleep quality may be high responders to HBT.

The Relationship between "Shofuku-Fujin" (Abnormality of Abdominal Examination in Japanese Kampo Medicine) and Body Composition by Bioelectrical Impedance Analysis: A Cross-Sectional Study

Shofuku-fujin is an abnormal physical finding in Kampo medical practice. It is assumed to be often found in the elderly and contributes to the selection of Kampo formulas used mainly in elderly patients. However, few objective reports about Shofuku-fujin have been published to date. The aim of this study was to clarify the clinical features of patients showing Shofuku-fujin by using bioelectrical impedance analysis (BIA) and to objectively assess the potential clinical implications of these findings. We conducted a cross-sectional study of 1330 patients who visited our institute to undergo a medical examination by using data collected from September 2010 to March 2016. We extracted data on patient sex and age, anthropometric data, and body composition data that could potentially affect the appearance of Shofuku-fujin. Logistic regression analyses were performed by sex to analyze the various factors related to the appearance of Shofuku-fujin. Of the 1330 patients, the data of 386 men and 942 women were used for analysis. Multivariate logistic regression analysis showed that Shofuku-fujin was associated with older age (odds ratio (OR), 1.07; 95% confidence interval (CI), 1.05-1.10; p < 0.001), lower skeletal muscle mass index (SMI) (OR, 0.60; 95% CI, 0.43-0.85; p = 0.004), and lower body fat percentage (OR, 0.89; 95% CI, 0.85-0.93; p < 0.001) in men and older age (OR, 1.06; 95% CI, 1.04-1.07, p < 0.001) and lower body fat percentage (OR, 0.94; 95% CI, 0.92-0.96; p < 0.001) in women. On the basis of these results, the factors causing the appearance of Shofuku-fujin were aging, decreased muscle mass, and decreased body fat in men and aging and decreased body fat in women. Our results demonstrated that it may be better to consider a loss of muscle mass when examining a male patient with Shofuku-fujin.

Trunk Muscle Mass Measured by Bioelectrical Impedance Analysis Reflecting the Cross-Sectional Area of the Paravertebral Muscles and Back Muscle Strength: A Cross-Sectional Analysis of a Prospective Cohort Study of Elderly Population

Trunk muscles play an important role in supporting the spinal column. A decline in trunk muscle mass, as measured by bioelectrical impedance analysis (TMM-BIA), is associated with low back pain and poor quality of life. The purpose of this study was to determine whether TMM-BIA correlates with quantitative and functional assessments traditionally used for the trunk muscles. We included 380 participants (aged ≥ 65 years; 152 males, 228 females) from the Shiraniwa Elderly Cohort (Shiraniwa) study, for whom the following data were available: TMM-BIA, lumbar magnetic resonance imaging (MRI), and back muscle strength (BMS). We measured the cross-sectional area (CSA) and fat-free CSA of the paravertebral muscles (PVM), including the erector spinae (ES), multifidus (MF), and psoas major (PM), on an axial lumbar MRI at L3/4. The correlation between TMM-BIA and the CSA of PVM, fat-free CSA of PVM, and BMS was investigated. TMM-BIA correlated with the CSA of total PVM and each individual PVM. A stronger correlation between TMM-BIA and fat-free CSA of PVM was observed. The TMM-BIA also strongly correlated with BMS. TMM-BIA is an easy and reliable way to evaluate the trunk muscle mass in a clinical setting.