Body Trunk Research Articles

Smart Shirt for Measuring Trunk Orientation

Improper cycling posture is linked to a variety of spinal musculoskeletal diseases, including structural malformation of the spine and back discomfort. This paper presents a novel smart shirt integrated tri-axial gyroscope and accelerometer that can detect postural variation in terms of spinal curvature changes. To provide accurate feedback to the wearer and improve the wearer's correct movement, the garment is able to recognize trunk body posture. The gyroscope/accelerometer was placed around the upper and mid trunk of the user to record tri-axial angular velocity data. The device can also be used to help determine the trunk bending angle and monitor body postures in order to improve optimal orientation and position. The garment enables continuous measurement in the field at high sample rates (50 Hz), and the sensor has a large measurement range (16 g, 2000°/s). As electronic components are non-washable, instead of encapsulating them, a detachable module was created. In this, magnets are embedded in the jersey, and allow the positioning and removal of the sensor. The test results show that the average trunk-bending angle was 21.5°, and 99 percent of the observed angle fell within the standard (ranging from 8° to 35°). The findings demonstrate the feasibility of employing the smart shirt sensor to estimate trunk motions in the field on a regular basis.

Automated volume measurement of abdominal adipose tissue from entire abdominal cavity in Dixon MR images using deep learning.

The purpose of this study was to realize an automated volume measurement of abdominal adipose tissue from the entire abdominal cavity in Dixon magnetic resonance (MR) images using deep learning. Our algorithm involves a combination of extraction of the abdominal cavity and body trunk regions using deep learning and extraction of a fat region based on automatic thresholding. To evaluate the proposed method, we calculated the Dice coefficient (DC) between the extracted regions using deep learning and labeled images. We also compared the visceral adipose tissue (VAT) and subcutaneous adipose tissue volumes calculated by employing the proposed method with those calculated from computed tomography (CT) images scanned on the same day using the automatic calculation method previously developed by our group. We implemented our method as a plug-in in a web-based medical image processing platform. The DCs of the abdominal cavity and body trunk regions were 0.952 ± 0.014 and 0.995 ± 0.002, respectively. The VAT volume measured from MR images using the proposed method was almost equivalent to that measured from CT images. The time required for our plug-in to process the test set was 118.9 ± 28.0s. Using our proposed method, the VAT volume measured from MR images can be an alternative to that measured from CT images.

Reliability and Validity of a Novel Reactive Agility Test with Soccer Goalkeeper-Specific Movements.

The purpose of this study was to develop a reactive agility test with soccer goalkeeper (GK)-specific movements (G-RAT) and to examine the reliability and validity of college-aged GKs. We designed a five-branch star-shaped course with diving and ball-catching movements under reactive conditions. In the setup, a start−goal line was set on the top of a branch and 3.5 m away from the center of the star-shaped setting. Content validity was assessed by six experts, and the item-content validity index (I-CVI) was calculated. Thirty-three male GKs performed the test trial twice. One test trial of G-RAT consists of three shuttles from the start−goal line to diving and ball-catching. For the reactive condition, GKs were instructed on which ball directions should dive when their body trunk reached 1.5 m away from the start−goal line. GKs were classified into regular (R) or non-regular (NR) groups. The intraclass correlation coefficient (ICC) and the receiver operating characteristic (ROC) curve analyses were used to assess the reliability and predictive power as convergent validity. The I-CVI was 0.83, which was greater than the acceptable level of 0.78. The ICC value was 0.94 (p < 0.01; 95% confidence interval (95%CI), 0.88−0.97). The GKs completed the test 14.3 ± 0.7 and 15.3 ± 1.0 s in the R and NR group (p < 0.01; Cohen’s d = 0.89), respectively. The area under the curves of G-RAT was 0.80 (95%CI, 0.64−0.96). These results show that a GK-specific agility test under reactive conditions would have sufficient reliability and both content and convergent validity in college-aged GKs.

