Thigh Volume Research Articles

One-Year Longitudinal Assessment of Patients With CMT1A Using Quantitative MRI.

Intramuscular fat fraction (FF) assessed using quantitative MRI (qMRI) has emerged as one of the few responsive outcome measures in CMT1A suitable for future clinical trials. This study aimed to identify the relevance of multiple qMRI biomarkers for tracking longitudinal changes in CMT1A and to assess correlations between MRI metrics and clinical parameters. qMRI was performed in CMT1A patients at 2 time points, a year apart, and various metrics were extracted from 3-dimensional volumes of interest at thigh and leg levels. A semiautomated segmentation technique was used, enabling the analysis of central slices and a larger 3D muscle volume. Metrics included proton density (PD), magnetization transfer ratio (MTR), and intramuscular FF. The sciatic and tibial nerves were also assessed. Disease severity was gauged using Charcot Marie Tooth Neurologic Score (CMTNSv2), Charcot Marie Tooth Examination Score, Overall Neuropathy Limitation Scale scores, and Medical Research Council (MRC) muscle strength. Twenty-four patients were included. FF significantly rose in the 3D volume at both thigh (+1.04% ± 2.19%, p = 0.041) and leg (+1.36% ± 1.87%, p = 0.045) levels. The 3D analyses unveiled a length-dependent gradient in FF, ranging from 22.61% ± 10.17% to 26.17% ± 10.79% at the leg level. There was noticeable variance in longitudinal changes between muscles: +3.17% ± 6.86% (p = 0.028) in the tibialis anterior compared with 0.37% ± 4.97% (p = 0.893) in the gastrocnemius medialis. MTR across the entire thigh volume showed a significant decline between the 2 time points -2.75 ± 6.58 (p = 0.049), whereas no significant differences were noted for the 3D muscle volume and PD. No longitudinal changes were observed in any nerve metric. Potent correlations were identified between FF and primary clinical measures: CMTNSv2 (ρ = 0.656; p = 0.001) and MRC in the lower limbs (ρ = -0.877; p < 0.001). Our results further support that qMRI is a promising tool for following up longitudinal changes in CMT1A patients, FF being the paramount MRI metric for both thigh and leg regions. It is crucial to scrutinize the postimaging data extraction methods considering that annual changes are minimal (around +1.5%). Given the varied FF distribution, the existence of a length-dependent gradient, and the differential fatty involution across muscles, 3D volume analysis appeared more suitable than single slice analysis.

Prediction of Expected Fetal Weight From Fetal Limb Soft Tissue Measurements [ID 2683393

INTRODUCTION: This study was to investigate a combination of new formulas that predict birth weight in full-term pregnancy by measuring the thickness of the humerus soft tissue and femur soft tissue in fetuses using three-dimensional (3D) ultrasound. METHODS: There were a total of 110 mothers and newborns who were hospitalized with selective cesarean section, induced delivery, or natural delivery between April 2019 and August 2021. We retrospectively investigated fetal biometric parameters (BPD, HC, AC, FL, partial arm volume [Avol], and partial thigh volume [Tvol]), as measured by 4D View 9.0 and GE Healthcare Ultrasound while the mother was admitted to the delivery ward before delivery. The study was approved by the ethics board of the National Medical Center (NMC-2022-03-026). RESULTS: Among the several combinations that showed the expected weight, the weight predicted by AC/BPD/Tvol gave the strongest correlation (0.780) with the actual weight of the newborn, with an error rate of 6.4%. In boys, among the several combinations indicating the predicted body weight, AC/Avol/BPD had the highest correlation coefficient with the actual body weight (0.791), with an error rate of 5.0%. In girls, among several combinations, AC/Tvol/BPD had the highest correlation coefficient with actual body weight (0.878), with an error rate of 5.3%. CONCLUSION: The fetal weight predicted using Tvol and Avol measured using 3D ultrasound as parameters had a lower error rate for birth weight than the predicted weight measured by conventional 2D ultrasound. The parameters highly correlated with birth weight; however, differences were seen between the sexes.

Optical Three-Dimensional Imaging for Objective Evaluation of the Donor Site after Anterolateral Thigh Flap Surgery.

