Extremity Body Composition Research Articles

Effect of resistance exercise on stress, lower extremity edema, and body composition in intensive care unit nurses.

This study investigated the effects of resistance exercises using elastic bands on stress, lower extremity edema, and body composition in intensive care unit nurses. Twenty-three and 21 participants were classified into the experimental and control groups, respectively. Only the experimental group was subjected to a resistance exercise program using elastic bands for 8 weeks. Variables were measured before the experimental treatment and at the 4th and 8th weeks post-treatment. Stress was assessed using a numeric rating scale and stress index. Lower extremity edema was determined using a tape measure. Body composition around the calf and tibia muscle was measured using a body composition analyzer. The homogeneity of participants' general characteristics and the dependent variable was ensured. Following experimental treatment, subjective (F = 11.674, P < .001) and objective stresses (F = 6.965, P < .001) decreased. No difference was detected in calf and ankle circumference between the groups, while differences in muscle thickness (left, F = 31.708, P < .001; right, F = 18.630, P < .001) and fat thickness (left, F = 19.984, P < .001; right, F = 24.640, P < .001) were observed. Muscle thickness increased, and fat thickness decreased in the body composition around the lower extremities. Resistance exercises using the TheraBand can be an intervention to decrease stress and improve lower extremity body composition in intensive care unit nurses.

혈류제한 운동이 휠체어 컬링 선수의 신체조성 및 근력에 미치는 영향

The purpose of this study was to examine the effects of 4 weeks of delivery technique exercise with blood flower restriction(BFR) on upper extremity body composition and muscle strength and the effect of passive lower extremity muscle exercise with BFR band on lower extremity body composition of wheelchair curling players with spinal cord injury.BR Six wheelchair curling players were collected. Body composition and muscle strength extremities were measured pre and post exercise. BFR exercise program was progressed 3 times/week for 4 weeks. The data was analysed by Wilcoxon signed-rank test. Body composition was not significantly different on upper and lower extremities. In the muscle strength, total work(J) in 60 deg/sec on left elbow flexion were significantly decreased, but wrist flexion were significantly improved both left and right (p.05).BR In conclusion, the delivery technique exercise with BFR was found to help improve the forearm strength of wheelchair curlers. The delivery technique exercise with BFR is recommended as an auxiliary exercise to improve the performance of wheelchair curlers.

Assessment of kidney function: clinical indications for measured GFR.

In the vast majority of cases, glomerular filtration rate (GFR) is estimated using serum creatinine, which is highly influenced by age, sex, muscle mass, body composition, severe chronic illness and many other factors. This often leads to misclassification of patients or potentially puts patients at risk for inappropriate clinical decisions. Possible solutions are the use of cystatin C as an alternative endogenous marker or performing direct measurement of GFR using an exogenous marker such as iohexol. The purpose of this review is to highlight clinical scenarios and conditions such as extreme body composition, Black race, disagreement between creatinine- and cystatin C–based estimated GFR (eGFR), drug dosing, liver cirrhosis, advanced chronic kidney disease and the transition to kidney replacement therapy, non-kidney solid organ transplant recipients and living kidney donors where creatinine-based GFR estimation may be invalid. In contrast to the majority of literature on measured GFR (mGFR), this review does not include aspects of mGFR for research or public health settings but aims to reach practicing clinicians and raise their understanding of the substantial limitations of creatinine. While including cystatin C as a renal biomarker in GFR estimating equations has been shown to increase the accuracy of the GFR estimate, there are also limitations to eGFR based on cystatin C alone or the combination of creatinine and cystatin C in the clinical scenarios described above that can be overcome by measuring GFR with an exogenous marker. We acknowledge that mGFR is not readily available in many centres but hope that this review will highlight and promote the expansion of kidney function diagnostics using standardized mGFR procedures as an important milestone towards more accurate and personalized medicine.

Lean mass modulates glomerular filtration rate in males of normal and extreme body composition.

