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Chen L, Jin KX, Yang J, Ouyang JJ, Chen HG, Zhou SR, Luo XQ, Liu M, Kuang L, Xie YL, Hu Y, Chen L, Ni ZH, Du XL. Total body water percentage and 3rd space water are novel risk factors for training-related lower extremity muscle injuries in young males. Chin J Traumatol 2024:S1008-1275(24)00001-4. [PMID: 38262890 DOI: 10.1016/j.cjtee.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/08/2023] [Accepted: 01/01/2024] [Indexed: 01/25/2024] Open
Abstract
PURPOSE To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis. METHODS A total of 282 healthy young male volunteers aged 18 - 20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conforms to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q1, Q3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy. RESULTS Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4 % (66 cases). These patients showed higher percentages of lean body mass (p = 0.001), total body water (TBW, p = 0.006), extracellular water (p = 0.020) and intracellular water (p = 0.010) as well as a larger ratio of basal metabolic rate/total weight (p = 0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat (p = 0.001) and body fat mass index (p = 0.002) was lower. Logistic regression analysis showed that TBW percentage > 65.35% (p = 0.050, OR = 3.114) and 3rd space water > 0.95% (p = 0.045, OR = 2.342) were independent risk factors for lower extremity muscle injuries. CONCLUSION TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.
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Affiliation(s)
- Liang Chen
- Department of Orthopedic, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Ke-Xing Jin
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Jing Yang
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Jun-Jie Ouyang
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Han-Gang Chen
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Si-Ru Zhou
- War Trauma Medical Center, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Xiao-Qing Luo
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Mi Liu
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Liang Kuang
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yang-Li Xie
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yan Hu
- Department of Military Basic Training and Army Management, Army Health Service Training Base, Army Medical University, Chongqing, 400042, China
| | - Lin Chen
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Zhen-Hong Ni
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China.
| | - Xiao-Lan Du
- Department of Wound Repair and Rehabilitation Medicine, Center of Bone Metabolism and Repair, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China; Department of Army Occupational Disease, Laboratory for Prevention and Rehabilitation of Training Injuries, State Key Laboratory of Trauma and Chemical Poisoning, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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Tomaszewska JZ, Georgakis A. Electroglottography in Medical Diagnostics of Vocal Tract Pathologies: A Systematic Review. J Voice 2023:S0892-1997(23)00388-0. [PMID: 38143204 DOI: 10.1016/j.jvoice.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/26/2023]
Abstract
Electroglottography (EGG) is a technology developed for measuring the vocal fold contact area during human voice production. Although considered subjective and unreliable as a sole diagnostic method, with the correct application of relevant computational methods, it can constitute a most promising non-invasive voice disorder diagnostic tools in a form of a digital vocal tract pathology classifier. The aim of the following study is to gather and evaluate currently existing digital voice quality assessment systems and vocal tract abnormality classification systems that rely on the use of electroglottographic bio-impedance signals. To fully comprehend the findings of this review, first the subject of EGG is introduced. For that, we summarise most relevant existing research on EGG with a particular focus on its application in diagnostics. Then, we move on to the focal point of this work, which is describing and comparing the existing EGG-based digital voice pathology classification systems. With the application of PRISMA model, 13 articles were chosen and analysed in detail. Direct comparison between chosen studies brought us to pivotal conclusions, which have been described in Section 5 of this report. Meanwhile, certain limitations arising from the literature were identified, such as questionable understanding of the nature of EGG bio-impedance signals. The appropriate recommendations for future work were made, including the application of different methods for EGG feature extraction, as well as the need for continuous EGG datasets development containing signals gathered in various conditions and with different equipments.
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Showkat I, Khanday FA, Beigh MR. A review of bio-impedance devices. Med Biol Eng Comput 2023; 61:927-950. [PMID: 36637716 DOI: 10.1007/s11517-022-02763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/27/2022] [Indexed: 01/14/2023]
Abstract
Bio-impedance measurement analysis primarily refers to a safe and a non-invasive technique to analyze the electrical changes in living tissues on the application of low-value alternating current. It finds applications both in the biomedical and the agricultural fields. This paper concisely reviews the origin and measurement approaches for concepts and fundamentals of bio-impedance followed by a critical review on bio-impedance portable devices with main emphasis on the embedded system approach which is in demand due to its miniature size and present lifestyle preference of monitoring health in real time. The paper also provides a comprehensive review of various bio-impedance circuits with emphasis on the measurement and calibration techniques.