Background: The high volume of the fasciomyocutaneous anterolateral thigh flaps (ALT) is suitable for the reconstruction of pronounced soft tissue defects. At the same time, harvesting ALT results in a drastic change in thigh shape. Here, we present an optical three-dimensional imaging method for thigh comparison, which can be an objective and reproducible method for evaluating donor sites after ALT harvesting. Methods: In total, 128 thighs were scanned with an optical three-dimensional scanner, Vectra XT ®. Sixty-eight non-operated right and left thighs were compared and served as a control. Sixty thighs were scanned in the ALT group. The average surface area deviations, thigh volume, thigh circumference, and flap ratio to thigh circumference were calculated. The results were correlated with Δthigh circumference and Δvolume of the unoperated thighs of the control group. Results: No significant difference between the thigh volumes of the right and left thighs was found in the control group. Removal of an ALT flap showed a significant (p < 0.007) volume reduction compared to unoperated thighs (2.7 ± 0.8 L and 3.3 ± 0.9 L, respectively). Flap area correlated strongly with the Δthigh circumference (r = 0.66, p < 0.001) and Δvolume (r = 0.68, p < 0.001). Strong correlations were observed between flap ratio and thigh circumference with Δhigh circumference (r = 0.57, p < 0.001) and Δvolume (r = 0.46, p < 0.05). Conclusions: Optical three-dimensional imaging provides an objective and reproducible tool for detecting changes in thigh morphology volume differences after ALT harvesting.

Association of maternal obesity with growth of fetal fractional limb volume

BackgroundMaternal obesity influences birth weight and newborn adiposity. Fetal fractional limb volume has recently been introduced as a useful parameter for the proxy of fetal adiposity. However, the association between maternal adiposity and the growth of fetal fractional limb volume has not been examined. AimsTo investigate the association of maternal pre-pregnancy BMI with the growth of fetal fractional limb volume. Study designProspective cohort study. SubjectsWomen with singleton uncomplicated pregnancies enrolled between July 2017 and June 2020. Outcome measuresFetal fractional limb volume was assessed between 20 and 40 weeks' gestation, measured as cylindrical limb volume based on 50 % of the total diaphysis length. The measured fractional limb volume at each gestational week were converted to z-scores based on a previous report. The association between pre-pregnancy BMI and fetal fractional limb volume was examined. Maternal age, parity, gestational weight gain and fetal sex were considered as potential confounding variables. ResultsUltrasound scans of 455 fractional arm volume and thigh volume were obtained. Fractional limb volume increased linearly until the second trimester of gestation, then increased exponentially in the third trimester. Maternal pre-pregnancy BMI was significantly correlated with z-scores of fractional arm volume and thigh volume across gestation. The post-hoc analysis showed the association between pre-pregnancy BMI and fractional arm volume was significant especially between 34 and 40 weeks. ConclusionsMaternal obesity influences the growth pattern of fetal fractional limb volume. Fractional arm volume may potentially provide a useful surrogate marker of fetal nutritional status in late gestation.

Correlation between low skeletal muscle index and 3D anthropometric data measured by 3D body scanner: screening sarcopenia.

The screening tools for sarcopenia are measuring calf circumference, SARC-F or SPPB. However, not all of these tools have high sensitivity, specificity, and low margins of error. This research investigates potential of 3D anthropometry of the lower extremities on screening of sarcopenia. From October 2022 to February 2023, we retrospectively analyzed results of 3D body scanner and bio-impedance analysis for patients aged 45 to 85 at risk of sarcopenia. The 3D scanner measured the surface and volume values of both thighs and calves. When skeletal muscle index (SMI) is less than 5.7, patients were classified to Low SMI group, indicative of sarcopenia. A total six out of 62 patients were classified to Low SMI group, showing significantly lower values of right, left, mean calf volumes and mean calf surface than the other patients (right calf volume 2.62 L vs. 3.34 L, p = 0.033; left calf volume 2.62 L vs. 3.25 L, p = 0.044; mean calf volume 2.62 L vs. 3.29 L, p = 0.029; mean calf surface 0.12 m2 vs. 0.13 m2, p = 0.049). There was no statistical difference in thigh volume and surface. Through AUC-ROC analysis, mean calf volume was the most significant cut-off value (right calf volume 2.80 L, AUC = 0.768; left calf volume 2.75 L, AUC = 0.753; mean calf volume 3.06 L, AUC = 0.774; mean calf surface 0.12 m2, AUC = 0.747). The calf volume and surface values have significant relationship with low SMI, and the mean calf volume was the most significant cut-off screening value for Low SMI. The 3D scanner demonstrated its value as a new means for screening sarcopenia.

Navigating the nexus among thigh volume, myokine, and immunocytes in older adults with sarcopenia: A retrospective analysis in a male cohort