Understanding determinants of glomerular filtration rate (GFR) is important in aiding prediction and interpretation of kidney function. Body composition is known to affect GFR but is not included in current screening of kidney disease. We investigated the association between GFR and body composition in healthy young men with differing body mass but without known diabetes or kidney injury. Three groups were recruited: normal BMI (n = 22) with a body mass index (BMI) <25 kg/m(2) , muscular (n = 23) with BMI ≥30 kg/m(2) and bioelectrical impedance body fat ≤20% and obese (n = 22) with BMI ≥30 kg/m(2) and bioelectrical impedance body fat ≥30%. Dietary analyses, GFR clearance by (99m) Tc-DTPA, urine protein and body composition by dual-energy X-ray absorptiometry were measured in all participants. Linear and nonlinear associations of constituents of body composition with GFR were assessed. Muscular men had a higher GFR (mean 186.4 mL/min; 95% CI 171.7-201.1) than normal BMI and obese groups (P = 0.0007). Urine protein and albumin excretion were not elevated in any participants. On multiple regression analysis (r(2) = 0.60), the variables with strong associations with GFR were age (P = 0.0009) and lean mass (P = 0.0001). Fat mass, protein intake and smoking status were not associated. Skeletal muscle mass correlated significantly with GFR in all subgroups. Age and lean mass were strong determinants of GFR. Estimates of GFR should therefore be indexed to an estimate of lean mass.

P1-103 Bias of impedance equation for estimating extremes of body composition

IntroductionResistance and reactance are often used in body composition compartment regressions which require the assumptions that the body is a cylinder of constant transversal area and the hydration is constant....

Performance evaluation of a multiplex assay for future use in biomarker discovery efforts to predict body composition

Interest in biomarker patterns and disease has led to the development of immunoassays that evaluate multiple analytes in parallel while using little sample. However, there are no current standards for multiplex configuration, validation, and quality. Thus, validation by platform, population, and question of interest is recommended. We sought to determine the best blood fraction for multiplex evaluation of circulating biomarkers in post-menopausal women, and to explore body composition phenotype discrimination by biomarkers. Archived serum and plasma samples from a sample of healthy post-menopausal women with the highest (n=9) and lowest (n=11) percent lean mass, as determined by dual-energy X-ray absorptiometry, were used to measure 90 analytes using bead-based, suspension multiplex assays. Replicates of serum and plasma were analyzed in a random selection of four of these individuals. Ninety percent of the analytes were detectable for ≥ 50% of samples; when limited to these well detected analytes, mean replicate correlations for serum and plasma were 0.87 and 0.85, respectively. Serum had lower error rates discriminating phenotypes; seven serum vs. two plasma analytes discriminated extreme body phenotypes. Serum and plasma performed similarly for the majority of the analytes. Serum showed a slight advantage in predicting extreme body composition phenotypes in postmenopausal women using parallel evaluation of analytes.

Lower extremity muscle mass predicts functional performance in mobility-limited elders.

This study examined the influence of lower extremity body composition and muscle strength on the severity of mobility-disability in community-dwelling older adults. Fifty-seven older males and females (age 74.2 +/- 7 yrs; BMI 28.9 +/- 6 kg/m2) underwent an objective assessment of lower extremity functional performance, the Short Physical Performance Battery test (SPPB). Participants were subsequently classified as having moderate (SPPB score 7: n = 38) or severe mobility impairments (SPPB score <or= 7: n = 19). Body composition was assessed using dual-energy X-ray absorptiometry and provided measures of bone mineral density (BMD), total leg lean mass (TLM) and total body fat. Maximal hip extensor muscle strength was estimated using the bilateral leg press exercise. Multiple logistic regression analysis was utilized to identify the significant independent variables that predicted the level of mobility-disability. TLM was a strong independent predictor of the level of functional impairment, after accounting for chronic medical conditions, BMD, body fat, body weight and habitual physical activity. In a separate predictive model, reduced muscle strength was also a significant predictor of severe functional impairment. The severity of mobility-disability was not influenced by gender (p = 0.71). A strong association was elicited between TLM and muscle strength (r = 0.78, p < 0.01). These data suggest that lower extremity muscle mass is an important determinant of physical performance among functionally-limited elders. Such findings may have important implications for the design of suitable strategies to maintain independence in older adults with compromised physical functioning. Additional studies are warranted to assess the efficacy of lifestyle, exercise or therapeutic interventions for increasing lean body mass in this population.

