Trunk Muscle Mass Changes During Chemotherapy in Children and Adolescents with Lower-Limb Osteosarcoma: A Retrospective Study Comparing Surgical Procedures.

Background:We reported that creatine kinase (CK) levels were increased by JAK inhibitors in rheumatoid arthritis (RA) patients in a retrospective study 1. There are no reports of whether JAK selectivity...

Objective: This preliminary study aimed to investigate six-month longitudinal changes in upper limb, lower limb, and trunk muscle mass, as well as gait speed and handgrip strength, in older adults receiving a nutritional intervention and rehabilitation.Methods: This longitudinal study included 18 community-dwelling older adults (age 80.4 ± 3.8 years) attending a daycare facility. Participants received a nutritional supplement drink and an individualized exercise program consisting of resistance training and cycle ergometer exercise. Upper limb, lower limb, and trunk muscle mass (using bioelectrical impedance analysis), maximal gait speed, and handgrip strength were measured at baseline, three months, and six months. Data were analyzed using a repeated measures analysis of variance (ANOVA).Results: A repeated measures ANOVA showed significant change over time in both trunk muscle mass and upper limb muscle mass (p < 0.05). Post hoc tests confirmed that the increase in trunk muscle mass was significant between baseline and six months, whereas no significant pairwise differences were found for upper limb muscle mass. No significant changes were observed for the other variables.Conclusion: This preliminary study suggests that a six-month combined nutritional and exercise intervention may significantly increase trunk muscle mass in older adults requiring daycare. These findings highlight the potential importance of targeting trunk muscles in rehabilitation nutrition strategies and warrant further investigation in larger, controlled studies.

Cancer confers the risk for cardiovascular diseases. This longitudinal study aimed to explore the relationship between changes in aortic morphology and muscle mass in cancer. One hundred patients with cancer who underwent thoracoabdominal enhanced computed tomography (CT) at baseline and 1-year follow-up were retrospectively included. Aortic diameter and tortuosity were assessed using CT. Skeletal muscle mass was also evaluated. Pearson correlation analysis and multivariate-adjusted regression models were used to explore the relationship between changes in aortic morphology and muscle mass. Thirty-six patients were male. The average patient age was 57.3 ± 11.3 years. Breast cancer was the most common malignancy. A significant increase in aortic diameter and tortuosity and a decrease in muscle mass were observed. Aortic morphological changes were correlated with changes in muscle mass, diastolic pressure, and high-density lipoprotein cholesterol and C-reactive protein levels. In the fully adjusted multivariable regression analysis, a one-unit increase in muscle mass change was associated with a decrease of 0.503, 0.382, 0.241, 0.174, and 0.163 mm in the diameter of the L1-L5 aortic segments, respectively; a 0.020 decrease in aortic tortuosity; a 0.017 decrease in descending thoracic tortuosity; and a 0.016 decrease in abdominal aortic tortuosity. Increased muscle mass helps maintain aortic morphology in cancer, suggesting that muscle loss is a key factor in increased cardiovascular risk. Muscle might be an important therapeutic target to improve cancer patients’ prognosis.