BackgroundThis study investigated the association among thigh volume features, interleukin (IL)-6, and immunocytes in the context of the older people with sarcopenia. Materials and methodsThis study comprised a cohort of 437 older males diagnosed with sarcopenia, and their average age of 70.41 ± 4.86 years. This study involved conducting correlation and multiple linear regression analyses to investigate the connections between thigh volume, IL-6, and immunocytes. ResultsTotal thigh volume (TTV) showed positive connections with thigh muscle volume (TMV), natural killer (NK) cells, and CD8 + T cells. TMV had negative associations with thigh fat volume (TFV) and IL6 but displayed positive connections with other factors. IL-6 had adverse associations with all the other variables except for TFV. NK cells showed significant positive relations with all adaptive immune cells, though showing not TFV and IL-6. The CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD19+ B cells exhibited positive correlations with each other including NK cells, though showing not TFV and IL-6. In the regression analysis, TMV exhibited significant positive effects on NK cells (β = 0.304), CD3+ T cells (β = 0.182), CD4+ T cells (β = 0.109), CD8+ T cells (β = 0.226), and CD19+ B cells (β = 0.197). On the other hand, IL-6 had significant negative effects on NK cells (β = -0.292), CD3+ T cells (β = -0.352), CD4+ T cells (β = -0.184), CD8+ T cells (β = -0.387), and CD19+ B cells (β = -0.366). ConclusionsThis study found that there existed a direct association among thigh muscle with sarcopenia, myokine, and immunocytes. Simple summaryThe aging process involves the immune system playing a vital role in sarcopenia development, and it is thought that myokines released by skeletal myocytes. However, the exact relationship between TMV, myokines, and immunocytes in older male adults affected by sarcopenia remains unclear. This study found that myokines observed in sarcopenia showed a negative correlation with immunocytes, while muscle mass had a positive correlation with immunocytes. In the meantime, this research delved into the use of a regression model to examine how TMV and myokines individually contribute to explaining the presence of innate and adaptive immunocytes in older individuals with sarcopenia.

Effectiveness of manual lymphatic drainage and intermittent pneumatic compression in lymphedema maintenance therapy.

Background: To compare the effectiveness of intermittent pneumatic compression (IPC) and/or manual lymphatic drainage (MLD) associated to compression stockings in the maintenance treatment of lymphedema. Patients and methods: Patients in the maintenance phase of lymphedema therapy with MLD and compression since more than a year with stable values for weight and circumferences of ankle and calf were asked to participate in a study: Compression had to be worn daily, (1) 4 weeks IPC+MLD, (2) 4 weeks MLD alone, (3) 4 Weeks IPC alone (Order 1 and 3 was randomized). At the beginning and after each 4 weeks, circumference measurements (by hand and by machine: BT600®, Bauerfeind) were documented, pain and discomfort were assessed, and quality-of-life questionnaires were completed. Results: Of 20 participants, 18 (14 female, 4 male), mean age 59.6 years (48-89) could be evaluated. 11 subjects had bilateral, 7 unilateral, 5 primary, 13 secondary lymphedema since 2-20 years (mean 7.7), the subjects had received MLD and compression for 2-14 years (mean 6.4), 1-3 times per week (mean 1.5). The BMI ranged between 21 and 47 (mean 33.7). No differences between any phases were found for: Calf and thigh volume, circumference of calf. Only the ankle circumference was significant less (-0.22cm) when using "both" (IPC+MLD). Compared to before the study, quality of life was better in all three phases, but with a significantly higher improvement in the phases with IPC than in the phases without. Conclusions: There were no differences in objective measurement between MLD alone, IPC alone or both, excepting the minimal significant difference in ankle circumference after IPC+MLD. QOL favored IPC application. Considering the economic consequences of these results, a change of maintenance therapy with MLD weekly over years in favor of permanent care with IPC and few appointments of MLD per year should be considered and further investigated.

Fish oil supplementation fails to modulate indices of muscle damage and muscle repair during acute recovery from eccentric exercise in trained young males

ABSTRACT We aimed to investigate the influence of 4-wk of fish oil (FO) supplementation on markers of muscle damage, inflammation, muscle soreness, and muscle function during acute recovery from eccentric exercise in moderately trained males. Sixteen moderately-trained males ingested 5 g/d of FO (n = 8) or soybean oil (placebo) capsules (n = 8) for 4-wk prior to- and 3-d following an acute eccentric exercise bout. Eccentric exercise consisted of 12 sets of isokinetic knee extension and knee flexion. Indices of muscle damage, soreness, function and inflammation were measured at baseline and during exercise recovery. Eccentric exercise elicited an increase in muscle soreness (p < 0.010) and thigh volume (p < 0.001), and reduced peak isometric torque by 31.7 ± 6.9%, (p < 0.05, 95% CI 10.6–52.8) during 3-d of recovery. Blood omega-3 polyunsaturated fatty acid concentration was 14.9 ± 2.4% higher in FO than PLA (p < 0.01, 95% CI 9.8–20.1). However, FO did not ameliorate the cumulative creatine kinase response (expressed as AUC; p = 0.368), inflammation (p = 0.400), muscle soreness (p > 0.140), or muscle function (p > 0.249) following eccentric exercise. FO supplementation confers no clear benefit in terms of ameliorating the degree of muscle damage, or facilitating the muscle repair process, during acute eccentric exercise recovery. These data suggest that FO supplementation does not provide an effective nutritional strategy to promote exercise recovery, at least in moderately-trained young men. Abbreviations: ANOVA: Analysis of variance; AUC: Area under curve; CI: Confidence interval; CK: Creatine kinase; CMJ: Countermovement jump; COX: Cyclooxygenase; CRP: C-reactive protein; DHA: Docosahexaenoic acid; DOMS: Delayed-onset muscle soreness; EIMD: Exercise-induced muscle damage; En%: Energy percent; EPA: Eicosapentaenoic acid; FO: Fish oil; IL-6: Interleukin-6; LDH: Lactate dehydrogenase; LOX: Lipoxygenase; Mb: Myoglobin; mTOR: Mechanistic target of rapamycin; PLA: Placebo; ROM: Range of motion; ROS: Reactive oxygen species; SD: Standard deviation; SEM: Standard error of the mean; TNF-α: Tumour necrosis factor alpha; VAS: Visual analogue scale; Ω3-PUFA: Omega-3 polyunsaturated fatty acids; Ω6-PUFA: Omega-6 polyunsaturated fatty acids Highlights The anti-inflammatory properties of omega-3 polyunsaturated fatty acids, alongside their propensity to incorporate into the muscle phospholipid membrane underpins the idea that fish oil supplementation may attenuate muscle damage and promote muscle repair following eccentric-based exercise. Four weeks of high-dose (5 g/d) fish oil supplementation prior to eccentric exercise failed to attenuate the rise in creatine kinase concentration and muscle soreness during acute exercise recovery in physically-active young men. Future studies are warranted to investigate the efficacy of combining omega-3 polyunsaturated fatty acids with other nutrients (i.e. protein/amino acids) for the promotion of muscle recovery following eccentric-based damaging exercise.