Association of daily sitting time and leisure-time physical activity with body fat among U.S. adults

BackgroundProlonged sitting and reduced physical activity lead to low energy expenditures. However, little is known about the joint impact of daily sitting time and physical activity on body fat distribution. We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults. MethodsThis was a cross-sectional analysis of U.S. nationally representative data from the National Health and Nutrition Examination Survey 2011–2018 among adults aged 20 years or older. Daily sitting time and leisure-time physical activity (LTPA) were self-reported using the Global Physical Activity Questionnaire. Body fat (total and trunk fat percentage) was determined via dual X-ray absorptiometry. ResultsAmong 10,808 adults, about 54.6% spent 6 h/day or more sitting; more than one-half reported no LTPA (inactive) or less than 150 min/week LTPA (insufficiently active) with only 43.3% reported 150 min/week or more LTPA (active) in the past week. After fully adjusting for sociodemographic data, lifestyle behaviors, and chronic conditions, prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes. When stratifying by LTPA, the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insufficiently active. In the joint analyses, inactive/insufficiently active adults who reported sitting more than 8 h/day had the highest total (female: 3.99% (95% confidence interval (95%CI): 3.09%–4.88%); male: 3.79% (95%CI: 2.75%–4.82%)) and trunk body fat percentages (female: 4.21% (95%CI: 3.09%–5.32%); male: 4.07% (95%CI: 2.95%–5.19%)) when compared with those who were active and sitting less than 4 h/day. ConclusionProlonged daily sitting time was associated with increased body fat among U.S. adults. The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Effect of trunk exercise upon lumbar IVD height and vertebral compliance when performed supine with 1 g at the CoM compared to upright in 1 g

BackgroundSpinal unloading in microgravity is associated with stature increments, back pain, intervertebral disc (IVD) swelling and impaired spinal kinematics. The aim of this study was to determine the effect of lateral stabilization, trunk rotation and isometric abdominal exercise upon lumbar IVD height, and both passive and active vertebral compliance when performed supine on a short-arm human centrifuge (SAHC)—a candidate microgravity countermeasure—with 1 g at the CoM, compared to that generated with equivalent upright exercise in 1 g.Methods12 (8 male) healthy subjects (33.8 ± 7 years, 178.4 ± 8.2 cm, 72.1 ± 9.6 kg) gave written informed consent. Subjects performed three sets of upper body trunk exercises either when standing upright (UPRIGHT), or when being spun on the SAHC. Lumbar IVD height and vertebral compliance (active and passive) were evaluated prior to SAHC (PRE SAHC) and following the first SAHC (POST SPIN 1) and second Spin (POST SPIN 2), in addition to before (PRE UPRIGHT), and after upright trunk exercises (POST UPRIGHT).ResultsNo significant effect upon IVD height (L2–S1) when performed UPRIGHT or on the SAHC was observed. Trunk muscle exercise induced significant (p < 0.05) reduction of active thoracic vertebral compliance when performed on the SAHC, but not UPRIGHT. However, no effect was observed in the cervical, lumbar or across the entire vertebral column. On passive or active vertebral compliance.ConclusionThis study, the first of its kind demonstrates that trunk exercise were feasible and tolerable. Whilst trunk muscle exercise appears to have minor effect upon IVD height, it may be a candidate approach to mitigate—particularly active—vertebral stability on Earth, and in μg via concurrent SAHC. However, significant variability suggests larger studies including optimization of trunk exercise and SAHC prescription with MRI are warranted.Trial RegistrationNorth Rhine ethical committee (Number: 6000223393) and registered on 29/09/2020 in the German Clinical Trials Register (DRKS00021750).

Relationship of creatinine cystatin C ratio with muscle mass and grip strength in memory clinic outpatients.

The purpose of this study was to examine the relationship of the serum creatinine/cystatin C ratio (CCR) with hand grip strength (HGS), total body muscle mass, trunk muscle mass, and skeletal muscle mass index (SMI) in patients attending a memory clinic. This cross-sectional study enrolled outpatients of a memory clinic in Japan from October 2010 to July 2017. We enrolled 1945 participants aged 60years or older with measured skeletal muscle mass, HGS, and serum creatinine and serum cystatin C levels. Linear multiple regression analysis was performed for men and women using total body muscle mass, trunk muscle mass, and SMI as objective variables. The exposure variables were selected from previous reports if they were strongly linked to muscle mass. Total body muscle mass and trunk muscle mass were corrected by dividing by body weight. Multiple regression analysis was also conducted for men and women using HGS as an objective variable. Because cognitive function and HGS are strongly related, we also conducted sensitivity analysis by excluding participants with a Mini-Mental State Examination score<24 to alleviate any concern that we did not fully adjust for the effect of cognitive dysfunction. In men, CCR was significantly associated with total body muscle mass, trunk muscle mass, and SMI (P=0.013, P=0.008, and P<0.001, respectively). In women, CCR was significantly associated with total body muscle mass and trunk muscle mass (P=0.013 and P<0.001, respectively), but not with SMI (P=0.932). On the other hand, CCR was significantly associated with grip strength in both men and women (P<0.001 and P<0.001, respectively). CCR was associated with both muscle mass and muscle strength. This study suggests that CCR is a useful marker not only for muscle mass but also for muscle strength.