Engaging in both resistance and endurance exercise within the same training program, termed 'concurrent exercise training,' is common practice in many athletic disciplines that require a combination of strength and endurance and is recommended by a number of organizations to improve muscular and cardiovascular health and reduce the risk of chronic metabolic disease. Dietary protein ingestion supports skeletal muscle remodeling after exercise by stimulating the synthesis of muscle proteins and can optimize resistance exercise-training mediated increases in skeletal muscle size and strength; however, the effects of protein supplementation on acute and longer-term adaptive responses to concurrent resistance and endurance exercise are unclear. The purpose of this systematic review is to evaluate the effects of dietary protein supplementation on acute changes in muscle protein synthesis and longer-term changes in muscle mass, strength, and aerobic capacity in responses to concurrent resistance and endurance exercise in healthy adults. A systematic search was conducted in five databases: Scopus, Embase, Medline, PubMed, and Web of Science. Acute and longer-term controlled trials involving concurrent exercise and protein supplementation in healthy adults (ages 18-65years) were included in this systematic review. Main outcomes of interest were changes in skeletal muscle protein synthesis rates, muscle mass, muscle strength, and whole-body aerobic capacity (i.e., maximal/peak aerobic capacity [VO2max/peak]). The quality of studies was assessed using the National Institute of Health Quality Assessment for Controlled Intervention Studies. Four acute studies including 84 trained young males and ten longer-term studies including 167 trained and 391 untrained participants fulfilled the eligibility criteria. All included acute studies demonstrated that protein ingestion enhanced myofibrillar protein synthesis rates, but not mitochondrial protein synthesis rates during post-exercise recovery after an acute bout of concurrent exercise. Of the included longer-term training studies, five out of nine reported that protein supplementation enhanced concurrent training-mediated increases in muscle mass, while five out of nine studies reported that protein supplementation enhanced concurrent training-mediated increases in muscle strength and/or power. In terms of aerobic adaptations, all six included studies reported no effect of protein supplementation on concurrent training-mediated increases in VO2max/peak. Protein ingestion after an acute bout of concurrent exercise further increases myofibrillar, but not mitochondrial, protein synthesis rates during post-exercise recovery. There is some evidence that protein supplementation during longer-term training further enhances concurrent training-mediated increases in skeletal muscle mass and strength/power, but not whole-body aerobic capacity (i.e., VO2max/peak).

Changes in physiological markers and physical performance in relation to paratroopers' initial body composition were investigated during a 20-day winter military field training (MFT) and the subsequent 10-day recovery period. Body composition, serum hormone concentrations and enzymatic biomarkers, and physical performance of 58 soldiers were measured before, during, and after MFT. Comparisons were done according to soldiers' body fat percentage before MFT between low-fat (<12% body fat) and high-fat (>12% body fat) groups. Correlations between body fat percentage preceding MFT and changes in muscle mass, physical performance, and serum hormone concentrations and enzymatic biomarkers were investigated. It was hypothesized that soldiers with a higher fat percentage would have smaller decrements in muscle mass, physical performance, and serum testosterone concentration. The change in muscle and fat mass was different between groups (p <0.001) as the low-fat group lost 0.8kg of muscle mass and 2.0kg of fat mass, while there was no change in muscle mass and a loss of 3.7kg of fat mass in the high-fat group during MFT. Fat percentage before MFT correlated with the changes in muscle mass (R2=0.26, p <0.001), serum testosterone concentration (R2=0.22, p <0.001), and evacuation test time (R2=0.10, p <0.05) during MFT. The change in muscle mass was correlated with the changes in evacuation test time (R2=0.11, p <0.05) and countermovement jump test results (R2=0.13, p <0.01) during MFT. Soldiers with a higher initial fat percentage lost less muscle mass, and had smaller decrements in some aspects of physical performance, as well as in serum testosterone concentration during MFT.

Concordance between changes in calf circumference and muscle mass exists: A narrative literature review

The Change in Muscle Mass Among Kidney Transplant Recipients: A Prospective Cohort Study

Introduction:Increased muscle mass may positively influence the recovery of balance function. In this study, we aimed to investigate the relationship between changes in muscle mass and improved balance in patients with cerebral infarction.Methods:This study included patients with cerebral infarction aged ≥65 years. The Berg balance scale (BBS) was used to evaluate balance function upon admission and discharge.Participants were categorized into two groups based on BBS improvement: those who achieved the minimal clinically important difference (BBS improvement group; 213 participants, 73.4%) and those who did not (no BBS improvement group; 77 participants, 26.6%). Multiple regression analyses were performed, with increase in BBS score as the primary variable of interest and gains in skeletal muscle mass index (SMI) (Model 1), trunk muscle mass index (TMI) (Model 2), and SMI and TMI (Model 3) as explanatory variables.Results:A total of 290 participants were analyzed. BBS gain exhibited an independent association with TMI gain (coefficient = 3.72, 95% confidence interval [CI] = 0.99-6.45, p = 0.008); however, no significant association was observed with SMI gain (coefficient = 0.03, 95% CI = −2.28 to 2.33, p = 0.983). Furthermore, in Model 3, TMI gain (coefficient = 4.28, 95% CI = 1.35-7.20, p = 0.004) was independently linked to BBS gain. However, in the subgroup analyses stratified by tertiles of rehabilitation volume, this association was not statistically significant in any subgroup.Conclusions:In patients with cerebral infarction, an increase in TMI was associated with greater improvements in balance function during hospitalization. These results suggest a potential role for trunk muscle mass in supporting balance recovery; however, owing to the observational nature of the study, the findings should be interpreted with caution and viewed as hypothesis-generating. In addition, the lack of association in the subgroup analyses underscores the potential influence of confounding factors, such as the amount and content of rehabilitation, and highlights the need for future studies to control for these variables.