Intensity-effects of strengthening exercise on thigh muscle volume, pro- or anti-inflammatory cytokines, and immunocytes in the older adults: A randomized controlled trial

BackgroundThis study investigated the intensity-effects of strength training on thigh muscle mass, cytokines, and immunocytes in the older adults. Materials and MethodsA total of 81 participated in this study. Participants were assigned randomly to four groups: control group (CON), low- (LSE), moderate- (MSE), and high-intensity strength exercise (HSE) groups. Three exercise groups worked out for 50 min/day, 3 days/week for 12 weeks. ResultsIn the thigh volume analyzed by computed tomography, the exercise groups showed a significant increase in the muscle mass, with a clear pattern of change observed in the groups who exercised with moderate to high intensity. The lowest levels of interleukin (IL)-6 in the MSE group (-20.94%) and tumor necrosis factor-α in the HSE group (-28.75%) were observed. Notably, IL-10 showed a significant increase (35.72%) only in the MSE group. In the CON group, natural killer (NK) cells showed a decrease, while in the exercise groups, their levels increased. The highest levels of NK cells were observed in the HSE group. Similar patterns of change were observed in CD4 T cells and CD19 B cells. CD3 and CD8 T cells exhibited significant increases in the MSE and HSE groups. Conclusions: This study presents evidence that engaging in moderate to high-intensity exercise may have a positive impact on cytokines and immunocytes by increasing muscle mass in older adults who may have sarcopenia. Simple SummaryEngaging in strength training exercises is considered crucial for maintaining the health of older individuals who are susceptible to sarcopenia. When resistance exercises are performed at a moderate to strenuous intensity, it is anticipated that positive changes can occur in cytokines and immunocytes. These changes can be observed through improvements in thigh muscle volumes as measured by computed tomography.

Effects of n-3 polyunsaturated fatty acid supplementation on quadriceps weakness immediately after total knee arthroplasty: a pilot, randomized, open-label clinical trial.

[Purpose] Severe quadriceps weakness immediately after total knee arthroplasty can be problematic. The n-3 long-chain polyunsaturated fatty acids have antioxidant and anti-inflammatory effects against ischemia-reperfusion injury, whereas n-6 long-chain polyunsaturated fatty acids exert pro-inflammatory effects, thereby promoting ischemia-reperfusion injury. [Participants and Methods] We explored the efficacy of preoperative n-3 long-chain polyunsaturated fatty acid supplementation against early quadriceps weakness among 20 patients scheduled for total knee arthroplasty (intervention group, n=10; control group, n=10). The intervention group received 645 mg of eicosapentaenoic acid) and 215 mg of docosahexaenoic acid daily for 30 days preoperatively. Serum eicosapentaenoic acid, docosahexaenoic acid, and arachidonic acid levels were measured preoperatively. We compared serum derivatives of reactive oxygen metabolites as oxidative stress biomarkers, knee circumference, thigh volume, knee pain during the quadriceps strength test, and quadriceps strength preoperatively and 4 days postoperatively to quantify the change. [Results] Preoperative n-3 long-chain polyunsaturated fatty acid supplementation significantly increased the (eicosapentaenoic acid+docosahexaenoic acid)/arachidonic acid ratio in the intervention group. A significantly lower increase in quadriceps weakness was exhibited in the intervention group than in the control group. However, changes in oxidative stress, knee/thigh swelling, and knee pain during strength testing did not significantly differ between the two groups. [Conclusion] Preoperative n-3 long-chain polyunsaturated fatty acid supplementation exhibited beneficial effects on quadriceps weakness immediately after total knee arthroplasty.