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Affiliation(s)
- Insha Showkat
- Department of Electronics and Instrumentation Technology, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India
| | - Farooq A Khanday
- Department of Electronics and Instrumentation Technology, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India.
| | - M Rafiq Beigh
- Department of Electronics, Govt. Degree College Sumbal, Sumbal, J&K, India
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Rashid Farokhi F, Kalateh E, Shafaghi S, Schneider AG, Mortazavi SM, Jamaati H, Hashemian SMR. Applying bio-impedance vector analysis (BIVA) to adjust ultrafiltration rate in critically ill patients on continuous renal replacement therapy: A randomized controlled trial. J Crit Care 2022; 72:154146. [PMID: 36116287 DOI: 10.1016/j.jcrc.2022.154146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Bioimpedance vector analysis (BIVA) has been suggested as a valuable tool in assessing volume status in critically ill patients. However, its effectiveness in guiding fluid removal by continuous renal replacement therapy (CRRT) has not been evaluated. METHODS In this randomized controlled trial, 65 critically ill patients receiving CRRT were allocated on a 1:1 ratio to have UF prescribed and adjusted using BIVA fluid assessment in the intervention group (32 patients) or conventional clinical parameters (33 patients). The primary outcome was the lean body mass (LBM) water content at CRRT discontinuation, and the secondary outcomes included the mortality rate, urinary output, the duration of ventilation support, and ICU stay. RESULTS The study group was associated with a lower water content of LBM (80.7 ± 9.4 vs. 85.9 ± 10.4%; p < 0.05), and a higher mean UF-rate and urinary output (1.5 ± 0.8 vs. 1.2 ± 0.5 ml/kg/h and 0.9 ± 0.9 vs 0.5 ± 0.6 ml/kg/h, both: p < 0.05). The mortality rate, the length of ICU stay, and ventilation support duration were similar. CONCLUSION BIVA guided UF prescription may be associated with a lower rate of fluid overload. Larger studies are required to evaluate its impact on patients' outcomes.
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Affiliation(s)
- Farin Rashid Farokhi
- CKD Research Centre, Shahid Beheshti University of Medical Science, Tehran, Iran; Nephrology Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran; Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Effat Kalateh
- Internal Medicine Department, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Shadi Shafaghi
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Antoine Guillaume Schneider
- Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; University of Lausanne, Lausanne, Switzerland.
| | - Seyed Mehdi Mortazavi
- Critical Care Department, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Seyed Mohammad Reza Hashemian
- Critical Care Department, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran; Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran.
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Abstract
BACKGROUND More elderly frail patients are now treated by peritoneal dialysis (PD). Frailty, sarcopenia and protein energy wasting (PEW) are all associated with increased mortality. Simple screening tools are required to identify patients to allow for interventions. As such, we wished to review the prevalence of frailty and compare frailty with sarcopenia and PEW in a contemporary PD population. PATIENTS AND METHODS We used the Clinical Frailty Score (CFS) to determine frailty, bio-impedance body composition and hand grip strength (HGS) to determine sarcopenia and combining laboratory, body composition and protein nitrogen appearance rate (PNA) to assess PEW. RESULTS Records of 368 PD patients, 61% male, mean age 60.9 ± 16.1 years, body mass index (BMI) 26.2 ± 5.1 kg/m2 were reviewed, with 71 classified as frail (19.3%; CFS > 4), and frailty associated with age (odds ratio (OR) 1.047, 95% confidence interval (CL) 1.01-1.085, p = 0.012), Stoke-Davies co-morbidity (OR 1.808, 95%CL 1.129-2.895, p = 0.014) and negatively with HGS (OR 0.906, 95% CL 0.897-0.992, p = 0.033); 17.7% met muscle loss and HGS criteria for sarcopenia, with fair agreement with frailty (kappa 0.24 (CL 0.09-0.38)). Only two patients (0.5%) met all four criteria for PEW, 26.1% met the reduced BMI criteria, 4.6% the serum albumin, 32.9% the PNA and 39.4% the reduced muscle mass. HGS correlated with lean muscle mass (r 2 = 0.42, p < 0.001). CONCLUSION Using the CFS, 19.3% of patients were classified as frail, compared to 17.7% with sarcopenia and <1% with PEW. The CFS requires no special equipment or laboratory tests and was associated with age, co-morbidity and HGS weakness.