Laparoscopic sleeve gastrectomy (LSG) drastically affects body composition. However, studies focusing on the association between the changes in the pre-and postoperative muscle mass and postoperative results are limited. We evaluated the association between changes in the muscle mass and weight loss and fat reduction. This retrospective study included 29 consecutive patients who underwent both LSG and a bioelectrical impedance analysis (BIA) consecutively. We investigated changes in the body composition on the BIA and visceral fat area (VFA) on computed tomography and correlational changes in muscle mass with weight loss and fat reduction. The total weight loss (%TWL) 12months after surgery was 30.9%. The VFAs pre- and postoperatively were 224 and 71.0cm2, respectively. The fat mass (FM), percentage of FM, appendicular skeletal muscle mass (ASM), and skeletal muscle mass index (SMI) decreased from pre- to postoperatively (54.8 vs. 32.2kg; 49.0 vs. 41.2%, 26.7 vs. 23.9kg, 9.24 vs. 8.27, respectively), whereas the percentage of ASM (%ASM) increased (22.1 vs. 28.0%). The rate of change in %ASM positively correlated with weight loss and fat reduction (%TWL, rs = 0.65; %VFA loss, rs = 0.62). The rate of change in %ASM was positively correlated with weight loss and fat reduction.

We investigated the relationship between trunk muscle mass and spinal pathologies by gender. This multicenter cross-sectional study included patients aged ≥ 30 years who visited a spinal outpatient clinic. Trunk and appendicular muscle mass were measured using bioelectrical impedance analysis. The Oswestry Disability Index (ODI), visual analog scale (VAS) score for low back pain, sagittal vertical axis (SVA), and EuroQol 5 Dimension (EQ5D) score were investigated to evaluate spinal pathology. The association between trunk muscle mass and these parameters was analyzed by gender using a non-linear regression model adjusted for patients’ demographics. We investigated the association between age and trunk muscle mass. We included 781 men and 957 women. Trunk muscle mass differed significantly between men and women, although it decreased with age after age 70 in both genders. Lower trunk muscle mass was significantly associated with ODI, SVA, and EQ5D score deterioration in both genders; its association with VAS was significant only in men. Most parameters deteriorated when trunk muscle mass was < 26 kg in men and < 19 kg in women. Lower trunk muscle mass was associated with lumbar disability, spinal imbalance, and poor quality of life in both genders, with significant difference in muscle mass.

BackgroundSarcopenia is associated with poor prognosis in patients with chronic liver disease (CLD). As rapid skeletal muscle wasting predicts worse prognosis and a novel therapy for sarcopenia needs to be evaluated for validation, accurate evaluation methods for relative changes in muscle mass are crucial.MethodsWe screened CLD patients who had skeletal muscle mass evaluation between June 2015 and December 2017. Patients were included if they had adequate information, were followed for &gt;6 months, and had skeletal muscle mass evaluation by both bioelectrical impedance analysis (BIA) and computed tomography (CT) imaging at baseline and the second evaluation point. We compared BIA and CT imaging in terms of their ability to quantify skeletal muscle mass and identify relative changes in muscle mass in CLD patients.ResultsOf the screened 447 CLD patients, 110 were included in this study, and 71 (64.5%) were men. The median age was 68 (range 21 to 90) years. In total, 83 (75.5%) and 32 (29.1%) patients had liver cirrhosis and hepatocellular carcinoma, respectively. Of them, 50 (45.5%) patients were liver cirrhosis patients without hepatocellular carcinoma through the observation period. Skeletal muscle mass index (SMI) by BIA, psoas muscle mass index (PMI), and SMI based on CT imaging were significantly correlated at baseline [SMI by simple CT method and SMI by BIA (r = 0.61, P &lt; 0.01), SMI by BIA and PMI (r = 0.65, P &lt; 0.01), and SMI by simple CT method and PMI (r = 0.82, P &lt; 0.01), respectively] and second evaluation point [SMI by simple CT method and SMI by BIA (r = 0.51, P &lt; 0.01), SMI by BIA and PMI (r = 0.58, P &lt; 0.01), and SMI by simple CT method and PMI (r = 0.92, P &lt; 0.01), respectively]. Similar to previous reports, based on the PMI and SMI by simple CT method, patients with more severe liver dysfunction experienced more rapid skeletal muscle mass loss (ΔSimple method/years and ΔPMI/years in patients with Child‑Pugh Classes A, B, and C: Child‑Pugh A, −3.34%; B, −11.77%; C, −18.78%; and Child‑Pugh A, −0.78%; B, −6.33%; C, −7.71%, respectively). Completely opposite results were obtained based on SMI by BIA (Child‑Pugh A, −0.70%; B, 1.42%; C, 12.48%). A subgroup analysis revealed that in patients with fluid retention and diuretic administration, SMI by BIA increased with time (P &lt; 0.01).ConclusionsFor accurate evaluation of the relative changes in skeletal muscle mass in patients with CLD, CT imaging method, and not BIA, is one of the proper methods.