Ultrasonographic and strain elastographic features of epidermal cyst according to body location.

There are not many studies on the differences of ultrasound (US) findings between epidermal cysts (ECs) located in the trunk and those in the extremities. To compare the sonographic findings of ECs according to location in the body (trunk vs. extremity) and evaluated the feasibility of strain elastography (SE). This is a retrospective study of 76 patients with surgically confirmed non-ruptured EC who underwent US including SE. The US analyses included size, shape, ratio of depth to length (DLR), involvement of more than half the dermis, "submarine sign," and SE characters of each lesion. SE findings were assigned into four grades based on elasticity. The submarine sign was more significantly observed in ECs located in the trunk versus extremities (P value = 0.004 and 0.035, respectively). Truncal lesions were significantly more likely to possess an ovoid shape (P < 0.05) and exhibited higher DLR (P < 0.05). There were more cases with low elasticity according to SE (grade 3 or 4) compared to high elasticity (grade 1 or 2). However, we did not observe significant differences between the two locations (P > 0.05). More-than-half signs also did not exhibit a significant difference (P > 0.05). The submarine sign, ovoid shape, and tall lesions (higher DLR) are common in the trunk. However, the degree of elasticity and number of more-than-half signs did not differ between the two groups.

Design and evaluation of a double rope rehabilitation robot for sit-to-stand training

A double rope rehabilitation robot for sit-to-stand training is developed for human lower limb rehabilitations. Two kinds of training methods are used to ensure the safety control of rehabilitation activities. During the sit-to-stand training, the robot sensor system measures the ground reaction force, center of pressure, tension of ropes, motion track of body trunk, and the rotation angle of each body segment, and then the control system calculates the joint torques of hip, knee and ankle in real time. Six volunteers are involved in the experiment, and the results verify that the rehabilitation robot can ensure the completion of natural track in sit-to-stand training and improve the joint torque. In addition, the user’s motor intention can be identified by the control system, and the lower limb motor function can be trained effectively by encouraging users to exert strength by themselves. Therefore, the developed rehabilitation robot can be used to evaluate human body dynamics parameters and may improve rehabilitation activities in clinical environment.

MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis

BackgroundAlthough lumbar spinal stenosis (LSS) often coexists with other degenerative conditions, few studies have fully assessed possible contributing factors for low back pain (LBP) in patients with LSS. The purpose of this study was to identify factors associated with the severity of LBP in patients with LSS.MethodsThe patients with neurogenic claudication caused by LSS, which was confirmed by magnetic resonance imaging (MRI) were included in this cross-sectional study. Data included ratings of LBP, buttock and leg pain, and numbness on a numerical rating scale (NRS), 36-item Short-Form Survey (SF-36) scores, muscle mass measured by bioelectrical impedance analysis, and radiographic measurements including lumbopelvic alignment and slippage. The severity of LSS, endplate defects, Modic endplate changes, intervertebral disc degeneration, and facet joint osteoarthritis were evaluated on MRI. Spearman correlation and multivariate linear regression analyses were used to examine the factors associated with the severity of LBP (NRS score).ResultsA total of 293 patients (135 male and 158 female, average age 72.6 years) were analyzed. LBP was moderately correlated with buttock and leg pain, and buttock and leg numbness. Significant but weak correlations were observed between LBP and body mass index, appendicular and trunk muscle mass, all domains of SF-36, pelvic tilt, total number of endplate defects and Modic endplate changes, and summary score of disc degeneration grading, but not severity or number of spinal stenoses. In the multivariate regression analysis, age, female sex, trunk muscle mass, diabetes, NRS buttock and leg pain, NRS buttock and leg numbness, SF-36 vitality, pelvic tilt, and total number of endplate defects were associated with the severity of LBP.ConclusionsTrunk muscle mass, lumbopelvic alignment, and endplate defects, but not severity of stenosis are partly associated with severity of LBP, but buttock and leg pain and buttock and leg numbness have strongest relationships with LBP in patients with LSS.