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Affiliation(s)
- Andrew Davenport
- Department of Renal Medicine, Royal Free Hospital, University College London, UK
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Sipers WMWH, Dorge J, Schols JMGA, Verdijk LB, van Loon LJC. Multifrequency bioelectrical impedance analysis may represent a reproducible and practical tool to assess skeletal muscle mass in euvolemic acutely ill hospitalized geriatric patients. Eur Geriatr Med 2020; 11:155-62. [PMID: 32297228 DOI: 10.1007/s41999-019-00253-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/21/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE Geriatric patients with low skeletal muscle mass (SMM) and strength have a poor clinical outcome following acute illness. Consequently, it is recommended to assess SMM and strength in patients admitted to the acute care geriatric ward. Bio-impedance analysis (BIA) is a practical tool to assess SMM in hospitalized patients. However, the reproducibility of this assessment may be compromised due to changing clinical conditions. The objective was to study the reproducibility of SMM assessment using multifrequency BIA (mf-BIA) in acutely ill geriatric patients. METHODS A total of 47 geriatric patients (age: 83 ± 7 years; n = 31 female) admitted to the acute geriatric ward participated in this pilot study. SMM was assessed on three occasions within the first week of hospital admission using the Maltron Bioscan-920-II. RESULTS Total skeletal SMM averaged 21.4 ± 5.7, 20.7 ± 5.4, and 20.8 ± 5.1 kg assessed at 2 ± 1, 3 ± 1 and 5 ± 2 days after hospital admission, respectively. Coefficient of variation (COV) of the three SMM measurements was 4.9 ± 4.5% with an intraclass correlation coefficient (ICC) of 0.976 (CI 95%: 0.961-0.986; P < 0.001). Hydration status affected the reproducibility of the measurement, with non-euvolemic patients (n = 16) showing a significantly higher COV (7.6 ± 5.9% vs 3.5 ± 2.9%; P < 0.01) and a lower ICC (0.983 vs 0.913; P < 0.001) when compared to the euvolemic patients (n = 31). CONCLUSION Mf-BIA seems a highly reproducible and reliable method to assess SMM throughout the first week of hospitalization in geriatric patients. However, since abnormal hydration status may compromise reliability of the measurement, assessment of SMM using mf-BIA may better be performed when euvolemic status has been established.
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Topete-Reyes JF, López-Lozano CA, López-Báez SL, Barbarín-Vázquez AV, Cervantes-Villalobos ML, Navarro-Rodríguez J, Parra-Michel R, Pazarín-Villaseñor HL, Meza-Guillén D, Torres-Tamayo M, Medina-Urrutia AX, Juárez-Rojas JG. Determinación del estado nutricional mediante el ángulo de fase en pacientes en hemodiálisis. GAC MED MEX 2019; 155:229-235. [PMID: 31219459 DOI: 10.24875/gmm.19004434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Multi-frequency bio-impedance analysis (BIA) accurately evaluates body composition. Objective To assess nutritional status and its relationship with body mass index (BMI) or with BIA-obtained phase angle in patients with end-stage renal disease (ESRD) on hemodialysis. Method BMI, BIA and dialysis malnutrition score (DMS) were assessed in 99 patients on hemodialysis (43.6 ± 17.2 years of age, 58.8% males). Multivariate linear regression analysis was used to determine BMI and phase angle independent associations with DMS. Results Malnutrition risk (DMS > 13) showed a gradual increase among patients with normal BMI and phase angle (44.4%), low BMI (45.8%), low phase angle (64.0%), and in those with both parameters at abnormal ranges (68.0%). The phase angle was the only variable that was independently associated with patient nutritional status (standardized coefficient beta -0.372, p < 0.001), accounting for 13.8% of DMS variation. Conclusion Phase angle is inversely and independently associated with malnutrition risk in patients with ESRD, which suggests that BIA-assessed body composition might be better than BMI in the clinical assessment of patients with ESRD.