Измерение массы плода с использованием автоматизированной трехмерной модели фракционного объема конечностей

Objective. To investigate the efficacy of using an automated three-dimensional (3D) fractional limb volume model to calculate estimated fetal weight (EFW) and predict fetal macrosomia. Patients and methods. This prospective observational study included 66 pregnant women who reached 30+0 to 41+3 weeks’ gestation. All patients underwent ultrasonography with fractional thigh volume (TVol) and fractional arm volume (AVol) measurements using 5D Limb Vol software (Samsung Medison W10 ultrasound system). Mean percentage error (MPE) was determined to assess the accuracy of fetal weight estimation. Results. Fractional thigh and arm volumes had a strong correlation with fetal weight (0.834 and 0.617, respectively) and increased linearly with gestational age. When performing a ROC analysis, TVol was found to be a predictor of fetal macrosomia with a sensitivity of 82.35% and specificity of 84.21%, and an experimental model including fetometric parameters (head circumference, abdominal circumference, and femur length) and TVol explained 83% of the variance in birth weight (p = 0.001). In our study, the formulas that included TVol and AVol to calculate EFW were less accurate than the Hadlock formula, with MPE of -1.25 ± 5.75, whereas when using the 3D model with TVol and AVol, MPE was 9.65 ± 7.84 and -9.16 ± 7.63, respectively. However, the experimental model with TVol produced more accurate EFW values compared to the Hadlock formula: the proportion of measurements with an estimated error ≤5% was 94.4% and 100% with an estimated error ≤10% (p &lt; 0.001). Conclusion. Fractional limb volume is an easily reproducible and promising parameter, and its use may be helpful to increase the accuracy of standard fetometry. Fractional thigh volume demonstrated high predictive ability for macrosomia, and its addition to standard fetometric parameters improved the model for fetal weight estimation. Key words: estimated fetal weight, fractional thigh and arm volumes, macrosomia, 5D Limb VolTM

Optimisation of intermittent pneumatic compression in patients with lymphoedema of the legs

Intermittent pneumatic compression (IPC) has established itself as a cornerstone in the combined decongestive therapy (CDT) of leg oedema, however, there is little evidence on the degree of volume shifts. We performed continuous volume measurements during CDT to quantify volume shifts in a controlled trial. In addition, "wrapping/underpadding" and medical compression stockings were evaluated regarding decongestion and leg oedema, respectively. The volume reduction of CDT in patients with lymphoedema of the legs was measured. The additive decongesting effect of a padding surrounding the leg under the lymph cuff (IPC +) was evaluated. The efficacy of compression stockings in the maintenance phase was analysed. Volume reductions were observed on the thigh (2%) and lower leg (5%) utilising IPC. Further significant volume reduction of the thigh (6%, p < 0.001) and lower leg (8%, p = 0.002) was observed with IPC +. Considering the thigh volume, patients with thigh-length compression stockings in the maintenance phase showed a significantly less pronounced increase in volume than patients with below-knee compression stockings (98% vs. 101% after six weeks; p < 0.05). The additional padding of the leg during an IPC session induces significantly more pronounced volume reduction. Medical compression stockings help to prevent volume increase in the maintenance phase.

The Significance of Three Dimensional Soft Tissue Markers in Estimating Fetal Weight Among Iraqi women; A Cross-Sectional Study

Background Estimating fetal weight (EFW) is essential for safeguarding laboring mothers and newborns. Higher birth weight is associated with poor delivery outcomes; earlier detection is crucial to improve the outcome. Current use of a two-dimensional ultrasonic shows limitations, especially among higher birth weight and those in the late third trimester. We aimed to examine whether the fractional thigh volume (FTV), a three-dimensional ultrasonic parameter, can predict fetal birth weight at 38-42 weeks. Methods A cross-sectional study recruited 80 pregnant women who fulfilled the criteria; at University Hospital from June 2018 for 14 months. Patients were referred cases for labor induction. Women were assessed by clinical and obstetrical examination. A three-dimensional ultrasound evaluated FTV at the labor ward; 24-48 hours before delivery. Maternal demographics, an indication of admission, and outcomes were recorded. After delivery, the infants' actual birth weight was recorded. Results The actual birth weight versus EFW by FTV was 3438.01 ±693.04 vs. 3548.47±706.71 grams. A third-degree polynomial equation highlighted the correlation between the EFW by FTV versus actual birth weight. ANOVA tested the equation accuracy, as F-ratio was 299.58, P value&lt; 0.0001. The concordance correlation coefficient was 0.95. Conclusion, the strong correlations of FTV in predicting fetal weight with a substantial concordance agreement, besides its simplicity and rapid examination time, especially when incorporated into commercial software, makes FTV a recommended marker for predicting EFW.