Introduction: After stroke, paralysis reduces muscle strength on the affected side. The lost muscle strength can be partially restored through stroke rehabilitation. However, even if muscle strength is restored, it is not clear whether muscle mass and quality improve. In recent years, it has become possible to measure muscle mass noninvasively using bioelectrical impedance analysis. Additionally, it is known that the phase angle measured by bioelectrical impedance analysis reflects muscle quality. We measured changes in muscle strength, mass, and quality using a hand dynamometer and bioelectrical impedance analysis in patients undergoing rehabilitation after stroke and examined their relationships with activities of daily living (ADLs) improvement. Hypothesis: Post-stroke rehabilitation improves muscle strength, mass, and quality, as well as ADLs. Methods: This retrospective study was performed at two stroke rehabilitation units from January 2017 to March 2019. Muscle mass and quality were assessed using bioelectrical impedance analysis. ADLs were assessed using the functional independence measure (FIM). We measured the grip strength of the non-affected and affected sides as muscle strength. Each measurement was performed at admission and 4 weeks later. We assessed changes in motor FIM items and examined relationships among data. Results and Conclusions: This study included 179 patients (mean age, 75.5±13.0 years; male/female, 89/90; mean duration after stroke, 27.6±8.7 days). Patients received stroke rehabilitation (159.8±21.6 min/day) 7 days a week individually. Muscle strength and quality significantly increased after 4 weeks on both the non-affected and affected sides. Muscle mass decreased, but there was no significant difference. The results were similar when analyzed by sex. Changes in muscle strength and quality were significantly correlated with ADLs improvement (r=0.56 and 0.43, respectively), but muscle mass was not correlated with ADLs improvement. Thus, post-stroke rehabilitation improves muscle strength and quality, as well as ADLs. Muscle mass is not appropriate to measure the effects of stroke rehabilitation, and it is desirable to instead use muscle strength and quality to assess stroke rehabilitation.

We investigated changes in skeletal muscle mass and bone mineral density in degenerative lumbar scoliosis (DLS) patients during a 2-year follow-up following diagnosis. This study included 418 Japanese women, identifying 50 patients for the DLS group (mean age 76.4years) and 368 patients for the control group (mean age 73.4years). Whole-body skeletal muscle mass was measured using a Bioelectrical Impedance Analyzer. Bone mineral density (BMD) was measured using DXA. Skin autofluorescence (SAF), a marker of advanced glycation end products in the skin, was measured using a spectroscope. Spinal alignment, skeletal muscle mass, BMD, grip strength, and SAF were examined and the amount of change 1 and 2years from the initial examination for each item was compared between groups. Height, body fat mass, grip strength, upper limb muscle mass, and trunk muscle mass in the DLS group were significantly lower, and lumbar spine BMD was significantly greater compared to controls at the first visit (p < 0.05). There was no significant difference in spinal alignment in the DLS group after 2years compared with baseline. Trunk muscle mass also decreased significantly more in the DLS group (-2.7%) than in the control group (-1.1%) over the 2-year follow-up (p < 0.05). In this study, trunk muscle mass in the DLS group decreased about 2.4 times more in 2years compared with the control group (p < 0.05). It may be possible to clarify the mechanism of kyphoscoliosis progression in the future with large-scale longitudinal studies.