GFR Estimation Using Cystatin C Is Not Independent of Body Composition

Cystatin C (CysC) is an endogenous marker of glomerular filtration rate (GFR) that is claimed to be unaffected by body composition. In this study, we tested this speculation. In 77 patients with chronic kidney disease (mean age, 65.1 +/- 11.9 [SD] years; mean indexed GFR, 45.7 +/- 28.6 mL/min/1.73 m(2) [0.76 +/- 0.48 mL/s]), we evaluated kidney function (GFR) by means of inulin clearance. CysC level was determined by using a particle-enhanced turbidimetric immunoassay. Total lean (LM) and fat masses were measured by means of dual-energy x-ray absorptiometry. Multiple regression was used to analyze relationships between absolute GFR, LM, fat mass, demographic and anthropometric variables (age, sex, height, and weight), and CysC levels. Then prediction equations were built that included only CysC level or CysC level and LM. Their performance to predict absolute GFR was evaluated in a subset of patients with extreme body composition (LM or fat mass > +/-1 SD of the entire sample). Only absolute GFR and LM significantly explained variance in CysC levels, and an equation including LM explained more variance in absolute GFR than an equation including CysC level alone. Consequently, the equation including LM performed better than the equation with only CysC level, especially in patients with extreme body composition, showing reduced bias and improved limits of agreement and accuracy (71.4% versus 51.4% of patients' predicted GFR did not deviate by >30% of GFR). LM is a previously unrecognized, but important, factor affecting CysC level, and GFR estimation improves when including LM. CysC level is not independent of body composition, as previously assumed, and hence accounting for body composition improves CysC-based GFR estimation.

Increasing muscle mass in spinal cord injured persons with a functional electrical stimulation exercise program

Objective: To determine the magnitude of changes in muscle mass and lower extremity body composition that could be induced with a regular regimen of functional electrical stimulation (FES)-induced lower-extremity cycling, as well as the distribution of changes in muscle mass among the thigh muscles in persons with spinal cord injury (SCI). Study Design: Thirteen men with neurologically complete motor sensory SCI underwent a 3-phase, FES-induced, ergometry exercise program: phase 1, quadriceps strengthening; phase 2, progressive sequential stimulation to achieve a rhythmic pedaling motion (surface electrodes placed over the quadriceps, hamstrings, and gluteal muscles); phase 3, FES-induced cycling for 30 minutes. Participants moved from one phase to the next when they met the objectives for the current phase. Measures: Computed tomography of legs to assess muscle cross-sectional area and proportion of muscle and adipose tissue. Scans were idone at baseline (before subjects started the program), at first follow-up, typically after 65.4 ± 5.6 (SD) weekly sessions, and at second follow-up, typically after 98.1 ± 9.1 sessions. Results: Increases in cross-sectional areas were found in the following muscles rectus femoris (31%, p < .001), sartorius (22%, p < .025), adductor magnus-hamstrings (26%, p < .001), vastus lateralis (39%, p = .001), vastus medialis-intermedius (31%, p = .025). cross-sectional area of adductor longus and gracilis muscles did not change. The ratio of muscle to adipose tissue increased significantly in thighs and calves. There was no correlation among the total number of exercise sessions and the magnitude of muscle hypertrophy. Conclusions: Muscle cross-sectional area and the muscle to adipose tissue ratio of the lower extremities increased during a regular regimen of 2.3 FES-induced lower extremity cycling sessions weekly. The distribution of changes was related to the proximity of muscles to the stimulating electrodes.