Characteristics of Japanese Older Adults Whose Trunk Muscle Mass Decreased during the COVID-19 Pandemic.

The coronavirus (COVID-19) pandemic significantly affected the physical and mental functions in older adults, resulting in “corona-frailty”. This 2-year prospective study characterized changes in quantitative measures and corona-frailty among a cohort of community-dwelling older women. Changes were evaluated using face-to-face interactions with 39 Japanese women (mean age: 76.1 ± 5.9) in 2019 (pre-pandemic baseline) and 2021 (follow-up during the pandemic). Quantitative measurements of handgrip strength, walking speed, calf circumference, body composition, and background factors were evaluated. Body weight and trunk muscle mass significantly decreased at follow-up. Multiple regression analysis, using change in trunk muscle mass as the dependent variable and background factors as independent variables, identified that decrease in trunk muscle mass was associated with “being robust at baseline” and answering “Yes” to the question of “Do you go out less frequently compared with last year”? The 2-year trunk muscle mass change for each baseline frailty stage showed a significant decrease only in the robust group (−8.0%). The decrease in trunk muscle mass might be related to pandemic-induced lifestyle restraint, suggesting that robust older adults who are healthy and active should take measures that focus on trunk muscles to avoid “corona-frailty”.

Markerless Optical Motion Capture System for Asymmetrical Swimming Stroke

This work presents the development of a markerless optical motion capture system of the front-crawl swimming stroke. The system only uses one underwater camera to record swimming motion in the sagittal plane. The participant in this experiment was a swimmer who is active in the university’s swimming club. The recorded images were then segmented to obtain silhouettes of the participant by a Gaussian Mixture Model. One of the swimming images was employed to generate a human body model that consists of 15 segments. The silhouette and model of the participant were subjected to an image matching process. The shape of the body segment was used as the feature in the image matching. The model was transformed to estimate the pose of the participant. The intraclass correlation coefficient between the results of the developed system and references were evaluated. In general, all body segments, except head and trunk, had a correlation coefficient higher than 0.95. Then, dynamics analysis by SWUM was conducted based on the joint angle acquired by the present work. The simulation implied that the developed system was suitable for daily training of athletes and coaches due to its simplicity and accuracy.

Central Pattern Generators for Breathing and Gait and Possible Medical Application of Oriental BodyWork: Access to Extrapyramidal and Body Trunk Movement System Through Breathing Methods

The neurophysiological background of oriental bodywork based on breathing methods is poorly understood. Recently, experimental techniques using genetically engineered animals have been applied to identify and analyze the functions of motor columns such as medial motor column (MMC), known as evolutionarily old locomotion central pattern generators (CPGs) in lamprey. In oriental bodywork between two individuals, locomotion-related body reactions are often observed. In Nishino Breathing Methods (NBM), the extrapyramidal system is likely to be accessed through the practice of Sokushin-kokyu (whole body awareness with breathing), Karin (body axis rotation and reactivation with breathing), and Taiki (body trunk mutual signaling with breathing; the coordination of two individual body trunks). In addition, kinesiological discussions of ancient oriental traditions, such as the practice of mysterious hand-back contact and the active expiration that relates to music and body trunk reaction, are presented. Based on the hypothesis that oriental bodywork is accessing the extrapyramidal body trunk motor system (basal ganglia to spiral locomotion CPGs), this paper discusses the inter-individual body reactions coexisting through different evolutionary levels in multilayered motor systems, and their possible medical applications.

Effects of WB-EMS and protein supplementation on body composition, physical function, metabolism and inflammatory biomarkers in middle-aged and elderly patients with sarcopenic obesity: A meta-analysis of randomized controlled trials.