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Affiliation(s)
- Jorge F Topete-Reyes
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Carlos A López-Lozano
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Sandra L López-Báez
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Anel V Barbarín-Vázquez
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Ma L Cervantes-Villalobos
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Jesemil Navarro-Rodríguez
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - Renato Parra-Michel
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | - H Leonardo Pazarín-Villaseñor
- Instituto Mexicano del Seguro Social, Hospital General Regional 46, Servicio de Nefrología, Guadalajara, Jalisco, México
| | | | - Margarita Torres-Tamayo
- Instituto Nacional de Cardiología "Ignacio Chávez", Departamento de Endocrinología, Ciudad de México, México
| | - Aída X Medina-Urrutia
- Instituto Nacional de Cardiología "Ignacio Chávez", Departamento de Endocrinología, Ciudad de México, México
| | - Juan G Juárez-Rojas
- Instituto Nacional de Cardiología "Ignacio Chávez", Departamento de Endocrinología, Ciudad de México, México
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Deacon R, de Noronha M, Shanley L, Young K. Does the speed of aquatic therapy exercise alter arm volume in women with breast cancer related lymphoedema? A cross-over randomized controlled trial. Braz J Phys Ther 2018; 23:140-147. [PMID: 30471966 DOI: 10.1016/j.bjpt.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/29/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To identify whether slow aquatic exercise in the form of modified Ai Chi is more effective than conventional (faster pace) aquatic therapy at reducing arm volume in women with or at risk of breast cancer related lymphoedema. METHODS Randomized, cross-over controlled trial with concealed allocation and blinded assessment. Eighteen women with a history of breast cancer related lymphoedema were recruited. Participants received two intervention sessions (randomized order) with one week apart. Interventions were a 50min conventional aquatic intervention or a 50min modified Ai Chi. Arm volume was measured as the difference between affected and unaffected arm; bio-impedance was measured as an index of extracellular fluid; satisfaction was measured via a 12 question form. Outcomes were measured before, immediately after and one hour after intervention. RESULTS Comparison between interventions showed larger decreased arm volume of 140mL (95%CI 17-263) immediately after intervention in favor of the Ai Chi intervention, however it was not sustained at 1h follow-up. A post hoc analysis showed 72% of participants had a decrease in arm volume immediately after Ai Chi compared to 28% immediately after conventional aquatic therapy; with a number needed to treat of 3 (95%CI 1.4-6.6). There were no differences between interventions for bio-impedance. Satisfaction was good for both interventions. CONCLUSION Slow pace aquatic exercise is more effective than conventional aquatic exercise immediately after intervention for arm volume. Also, undesirable increase in arm volume seems to subside after 1h, which can be beneficial if therapy does not address arm volume. TRIAL REGISTRATION ACTRN12614000557639 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614000557639).
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Barnes KS, Smeed B, Taylor R, Hood V, Brooke-Wavell K, Slee A, Ryg J, Masud T. The prevalence of sarcopenia in fallers and those at risk of falls in a secondary care falls unit as measured by bio-impedance analysis. J Frailty Sarcopenia Falls 2018; 3:128-131. [PMID: 32300701 PMCID: PMC7155343 DOI: 10.22540/jfsf-03-128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 11/29/2022] Open
Abstract
Objectives: Sarcopenia is characterised by loss of skeletal muscle mass and strength with adverse outcomes: physical disability, poor quality of life and death. Low muscle mass and strength are risk factors for falls, although there are few data available on the prevalence of sarcopenia in fallers. This study aimed to determine prevalence of sarcopenia in older people referred to a falls clinic. Methods: Consecutive patients referred to a secondary care falls unit were recruited. Sarcopenia was diagnosed using the European Working Group on Sarcopenia definition (low muscle mass and function) and cut-off points. Bio-impedance measured appendicular skeletal muscle mass. Gait speed and grip strength were functional measures. Results: Fifty-eight patients were recruited. Mean (SD) grip strength for women and men respectively were 17.9 (4.9) and 29.9(8.7) kg, mean (SD) gait speeds were 0.61(0.18) and 0.72 (0.4) m/s, mean (SD) appendicular skeletal muscle index in women and men were 6.98(1.0) and 7.85 (1.0) kg/m2 (p=0.018). Prevalence of sarcopenia was 9.8% (95% CI=1.6%-18%). Conclusions: Sarcopenia, as measured by bio-impedance is not uncommon in older people accessing a secondary care falls clinic. Bio-impedance was simple to perform, although further validation against gold standard methods is needed. As nutritional and exercise interventions for sarcopenia are available, simple methods for diagnosing sarcopenia in fallers should be considered.
