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Maruyama M, Kagaya Y, Kajiwara S, Oikawa T, Horikawa M, Fujimoto M, Sasaki M. The Validity of Quadriceps Muscle Thickness as a Nutritional Risk Indicator in Patients with Stroke. Nutrients 2024; 16:540. [PMID: 38398864 PMCID: PMC10891856 DOI: 10.3390/nu16040540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to investigate whether quadriceps muscle thickness (QMT) is useful for nutritional assessment in patients with stroke. This was a retrospective cohort study. Nutritional risk was assessed using the Geriatric Nutritional Risk Index (GNRI), with GNRI < 92 indicating a risk of malnutrition and GNRI ≥ 92 indicating normal conditions. Muscle mass was assessed using QMT and calf circumference (CC). The outcome was Functional Independence Measure (FIM) effectiveness. The cutoff values of QMT and CC for discriminating between high and low GNRI were determined using the receiver operating characteristic curve. The accuracy of the nutritional risk discrimination model was evaluated using the Matthews correlation coefficient (MCC). Multiple regression analysis was performed to assess the relationship between nutritional risk, as defined by QMT and CC, and FIM effectiveness. A total of 113 patients were included in the analysis. The cutoff values of QMT and CC for determining nutritional risk were 49.630 mm and 32.0 cm for men (MCC: 0.576; 0.553) and 41.185 mm and 31.0 cm for women (MCC: 0.611; 0.530). Multiple regression analysis showed that only nutritional risk defined by QMT was associated with FIM effectiveness. These findings indicate that QMT is valid for assessing nutritional risk in patients with stroke.
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Affiliation(s)
- Motoki Maruyama
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
- Department of Physical Therapy, Akita University Graduate School of Health Science, 1-1-1 Hondo, Akita 010-8543, Japan
- Department of Rehabilitation Medicine, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Yuki Kagaya
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Sota Kajiwara
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Takuto Oikawa
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
- Department of Physical Therapy, Akita University Graduate School of Health Science, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Manabu Horikawa
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Mika Fujimoto
- Department of Nutrition, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan;
| | - Masahiro Sasaki
- Department of Rehabilitation Medicine, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
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Xavier de Melo V, Mezzomo TR, Aristides Dall'igna AL, de Araújo Marques Dengo V, Stangarlin-Fiori L, Madalozzo Schieferdecker ME, Rodrigues Ferreira SM. Does the nutritional composition and category of administered enteral nutrition affect the nutritional status of patients receiving home nutritional therapy? Clin Nutr ESPEN 2022; 49:270-277. [DOI: 10.1016/j.clnesp.2022.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/10/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
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Muscle Thickness and Echogenicity Measured by Ultrasound Could Detect Local Sarcopenia and Malnutrition in Older Patients Hospitalized for Hip Fracture. Nutrients 2021; 13:nu13072401. [PMID: 34371911 PMCID: PMC8308882 DOI: 10.3390/nu13072401] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this work was to assess whether the muscle thickness and echogenicity were associated with dysphagia, malnutrition, sarcopenia, and functional capacity in acute hospital admission for a hip fracture. METHODS Observational study that assessed nutritional status by Global Leadership Initiative on Malnutrition, risk of dysphagia and sarcopenia by European Working Group on Sarcopenia in Older People and Barthel functional index. We measured muscle thickness and echogenicity of masseter, bicipital, and quadriceps rectus femoris (RF) and vastus intermedius (VI) by ultrasound. RESULTS One hundred and one patients were included in the study (29.7% sarcopenia and 43.8% malnutrition). Logistic regression models adjusted for age, sex, and body mass index showed an inverse association of the masseter thickness with both sarcopenia (OR: 0.56) and malnutrition (OR: 0.38) and quadriceps with sarcopenia (OR: 0.74). In addition, patients at high risk of dysphagia had lower masseter thickness (p: 0.0001) while patients able to self-feeding had thicker biceps (p: 0.002) and individuals with mobility on level surfaces higher thickness of biceps (p: 0.008) and quadriceps (p: 0.04). CONCLUSION Thickness of the masseter was associated with risk of dysphagia, biceps with the ability to self-feed, and that of the quadriceps RF-VI with mobility.
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DiLiberto FE, Haddad SL, Wilson WC, Courtney CA, Sara LK, Vora AM. Total ankle arthroplasty: Strength, pain, and motion. Clin Biomech (Bristol, Avon) 2021; 84:105342. [PMID: 33798842 DOI: 10.1016/j.clinbiomech.2021.105342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND While outcomes such as pain and ankle motion are well researched, information regarding the effect of total ankle arthroplasty on ankle plantarflexion strength is extraordinarily limited. The purpose of this study was to evaluate ankle plantarflexion strength before and after total ankle arthroplasty, and examine the interplay of pain, motion, and strength. METHODS This prospective case-control study included 19 patients with end-stage ankle arthritis who received a total ankle arthroplasty and 19 healthy control participants matched for age, sex, and body mass index. Pain was measured with a numeric pain rating scale. Passive sagittal plane ankle range of motion (°) and isokinetic ankle plantarflexion torque (Nm/kg) at 60 and 120°/s were measured with an instrumented dynamometer. t-tests or non-parametric tests were used to evaluate outcomes across time and between groups. Bivariate correlations were performed to evaluate the interplay of postoperative pain, motion, and torque. FINDINGS Patient pain and motion improved between the preoperative and six-month postoperative time points (d ≥ 0.7). Ankle plantarflexion torque was not different across time (d ≤ 0.5), but was lower than control group values postoperatively (d ≥ 1.4). Significant correlations between pain and motion (r = -0.48), but not torque (-0.11 ≤ r ≤ 0.13), were observed. INTERPRETATION Unchanged following surgery, impairments in muscle performance following total ankle arthroplasty do not appear to be changed by improved pain or motion. These findings provide impetus for postoperative strengthening interventions.