The patients with sarcopenic obesity (SO) have the characteristics of both sarcopenia and obesity, that is, less muscle mass and increased fat mass, and their morbidity, disability and mortality are higher than patients with sarcopenia or obesity alone. To investigate the effects of whole-body electromyostimulation (WB-EMS) training and protein supplementation intervention on body composition, physical function, metabolism and inflammatory biomarkers in middle-aged and elderly patients with SO. We searched for randomized controlled trials in seven databases, including PubMed, Web of Science, Embase, Cochrane Library, Scopus, SinoMed, and CNKI as of July 3, 2021. The methodological quality of each included study was assessed using the Physiotherapy Evidence Database (PEDro) scale. The Cochrane Risk of Bias Tool was used to assess the risk of bias. Statistical analysis was performed using Review Manager 5.3. Eleven randomized controlled studies with a total of 779 participants were included in this meta-analysis. WB-EMS training improved sarcopenia Z-score (MD=-1.52, 95% CI: -2.27, -0.77, P<0.0001) and waist circumference (WC) (MD=-1.41, 95% CI: -2.62, -0.20, P=0.02), and increased skeletal muscle mass index (SMI) (MD=1.27, 95% CI: 0.66,1.88, P<0.0001) and appendicular skeletal muscle mass (ASMM) (MD=0.68, 95% CI: 0.08, 1.27, P=0.03). Protein supplementation intervention reduced body fat rate (BF%) (MD=-1.28, 95% CI: -1.88, -0.68, P<0.0001, I2=0%), total body fat (TBF) (MD=-0.98, 95% CI: -1.65, -0.31, P=0.004, I2=0%) and trunk body fat mass (TBFM) (MD=-0.50, 95% CI: -0.94, -0.06, P=0.03, I2=0%), and increased grip strength (GS) (MD=1.13, 95% CI: 0.06, 2.21, P=0.04, I2=0%). The combination of WB-EMS and protein supplements is beneficial to most body components and physical functions, such as SMI (MD=1.21, 95% CI: 0.73, 1.51, P<0.00001, I2=0%), GS (MD=1.60, 95% CI: 0.80, 2.40, P<0.0001, I2=45%) and walking speed (WS) (MD=0.04, 95% CI: 0.02, 0.06, P<0.0001, I2=49%). Compared with protein supplementation alone, WB-EMS could have an additional beneficial effect on BF% (MD=-0.92, 95% CI: -1.80, -0.04, P=0.04) and WC (MD=-1.03, 95% CI: -1.70, -0.36, P=0.003). Nevertheless, the addition of protein supplements did not provide any additional benefit compared with WB-EMS alone. In addition, there was almost no positive effect of WB-EMS and protein supplements on metabolic and inflammatory biomarkers. As things stand, protein supplementation intervention can effectively reduce body fat percentage, fat mass, and increase grip strength in SO patients. Both WB-EMS and protein supplementation intervention had no significant effects on metabolic and inflammatory biomarkers. WB-EMS combined with protein supplementation intervention was beneficial for SO patients in many ways. Due to the small number of studies, further studies are needed to confirm the efficacy of WB-EMS alone or in combination with protein supplementation intervention in SO patients. INPLASY202190096 DOI:10.37766/inplasy2021.9.0096.

Unsupervised Domain Adaptation for Vertebrae Detection and Identification in 3D CT Volumes Using a Domain Sanity Loss.

A variety of medical computer vision applications analyze 2D slices of computed tomography (CT) scans, whereas axial slices from the body trunk region are usually identified based on their relative position to the spine. A limitation of such systems is that either the correct slices must be extracted manually or labels of the vertebrae are required for each CT scan to develop an automated extraction system. In this paper, we propose an unsupervised domain adaptation (UDA) approach for vertebrae detection and identification based on a novel Domain Sanity Loss (DSL) function. With UDA the model’s knowledge learned on a publicly available (source) data set can be transferred to the target domain without using target labels, where the target domain is defined by the specific setup (CT modality, study protocols, applied pre- and processing) at the point of use (e.g., a specific clinic with its specific CT study protocols). With our approach, a model is trained on the source and target data set in parallel. The model optimizes a supervised loss for labeled samples from the source domain and the DSL loss function based on domain-specific “sanity checks” for samples from the unlabeled target domain. Without using labels from the target domain, we are able to identify vertebra centroids with an accuracy of %. By adding only ten target labels during training the accuracy increases to %, which is on par with the current state-of-the-art for full supervised learning, while using about 20 times less labels. Thus, our model can be used to extract 2D slices from 3D CT scans on arbitrary data sets fully automatically without requiring an extensive labeling effort, contributing to the clinical adoption of medical imaging by hospitals.