ObjectiveMuscle depletion in patients undergoing liver transplantation affects the recipients' prognosis and therefore cannot be overlooked. We aimed to evaluate whether changes in muscle and fat mass during the preoperative period are associated with prognosis after deceased donor liver transplantation (DDLT).Materials and MethodsThis study included 72 patients who underwent DDLT and serial computed tomography (CT) scans. Skeletal muscle index (SMI) and fat mass index (FMI) were calculated using the muscle and fat area in CT performed 1 year prior to surgery (1 yr Pre-LT), just before surgery (Pre-LT), and after transplantation (Post-LT). Simple aspects of serial changes in muscle and fat mass were analyzed during three measurement time points. The rate of preoperative changes in body composition parameters were calculated (preoperative ΔSMI [%] = [SMI at Pre-LT − SMI at 1 yr Pre-LT] / SMI at Pre-LT × 100; preoperative ΔFMI [%] = [FMI at Pre-LT − FMI at 1 yr Pre-LT] / FMI at Pre-LT × 100) and assessed for correlation with patient survival.ResultsSMI significantly decreased during the preoperative period (mean preoperative ΔSMI, −13.04%, p < 0.001). In the multivariable analysis, preoperative ΔSMI (p = 0.016) and model for end-stage liver disease score (p = 0.011) were independent prognostic factors for overall survival. The mean survival time for patients with a threshold decrease in the preoperative ΔSMI (≤ −30%) was significantly shorter than for other patients (p = 0.007). Preoperative ΔFMI was not a prognostic factor but FMI increased during the postoperative period (p = 0.009) in all patients.ConclusionA large reduction in preoperative SMI was significantly associated with reduced survival after DDLT. Therefore, changes in muscle mass during the preoperative period can be considered as a prognostic factor for survival after DDLT.

With physical training and normal adolescent growth, gains in lean muscle mass can be seen among the healthy adolescent population. Assessing these gains is crucial to monitoring and adjusting training protocols and helping with client motivation and investment. However, the ability of common field tests to accurately predict changes in muscle mass among this population has yet to be proven. PURPOSE: The purpose of this study was to assess the ability of the standing long jump (SLJ) and 90° push-up (PU) test to accurately predict changes in lean mass (ΔLM) among healthy adolescents aged 12-18 years. METHODS: Forty-five healthy adolescents completed the standing long jump, 90° push-up test, and a full-body dual energy x-ray absorptiometry (DEXA) scan twice with 7-10 months between test sessions. The difference in each outcome was calculated and used to indicate change. Field test predictive ability was evaluated using multiple regression and accounted for age (yrs), sex (female = 0, male = 1), height (cm), body mass, and pubertal stage using the Pubertal Development Scale (PDS). RESULTS: A mean change of 2198.82 g of lean mass (range = -1193.60, 7307.70; SD = 1816.67) was shown using DEXA. The SLJ and PU had a mean change of 5.11 cm (range = -36.00, 35.70; SD = 16.40) and 0 repetitions (range = -13, 11; SD = 5.30) respectively. Both ΔSLJ (r = .340, p = .011) and ΔPU (r = .315, p = .018) had significant moderate relationships to ΔLM. The inclusion of ΔSLJ and ΔPU in the model accounted for an additional 8.8% of the variability (R2= .551 from .463) and 4.2% (R2= .593) respectively. The overall model explained 59.3% of the variability in lean mass change and resulted in the following predictive equation: ΔLM = 1237.59 + (-630.44 x age) + (-169.34 x PDS) + (847.31 x gender) + (33.89 x height) + (199.04 x BMI) + (29.07 x ΔSLJ) + (73.13 x ΔPU) CONCLUSIONS: Along with anthropometric developmental factors, the SLJ and PU tests can be used to estimate changes in lean muscle mass. However, these factors only account for approximately 60% of the change in lean muscle mass leaving the remaining 40% attributable to other (neural, mechanical, motivational) factors. Nevertheless, this prediction equation can assist in monitoring changes in lean muscle mass during adolescence.