Assessment of lower limb trophism in fetuses with open spina bifida using fractional thigh volume of three-dimensional ultrasound.

To assess the trophism of the lower limbs of fetuses with open spina bifida using fractional thigh volume (TVOL) of three-dimensional (3D) ultrasound. A prospective cross-sectional study was carried out with normal fetuses and with open spina bifida (myelomeningocele and rachischisis) at 26 weeks' gestation. The TVOL (delimitation of five cross-sectional areas of the middle portion of the limb) was evaluated, as well as the subjective assessment of hypotrophy and lower limb movement. Thirty-one fetuses with open spina bifida, 21 with myelomeningocele and 10 with rachischisis, and 51 normal fetuses were included. There were no significant differences in the TVOL between normal and spina bifida fetuses (p=0.623), as well as between normal fetuses, with myelomeningocele and with rachischisis (p=0.148). There was no significant difference in the TVOL of fetuses with spina bifida with or without lower limb hypotrophy (p=0.148). Fetuses with spina bifida and with lower limb movement had higher TVOL values than fetuses without lower limb movement (p=0.002). There were no significant differences in the TVOL measurement of normal and spina bifida fetuses (rachischisis and myelomeningocele). Fetuses with spina bifida without spontaneous movement of the lower limbs had lower TVOL values.

Exercise Leg Blood Flow Is Preserved in Long-term Breast Cancer Survivors Previously Treated With Anthracycline Chemotherapy.

The objective of this investigation was to compare the acute hemodynamic responses during single-leg knee extension (SLKE) exercise between female breast cancer (BC) survivors previously treated with anthracycline chemotherapy and age- and sex-matched control (CON) subjects. Fourteen BC survivors (age: 61 ± 7 yr; time post-anthracycline therapy: 12 ± 6 yr) and nine CON subjects (age: 59 ± 7 yr) performed SLKE exercise at 25%, 50%, and 75% of peak power output during which heart rate, blood pressure (BP), leg blood flow (Doppler ultrasonography), and vascular conductance (leg blood flow/mean BP) were measured. Quadriceps mass was estimated from thigh volume and skinfold measures. Breast cancer survivors had lower quadriceps mass compared with CON subjects (1803 ± 607 vs 2601 ± 1102 g, P = .04). No difference was found between groups for maximal SLKE power output (28 ± 11 vs 34 ± 17 W, P = .35), heart rate (109 ± 14 vs 103 ± 13 bpm, P = .36), or mean arterial BP (122 ± 18 vs 119 ± 26 mm Hg, P = .33). Rest and submaximal exercise mean arterial BP, leg blood flow (indexed to quadriceps muscle mass), and leg vascular conductance were not significantly different between BC survivors and CON subjects. Leg blood flow during submaximal SLKE exercise is preserved in long-term BC survivors previously treated with anthracycline chemotherapy.

Three-versus Two-Dimensional Sonographic Biometry for Predicting Birth Weight at Term

Because aberrant intrauterine growth is related with increased newborn morbidity and death, an accurate estimate of foetal weight is a crucial issue in perinatal treatment. Fetal biometric measures were taken using a 2D ultrasound to determine the birth weight of the baby. The purpose of this study is to compare the reliability of the traditional two-dimensional Hadlock formula for predicting foetal weight to that of three-dimensional ultrasound measurements of foetal thigh volume. Methods: One hundred pregnant women who presented to the Obstetrics and Gynecology department at Benha University Hospital with a singleton live pregnancy between weeks 37 and 40 and no foetal abnormality were included in the research. Patients carrying more than one child, who were in active labour, or who were pregnant with a medical condition were not included in the research. Before anybody took part in the research, they signed informed consent forms. The ranges for anticipated weight using 2D and 3D sonography are (2540–4010) and (2670–3810), respectively. Variations in 3D sonographic thigh volume were seen between (59.62 to 92.52). Comparing the weight predicted by 2D sonography and 3D sonography yielded similar results (P=0.883). Two-dimensional sonography could not accurately predict birth weight (P = 0.582). The discrepancy between the 3D sonographer's estimate and the actual birth weight was not statistically significant (P = 0.403). Actual birth weight was positively correlated with 2D sonography prediction (P 0.001). The actual birth weight was also positively correlated with the anticipated birth weight using 3D sonography (P 0.001). Predicting an expected birth weight for a foetus is aided by measuring the fractional TVol, the authors conclude. Measurements of fractional limb volume may be used to assess foetal size and growth at various stages of pregnancy, and future quantitative investigations should provide light on this topic. Exploring the best birth weight algorithm that adds TVol into conventional birth weight formulas requires large prospective research. Before this indicator may be used in clinical practise, further prospective studies are needed to determine whether or not soft tissue alterations, as measured by TVol, are associated with foetal growth limitation or macrosomia.