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Affiliation(s)
- Katherine Sarah Barnes
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Barbara Smeed
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Rachael Taylor
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Victoria Hood
- Department of Academic Physiotherapy, University of Nottingham, Nottingham, UK
| | | | - Adrian Slee
- Institute of Liver and Digestive Health, Royal Free Medical School, University College London, London, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Tahir Masud
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Abstract
Role of hemodynamic monitoring in critically ill patients is still controversial. While invasive monitoring is accurate, it may be counter-productive in view of its essentially invasive nature. Non-invasive monitoring is less intrusive but has not yet been well validated for accuracy compared with gold standard of invasive monitoring.
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Kalainy S, Reid R, Jindal K, Pannu N, Braam B. Fluid volume expansion and depletion in hemodialysis patients lack association with clinical parameters. Can J Kidney Health Dis 2015; 2:54. [PMID: 26702360 DOI: 10.1186/s40697-015-0090-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/19/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Achievement of normal volume status is crucial in hemodialysis (HD), since both volume expansion and volume contraction have been associated with adverse outcome and events. OBJECTIVES The objectives of this study are to assess the prevalence of fluid volume expansion and depletion and to identify the best clinical parameter or set of parameters that can predict fluid volume expansion in HD patients. DESIGN This study is cross-sectional. SETTING This study was conducted in three hemodialysis units. PATIENTS In this study, there are 194 HD patients. METHODS Volume status was assessed by multifrequency bio-impedance spectroscopy (The Body Composition Monitor, Fresenius) prior to the mid-week HD session. RESULTS Of all patients, 48 % (n = 94) were volume-expanded and 9 % of patients were volume-depleted (n = 17). Interdialytic weight gain was not different between hypovolemic, normovolemic, and hypervolemic patients. Fifty percent of the volume-expanded patients were hypertensive. Paradoxical hypertension was very common (31 % of all patients); its incidence was not different between patient groups. Intradialytic hypotension was relatively common and was more frequent among hypovolemic patients. Multivariate regression analysis identified only four predictors for volume expansion (edema, lower BMI, higher SBP, and smoking). None of these parameters displayed both a good sensitivity and specificity. LIMITATIONS The volume assessment was performed once. CONCLUSIONS The study indicates that volume expansion is highly prevalent in HD population and could not be identified using clinical parameters alone. No clinical parameters were identified that could reliably predict volume status. This study shows that bio-impedance can assist to determine volume status. Volume status, in turn, is not related to intradialytic weight gain and is unable to explain the high incidence of paradoxical hypertension.
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Verney J, Schwartz C, Amiche S, Pereira B, Thivel D. Comparisons of a Multi-Frequency Bioelectrical Impedance Analysis to the Dual-Energy X-Ray Absorptiometry Scan in Healthy Young Adults Depending on their Physical Activity Level. J Hum Kinet 2015; 47:73-80. [PMID: 26557191 PMCID: PMC4633269 DOI: 10.1515/hukin-2015-0063] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study aimed at comparing BIA and DXA results in assessing body composition in young adults depending on their physical activity level. Eighty healthy 19–30 years old subjects were enrolled and their body composition (Fat Mass and Fat-Free Mass) was assessed by dual-energy X-ray absorptiometry (DXA) and by a newly developed Bioelectrical Impedance Analyzer (BIA - Tanita MC780). A seven-day physical activity level was assessed using a 3-axial accelerometer. DXA-FM% and BIA-FM% were correlated (p<0.001; r= 0.852; ICC [IC95%]: 0.84 [0.75 – 0.90]; concordance coefficient: 0.844). DXA-FFM and BIA FFM were correlated (p<0.001; r=0.976; ICC [IC95%]: 0.95 [0.93 – 0.97], concordance coefficient: 0.955). DXA and BIA measurements of FM% and FFM were highly correlated in both boys and girls regardless of the physical activity level. Compared with DXA scans, newly developed bioelectrical impedance analyzers provide satisfactory fat mass and lean mass measures in healthy young women and men, despite their physical activity level.