The Effect of Obesity on the Waist Circumference Cut-Point Used for the Diagnosis of the Metabolic Syndrome in African Women: Results from the SWEET Study.

Waist circumference (WC) is one of the diagnostic criteria for metabolic syndrome (MetS). However, studies have shown that the waist cut-point may be influenced by BMI. The aim of this study was to, therefore, determine whether the presence of obesity influences the WC cut-point used to diagnose MetS in sub-Saharan African women. The second aim was to determine whether calculated cut-points of other waist-related and dual-energy X-ray absorptiometry (DXA)-determined anthropometric measures used for the diagnosis of MetS were also influenced by BMI. Biochemical, simple anthropometric and dual-energy X-ray absorptiometry-derived anthropometric data were collected in 702 black South African women from the Study of Women Entering and in Endocrine Transition (SWEET). A receiver operating characteristic curve analysis was used to determine waist, waist-to-hip (WHR) and waist-to-height ratios, body shape index (ABSI), total body fat, trunk fat, and peripheral (arm + leg) fat cut-points for MetS (without waist) in subjects with BMI above or below the median value. The estimated WC cut-points (107 cm, 93.5 cm) for women with high BMI and low BMI, respectively, and the cut-points for the other anthropometric variables for the diagnosis of MetS were greater in high BMI women compared to low BMI women. The exceptions were WHR and ABSI, for which the cut-points were very similar in both BMI groups, and peripheral fat, where the cut-point was lower in the high BMI group. Logistic regression analysis demonstrated that WC was associated with a higher risk (odds ratio [95% CIs]: 1.07 [1.04, 1.10]; p < 0.0001), whilst hip was associated with a lower risk (0.97 [0.94, 0.99]; p = 0.02) for MetS. These data suggest that with increasing BMI, the higher levels of protective gluteofemoral fat lead to the requirement for higher WC cut-points for MetS diagnosis. The opposing associations of waist and hip with MetS risk make WHR a more appropriate variable for diagnosing MetS among African women as the WHR cut-point is less influenced by increasing BMI than is WC, which was also observed for ABSI.

Structural equation modelling of mercury intra-skeletal variability on archaeological human remains

Archaeological burial environments are useful archives to investigate the long-term trends and the behaviour of mercury. In order to understand the relationship between mercury, skeletons and soil, we applied Partial Least Squares - Structural Equation Modelling (PLS-SEM) to a detailed, multisampling (n = 73 bone samples +37 soil samples) design of two archaeological graves dating to the 6th to 7th centuries CE (A Lanzada site, NW Spain). Mercury content was assessed using a DMA-80, and data about bone structure and the grave soil/sediments were obtained using FTIR-ATR spectroscopy. The theoretical model is supported by proxies of bone structure, grave soil/sediments, and location of the bone within the skeleton. The general model explained 61 % of mercury variance. Additionally, Partial Least Square – Prediction Oriented Segmentation (PLS-POS) was also used to check for segmentation in the dataset. POS revealed two group of samples depending on the bone phase (hydroxyapatite or collagen) controlling the Hg content, and the corresponding models explained 86 % and 76 % of Hg variance, respectively. The results suggest that mercury behaviour in the graves is complex, and that mercury concentrations were influenced by i) the ante-mortem status of the bone matrix, related to the weight of each bone phase; ii) post-mortem evolution of bone crystallinity, where bone loses mercury with increasing alteration; and iii) the proximity of the skeletal pieces to mercury target organs, as decomposition and collapse of the thoracic and abdominal soft tissues causes a secondary mercury enrichment in bones from the body trunk during early post-mortem. Skeletons provide a source of mercury to the soil whereas soil/sediments contribute little to skeletal mercury content.

Association between body mass index, trunk and total body fat percentage with urinary incontinence in adult US population.