Relationship between Intramuscular and Skin Temperature and Anthropometric Consideration for Post-exercise Cryotherapy: Developing Prediction Models for Clinical Use

OBJECTIVES To investigate the relationships among intramuscular cooling rates during (IM cooling rate) and after cold water immersion (CWI) (Post-IM cooling rate), skin tissue cooling rate during CWI (skin cooling rate), and anthropometric characteristics, and develop prediction models to assist clinical decision making.METHODS After a 30-min cycling trial, 16 young healthy adults received a CWI treatment (10 °C) until either intramuscular thigh temperature (2 cm sub-adipose) of the rectus femoris decreased 7 °C below preexercise level or 30 minutes was reached. Temperatures were recorded using skin and implantable finewire thermocouples. Before the cycling trial, %BF, anterior thigh adipose tissue thickness, muscle thickness, total thigh volume, and thigh circumference were measured. Pearson’s correlation coefficients were used to determine significant predictors of IM and Post-IM cooling rates (cooling rate: the amount of temperature reduction per minute). All predictors, including skin cooling rate, %BF, adipose tissue thickness, muscle thickness, total thigh volume, and thigh circumference, were included in multiple linear regression models to figure out factors that best predict the IM and Post-IM cooling rates.RESULTS Correlation analysis demonstrated significant correlations between IM cooling rate and skin cooling rate (r=.85), %BF (r=-.79), and adipose tissue thickness (r=-.79), and between Post-IM cooling rate and thigh circumference (r=-.68), adipose tissue thickness (r=-.58), total thigh volume (r=-.56), and %BF (r=-.53). Regression models identified skin cooling rate and %BF to have the greatest predictability for IM cooling rate (R2 =.82) and muscle thickness and thigh circumference to have the greatest predictability for the Post-IM cooling rate (R2 =.68).CONCLUSIONS This study provides justification for the use of skin cooling rates during CWI and %BF to estimate IM cooling rate and muscle thickness and thigh circumference to estimate Post-IM cooling rate. These findings will help practitioners to determine the duration of CWI treatment after exercise.

Examining Vascular Responses to Passive Movement in Premenopausal Females: Comparisons Across Sex and Menstrual Cycle Phase

PurposeVascular responses to passive movement represent a novel assessment of vascular function and serves as a critical component for adequate blood flow regulation during exercise. Although alterations to estradiol (E2) throughout the menstrual cycle, as well as sex differences, are known to impact vascular function, limited research exists in determining whether vascular responses to passive movement are altered in premenopausal females when compared across sex or menstrual cycle phase. We hypothesized that there would be no differences in leg blood flow responses to passive leg movement (PLM) in premenopausal females when compared to age‐matched males or when evaluated across follicular menstrual cycle phases, when E2 fluctuates the most.MethodsVascular responses to one‐minute of PLM were assessed in eleven premenopausal females (n = 21; 23 ± 4 yrs) and age‐matched males (n = 21; 24 ± 4 yrs). All the females completed the PLM assessment during the early (EF) and late follicular (LF) phase of their menstrual cycle, based on self‐reporting of menses. Lower limb microvascular function was assessed during PLM via changes in leg blood flow measured as peak change from baseline (LBFΔPEAK) and area‐under‐the‐curve (LBF AUC). Thigh volume, a known modulator of PLM responses, was also assessed in the passively moved limb in all participants via anthropometric measurements. Blood samples were obtained at rest from the antecubital vein of the arm to determine differences in E2 between the EF and LF phases of the menstrual cycle.ResultsThigh volume differed significantly between the females and age‐matched males (F: 4.9 ± 1.5 L; M: 8.2 ± 1.6 L; p &lt; 0.01) and, when examined in all participants, thigh volume was significantly correlated to PLM‐induced hyperemia evaluated as both LBFΔPEAK (r = 0.6; p &lt; 0.01) and LBF AUC (r = 0.4; p = 0.014). When the group differences in thigh volume were accounted for in the PLM analysis by employing thigh volume as a co‐variate, no significant differences in LBFΔPEAK (F: 542 ± 444; M: 794 ± 444 ml; p = 0.15) and LBF AUC (F: 164 ± 227; M: 249 ± 227 ml; p = 0.3) were revealed. The females reported no significant differences in PLM‐induced blood flow responses across menstrual cycle phases (EF vs LF) evaluated as LBFΔPEAK (EF: 385 ± 186; LF: 386 ± 154 ml; p = 0.9) or LBF AUC (EF: 123 ± 100; LF: 58 ± 84 ml; p = 0.11). Plasma E2 levels were significantly higher in females in the LF phase (215 ± 149 pg/ml) when compared to the EF phase (149 ± 98 pg/ml) of the menstrual cycle (p = 0.01).ConclusionThis study revealed no differences in PLM‐induced LBF responses in premenopausal females when compared to age‐matched males or when assessed across follicular menstrual cycle phases.