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Affiliation(s)
- Julien Verney
- Clermont University, Blaise Pascal University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France. ; CRNH-Auvergne, Clermont-Ferrand, France
| | - Chloé Schwartz
- Clermont University, Blaise Pascal University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France
| | - Saliha Amiche
- Clermont University, Blaise Pascal University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University hospital, Biostatistics unit (DRCI), Clermont-Ferrand, France
| | - David Thivel
- Clermont University, Blaise Pascal University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France. ; CRNH-Auvergne, Clermont-Ferrand, France
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Yan MT, Cheng CJ, Wang HY, Yang CS, Peng SJ, Lin SH. Evaluating Hyponatremia in Non-Diabetic Uremic Patients on Peritoneal Dialysis. Perit Dial Int 2015; 36:196-204. [PMID: 26374835 DOI: 10.3747/pdi.2014.00239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 01/08/2015] [Indexed: 11/15/2022] Open
Abstract
UNLABELLED ♦ BACKGROUND An approach to hyponatremia in uremic patients on peritoneal dialysis (PD) necessitates the assessment of intracellular fluid volume (ICV) and extracellular volume (ECV). The aim of the study was to evaluate the association of plasma sodium (Na(+)) concentration and body fluid composition and identify the causes of hyponatremia in non-diabetic PD patients. ♦ METHODS Sixty non-diabetic uremic patients on PD were enrolled. Baseline body fluid composition, biochemistry, hand-grip test, peritoneal membrane characteristics, dialysis adequacy, Na(+) and water balance, and residual renal function (RRF) were measured. These parameters were reevaluated for those who developed hyponatremia, defined as serum Na(+) concentration < 132 mmol/L and a decline in serum Na(+) > 7 mmol/L, during monthly visits for 1 year. Body fluid composition was determined by multi-frequency bioelectrical impedance (BIA). ♦ RESULTS There was no significant correlation between serum Na(+) concentrations and any other parameters except a negative correction with overnight ultrafiltration (UF) amount (p = 0.02). The ICV/ECV ratio was positively correlated with serum albumin (p < 0.005) and hand grip strength (p < 0.05). Over 1 year, 9 patients (M:F = 3:6, aged 35 - 77) with 4 different etiologies of hyponatremia were identified. Hyponatremic patients with a body weight (BW) loss had either an increased ICV/ECV ratio associated with primarily a negative Na(+) balance (n = 2) or a reduced ratio of ICV/ECV associated with malnutrition (n = 2). In contrast, hyponatremic patients with a BW gain had either a reduced ICV/ECV ratio associated with a rapid loss of RRF and a higher peritoneal permeability (n = 2) or a normal to increased ICV/ECV ratio associated with high water intake (n = 3). ♦ CONCLUSION Besides BW change and ultrafiltration rate, the assessment of ICV/ECV ratio is valuable in identifying the etiologies of hyponatremia in PD and provides a guide for optimal therapy.
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Affiliation(s)
- Ming-Tso Yan
- Division of Nephrology, Department of Medicine, Cathay General Hospital, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan National Defense Medical Center, Taipei, Taiwan
| | - Chih-Jen Cheng
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsiu-Yuan Wang
- Department of Nutrition, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chwei-Shiun Yang
- Division of Nephrology, Department of Medicine, Cathay General Hospital, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Sheng-Jeng Peng
- Division of Nephrology, Department of Medicine, Cathay General Hospital, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Shih-Hua Lin
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Huerta-Franco MR, Vargas-Luna M, Montes-Frausto JB, Morales-Mata I, Ramirez-Padilla L. Effect of psychological stress on gastric motility assessed by electrical bio-impedance. World J Gastroenterol 2012; 18:5027-33. [PMID: 23049210 PMCID: PMC3460328 DOI: 10.3748/wjg.v18.i36.5027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/18/2012] [Accepted: 05/26/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate gastric motility using electrical bio-impedance (EBI) and gastric changes as a result of stress induced by psychological tests.