To assess the association of body mass index (BMI), trunk and total body fat percentage with the prevalence and severity of urinary incontinence (UI) stratified by gender among a US adult population. A representative cross-sectional survey of participants aged ≥ 20 years was conducted using the data from the 2011-2018 National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to explore the association among the three obesity measures above with the prevalence and severity of UI. A total of 6964 individuals (4168 males and 2796 females) enrolled for the final analysis. Among males, the weighted prevalence of UI was 7.8%, with 1.3% stress urinary incontinence, 5.8% urge urinary incontinence and 0.7% mixed urinary incontinence. For females, the weighted prevalence of UI was 54.2%, with 31.9% stress urinary incontinence, 7.0% urge urinary incontinence and 15.6% mixed urinary incontinence. Multivariate logistic regression revealed increased BMI and trunk fat percentage significantly increased odds of UI (BMI: OR = 1.05 [per 1 kg/m2], 95% CI: 1.03-1.07, P < 0.001; trunk fat percentage: OR = 1.15 [per 5% increase in trunk fat percentage], 95% CI: 1.06-1.25, P = 0.002) in females. Similar trends were observed in the severity of UI (BMI: β = 0.07, 95% CI: 0.05-0.09, P < 0.001; trunk fat percentage: β = 0.18, 95% CI: 0.10-0.26, P < 0.001) by a multivariate linear regression. In males, no significant association was observed (BMI: OR = 0.99 [per 1 kg/m2], 95% CI: 0.97-1.02, P = 0.663; trunk fat percentage: OR = 0.95 [per 5% increase in trunk fat percentage], 95% CI: 0.84-1.08, P = 0.430; total fat percentage: OR = 0.94 [per 5% increase in total fat percentage], 95% CI: 0.80-1.10, P = 0.424). An increased BMI and trunk fat percentage are significantly associated with higher prevalence and severity of UI in females.

Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity

It is unclear how effective intermittent fasting is for losing weight and body fat, and the effects may depend on the timing of the eating window. This randomized trial compared time-restricted eating (TRE) with eating over a period of 12 or more hours while matching weight-loss counseling across groups. To determine whether practicing TRE by eating early in the day (eTRE) is more effective for weight loss, fat loss, and cardiometabolic health than eating over a period of 12 or more hours. The study was a 14-week, parallel-arm, randomized clinical trial conducted between August 2018 and April 2020. Participants were adults aged 25 to 75 years with obesity and who received weight-loss treatment through the Weight Loss Medicine Clinic at the University of Alabama at Birmingham Hospital. All participants received weight-loss treatment (energy restriction [ER]) and were randomized to eTRE plus ER (8-hour eating window from 7:00 to 15:00) or control eating (CON) plus ER (≥12-hour window). The co-primary outcomes were weight loss and fat loss. Secondary outcomes included blood pressure, heart rate, glucose levels, insulin levels, and plasma lipid levels. Ninety participants were enrolled (mean [SD] body mass index, 39.6 [6.7]; age, 43 [11] years; 72 [80%] female). The eTRE+ER group adhered 6.0 (0.8) days per week. The eTRE+ER intervention was more effective for losing weight (-2.3 kg; 95% CI, -3.7 to -0.9 kg; P = .002) but did not affect body fat (-1.4 kg; 95% CI, -2.9 to 0.2 kg; P = .09) or the ratio of fat loss to weight loss (-4.2%; 95% CI, -14.9 to 6.5%; P = .43). The effects of eTRE+ER were equivalent to reducing calorie intake by an additional 214 kcal/d. The eTRE+ER intervention also improved diastolic blood pressure (-4 mm Hg; 95% CI, -8 to 0 mm Hg; P = .04) and mood disturbances, including fatigue-inertia, vigor-activity, and depression-dejection. All other cardiometabolic risk factors, food intake, physical activity, and sleep outcomes were similar between groups. In a secondary analysis of 59 completers, eTRE+ER was also more effective for losing body fat and trunk fat than CON+ER. In this randomized clinical trial, eTRE was more effective for losing weight and improving diastolic blood pressure and mood than eating over a window of 12 or more hours at 14 weeks. ClinicalTrials.gov Identifier: NCT03459703.

Effects of Vibration Training on Weight Loss and Heart Rate Variability in the Obese Female College Students.