A Practical Application of Blood Flow Restriction Exercise

Exercise with blood flow restriction (BFR) is emerging as an effective training option to increase muscle size and strength, in healthy, clinical, and athletic populations. However, the need for specialized equipment and associated costs present a major barrier to its accessibility. The purpose of this study was to develop a practical method to implement BFR in the lower body using a thigh sphygmomanometer. Specifically, we aimed to 1) explore what factors should be accounted for when setting pressures with this type of restrictive cuff and 2) generate both a lab‐based and field‐based prediction equation to estimate arterial occlusion pressure (AOP). We hypothesized that measures of limb size and blood pressure would constitute significant predictors of lower body AOP. We also hypothesized that a multiple linear regression model including significant predictors would explain approximately 50% of the variance in AOP. Thirty‐eight normotensive healthy adults (age: 24±5 yrs, BMI: 25±4) visited the laboratory for one testing session. Brachial and femoral systolic (SBP) and diastolic (DBP) blood pressures were taken in the seated position. Next, thigh circumference, muscle thickness of the anterior thigh, and maximal isometric knee extension strength was assessed. Lean thigh volume was estimated using anthropometric measures. Lastly, lower body AOP was assessed in the seated position using an 18cm wide thigh sphygmomanometer and Doppler ultrasound (156±12 mmHg). A multiple linear regression analysis including brachial and femoral SBP and DBP, thigh circumference, muscle thickness, lean thigh volume, and maximal isometric knee extension strength was performed to assess which variables constituted significant predictors of AOP. Regression analysis was then repeated with only significant variables to generate both a lab‐based and field‐based prediction equation for AOP. Thigh circumference (β = 0.322, part = 0.876), brachial SBP (β = 0.362, part = 0.463) and isometric knee extension strength (β = 0.421, part = 0.076) constituted significant predictors of AOP. A lab‐based model including thigh circumference (β=0.278, part = 0.754), brachial SBP (β=0.492, part = 0.549), and isometric knee extension strength (β=0.306, part = 0.055) explained 56% of the variance in AOP. A field‐based model including only thigh circumference (β=0.316, part = 0.857) and brachial SBP (β=0.515, part = 0.658) explained 47% of the variance in AOP. Our results indicate that thigh circumference, brachial SBP, and isometric knee extension strength serve as predictors of AOP in the lower body when utilizing an 18cm wide sphygmomanometer as a restrictive cuff. Further, a field‐based prediction equation including thigh circumference and brachial SBP offers a practical way to estimate AOP. Future work will build upon this prediction equation by utilizing subjective measures of cuff tightness, effort, and muscle pain to further adjust exercising cuff pressures to an appropriate level. Results will help to provide researchers and practitioners with a practical way to implement BFR without the need for specialized equipment.

Does Parkinson's disease affect peripheral circulation and vascular function in physically active patients?

Previous studies demonstrated that aging, neurodegeneration, and the level of physical activity are associated with vascular alterations. However, in Parkinson's disease (PD) only cerebral vascular function has been investigated; instead, the contribution of PD on systemic vascular function and skeletal muscle circulation remains a matter of debate. In this study, the hyperemic response during the single passive leg movement test (sPLM), largely nitric oxide dependent, was examined at the level of the common femoral artery with an ultrasound Doppler system to assess systemic vascular function in 10 subjects with PD (PDG), compared with 10 aged-sex and physically active matched healthy elderly (EHG), and 10 physically active young healthy individuals (YHG). Interestingly, femoral blood flow at rest, normalized for the thigh volume, was similar in PDG (64 ± 15 mL·min-1·L-1), EHG (44 ± 8 mL·min-1·L-1), and YHG (58 ± 11 mL·min-1·L-1, all P values > 0.05). The sPLM-induced hyperemic response appeared markedly lower in PDG and EHG compared with YHG (8.3 ± 0.1 vs. 9.8 ± 0.8 vs. 17.3 ± 3.0 mL·min-1·L-1; P < 0.05) but the difference between PDG and EHG was negligible (P > 0.05). The results of our study indicate that peripheral circulation and vascular function are not reduced in physically active patients with PD, suggesting that these vascular changes could resemble the physiological adjustments of aging, without any impact from the disease.NOTE & NOTEWORTHY Our study verified an intact peripheral circulation in patients with Parkinson's disease (PD). However, using the single passive leg movement, we observed a similar reduction of the vascular integrity in physically active patients and matched elderly, compared with young, likely induced by aging but independent on the pathology. This comparable effect confirmed that the disease, at early stage, with a dynamic lifestyle does not worsen the vascular system but reveals the cardinal symptoms of PD.