METHODS: A group of 57 healthy women, aged 40-60 years, was recruited, and a clinical history and physical examination were performed. The women were free from severe anxiety, chronic or acute stress, severe depression, mental diseases and conditions that affect gastric activity. The women were evaluated under fasting conditions, and using a four-electrode configuration, the gastric signals were obtained through a BIOPAC MP-150 system. The volunteers were evaluated using the following paradigm: basal state, recording during the Stroop Test, intermediate resting period, recording during the Raven Test, and a final resting period. We analyzed the relative areas of the frequency spectrum: A1 (1-2 cpm), A2 (2-4 cpm), A3 (4-8 cpm), and A4 (8-12 cpm), as well as the median of area A2 + A3. The data were analyzed by an autoregressive method using a Butterworth filter with MatLab and Origin. Analysis of variance (ANOVA) and Friedman ANOVA (for nonparametric variables) were performed; in addition, pairs of groups were compared using the T dependent and Wilcoxon T tests.
RESULTS: The results of the main values of area A2 were not significantly different comparing the five steps of the experimental paradigm. Nevertheless, there was a tendency of this A2 region to decrease during the stress tests, with recuperation at the final resting step. When an extended gastric region was considered (1-4 cpm), significant differences with the psychological stress tests were present (F = 3.85, P = 0.005). The A3 region also showed significant changes when the stress psychological tests were administered (F = 7.25, P < 0.001). These differences were influenced by the changes in the adjacent gastric region of A2. The parameter that we proposed in previous studies for the evaluation of gastric motility by electrical bio-impedance (EBI) was the median of the area under the region from 2 to 8 cpm (A2 + A3). The mean values of these frequencies (median of the A2 + A3 area) with the stress test showed significant changes (F = 5.5, P < 0.001). The results of the Wilcoxon T test for the A4 area parameter, which is influenced by the breathing response, changed significantly during the Raven stress test (P < 0.05).
CONCLUSION: We confirm that the gastric response to acute psychological stress can be evaluated by short-term EBI.
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Huerta-Franco MR, Vargas-Luna M, Capaccione KM, Yañez-Roldán E, Hernández-Ledezma U, Morales-Mata I, Córdova-Fraga T. Effects of metoclopramide on gastric motility measured by short-term bio-impedance. World J Gastroenterol 2009; 15:4763-9. [PMID: 19824108 PMCID: PMC2761552 DOI: 10.3748/wjg.15.4763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the accuracy of short-term bio-impedance as a means of measuring gastric motility.
METHODS: We evaluated differences in the short-term electrical bio-impedance signal from the gastric region in the following conditions: (1) fasting state, (2) after the administration of metoclopramide (a drug that induces an increase in gastric motility) and (3) after food ingestion in 23 healthy volunteers. We recorded the real component of the electrical impedance signal from the gastric region for 1000 s. We performed a Fast Fourier Transform (FFT) on this data and then compared the signal among the fasting, medicated, and postprandial conditions using the median of the area under the curve, the relative area under the curve and the main peak activity.
RESULTS: The median of the area under the curve of the frequency range in the region between 2-8 cycles per minute (cpm) decreased from 4.7 cpm in the fasting condition to 4.0 cpm in the medicated state (t = 3.32, P = 0.004). This concurred with the decrease seen in the relative area under the FFT curve in the region from 4 to 8 cpm from 38.3% to 26.6% (t = 2.81, P = 0.012) and the increase in area in the region from 2 to 4 cpm from 22.4% to 27.7%, respectively (t = -2.5, P = 0.022). Finally the main peak position also decreased in the region from 2 to 8 cpm. Main peak activity in the fasting state was 4.72 cpm and declined to 3.45 cpm in the medicated state (t = 2.47, P = 0.025). There was a decrease from the fasting state to the postprandial state at 3.02 cpm (t = 4.0, P = 0.0013).
CONCLUSION: Short-term electrical bio-impedance can assess gastric motility changes in individuals experiencing gastric stress by analyzing the area medians and relative areas under the FFT curve.
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