Objective The present study examined the effects of a 12-week whole-body vibration training (WBVT) regimen on heart rate variability (HRV) and body composition in the obese female college students. Methods Participants were assigned to either the WBVT (n = 17) or obese control group (n = 19). The students in the WBVT group conducted a 12-week (5 times per week and 30 min per time) exercise protocols (30 to 40 Hz of frequency and 4 mm of amplitude), and the obese control group did not perform regular physical training during 12 weeks of study. Then, body composition (body weight, BMI, body fat, body fat percentage; trunk fat mass, muscle mass, MM) and HRV (time domain and frequency domain index) were measured in all subjects before and after WBVT intervention. Results (1) After 12-week WBVT intervention, body fat mass, trunk fat mass, and body fat percentage significantly decreased and muscle mass increased in the WBVT group (P < 0.01, respectively); there was no significant change in body weight and BMI (P > 0.05, respectively). (2) After 12-week WBVT intervention, LFn, LF/HF, and HR significantly decreased (P < 0.05, P < 0.01), R-R interval and RMSSD significantly increased (P < 0.01, respectively), and there was no significant difference in HFn (P > 0.05). Nevertheless, there was no significant change before and after the test in body composition and HRV in the obese control group (P > 0.05, respectively). (3) After 12-week WBVT intervention, compared with the obese control group, body fat mass, body fat percentage, trunk fat mass, and LF/HF significantly decreased (P < 0.05, P < 0.01), muscle mass, and RMSSD increased (P < 0.05) in the WBVT group; but there were no significant difference in other indicators (P > 0.05) between the obese control group and WBVT group. (4) The reduction of body fat percentage before and after the WBVT intervention are positively correlated with the reduction in the LFn and LF/HF (r = 0.542, r = 0.504; P < 0.05, respectively) and negatively correlated with the increase in the RMSSD (r = −0.514, P < 0.05), and the reduction of trunk fat mass are positively correlated with the reduction in the LF/HF (r = 0.540, P < 0.05). Conclusion The results indicate that WBVT improves HRV and body composition in obese female college students, and the reduction in body fat percentage and trunk fat mass are associated with a shift in cardiac autonomic regulation towards vagal dominance and improve sympathetic-vagus balance after WBVT intervention. In conclusion, WBVT may be a feasible treatment to improve cardiac autonomic function and body composition.

Is the Side Bridge Test Valid and Reliable for Assessing Trunk Lateral Flexor Endurance in Recreational Female Athletes?

Simple SummaryAlthough the side bridge test has been widely used for assessing trunk lateral flexor endurance in sport, clinical, and scientific settings, to the best of the authors’ knowledge, no study has analyzed its validity and reliability in an only female population. The surface electromyography of eight abdominal, back, shoulder and hip muscles was measured during the test to analyze its validity. A one-week test-retest design was performed to evaluate its reliability. No significant differences were found between the trunk lateral flexors and the deltoids. The study data showed that the test performance could be significantly predicted by external oblique and deltoid normalized median frequency slopes and by body mass and trunk height. Based on the results of this study, the shoulder muscle activation and fatigue and the individuals’ anthropometric characteristics, especially the mass, played an important role in the side bridge test performance, which questions the validity of this multi-joint test to specifically assess trunk lateral flexor endurance. In addition, although the side bridge test showed a good data consistency, its intra-subject variability was high, which reduces its utility when small intra-subject changes in muscle endurance are important (e.g., elite sport).The side bridge test (SBT) is one of the most popular tests to assess isometric trunk lateral flexor endurance. The aim of this study was to assess the validity and reliability of the SBT in healthy females. Twenty-four (24.58 ± 3.92 years) physically active (1–2 h of moderate physical activity, 2–3 times a week) females voluntarily participated in this study. The surface electromyography (EMG) of eight abdominal, back, shoulder and hip muscles was measured during the SBT. Normalized median frequency slopes (NMFslope) were calculated to analyze the muscle fatigue. The EMG amplitudes were normalized to maximum EMG values to assess muscle activity intensity. A one-week test-retest design was performed to evaluate the SBT reliability through the ICC3,1 and typical error. Higher NMFslopes and normalized EMG amplitudes were found in deltoids, abdominal obliques, rectus abdominis, and erector spinae in comparison to latissimus dorsi, gluteus medius, and rectus femoris. However, no significant differences were found between the trunk lateral flexors and the deltoids. Linear regression analysis showed that SBT performance could be significantly predicted by external oblique and deltoid NMFslope (adjusted R2 = 0.673) and by body mass and trunk height (adjusted R2 = 0.223). Consistency analysis showed a high intraclass correlation coefficient (0.81) and a relatively high typical error (10.95 s). Despite the good relative reliability of the SBT, its absolute reliability was low and its validity questionable, as the shoulder muscle activation and fatigue and the individuals’ anthropometric characteristics played an important role in SBT performance.