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Affiliation(s)
- Frank E DiLiberto
- Rosalind Franklin University of Medicine & Science, College of Health Professions, Department of Physical Therapy, 3333 Green Bay Road, North Chicago, IL 60064, USA.
| | - Steven L Haddad
- Illinois Bone & Joint Institute, LLC, 720 Florsheim Drive, Libertyville, IL 60048, USA
| | - Walter C Wilson
- Rosalind Franklin University of Medicine & Science, College of Health Professions, Department of Physical Therapy, 3333 Green Bay Road, North Chicago, IL 60064, USA.
| | - Carol A Courtney
- Northwestern University, Feinberg School of Medicine, Physical Therapy and Human Movement Sciences, 645 N Michigan Avenue, Chicago, IL 60611, USA.
| | - Lauren K Sara
- Marquette University, College of Health Sciences, Department of Physical Therapy, 1250 W Wisconsin Avenue, Milwaukee, WI 53233, USA.
| | - Anand M Vora
- Illinois Bone & Joint Institute, LLC, 720 Florsheim Drive, Libertyville, IL 60048, USA
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Nakanishi N, Okura K, Okamura M, Nawata K, Shinohara A, Tanaka K, Katayama S. Measuring and Monitoring Skeletal Muscle Mass after Stroke: A Review of Current Methods and Clinical Applications. J Stroke Cerebrovasc Dis 2021; 30:105736. [PMID: 33756264 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105736] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/16/2021] [Accepted: 02/28/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke. MATERIAL AND METHODS Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke. RESULTS In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources. CONCLUSIONS We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.
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Affiliation(s)
- Nobuto Nakanishi
- Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
| | - Kazuki Okura
- Department of Rehabilitation, Akita University Hospital, 44-2 Hasunuma, Aza, Hiroomote, Akita 010-8543, Japan
| | - Masatsugu Okamura
- Department of Rehabilitation, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan
| | - Keishi Nawata
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, Fukuoka 807-8556, Japan
| | - Ayato Shinohara
- Department of Rehabilitation, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Kohei Tanaka
- Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama, Tennouji, Osaka 543-0035, Japan
| | - Sho Katayama
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 shikata, Kitaku, Okayama 700-8558, Japan
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Kinoshita H, Kobayashi M, Kajii Y, Satonaka A, Suzuki N. Calf circumference positively correlates with calf muscle thickness and negatively correlates with calf subcutaneous fat thickness and percent body fat in non-obese healthy young adults. J Sports Med Phys Fitness 2021; 62:343-349. [PMID: 33687177 DOI: 10.23736/s0022-4707.21.12152-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Calf circumference is measured for assessing sarcopenia, nutrition status, percent body fat or obesity. However, there has been no study that investigated the relationship between calf circumference and calf subcutaneous fat tissue thickness. Therefore, the purpose of this study was to investigate the relationship between calf circumference, calf muscle thickness, and calf subcutaneous fat tissue thickness in nonobese healthy young adults. METHODS The study participants were non-obese 22 women (20.1 ± 0.8 years) and 21 men (20.0 ± 0.8 years). The right calf circumference was measured in prone position at the point where the circumference was maximal by visual recognition using a measuring tape. Then, thickness of calf subcutaneous fat tissue and calf muscles were measured with an ultrasonic diagnostic equipment. RESULTS There was a positive relationship between calf circumference and calf muscle thickness both in women (r = 0.58, P < 0.01) and men (r = 0.46, P < 0.05), negative relathionship between calf circumference and calf subcutaneous fat tissue thickness both in women (r = -0.43, P < 0.05) and men (r = -0.67, P < 0.001), no correlation between calf circumference and percent body fat both in women (r = 0.04, P = 0.87) and men (r = 0.41, P = 0.06), and a negative relationship between calf subcutaneous fat tissue thickness and percent body fat both in women (r = -0.48, P < 0.05) and men (r = -0.46, P < 0.05). CONCLUSIONS Our present study showed that a larger calf indicated larger calf muscle thickness, and largely different from previous studies, a lower calf subcutaneous fat tissue thickness. That is because when the calf circumference increases, calf subcutaneous fat tissue thickness should be thinner to keep the percent body fat equal in non-obese healthy young adults. The finding will help to get a better understanding of the nature of the calf.
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Affiliation(s)
- Hina Kinoshita
- Department of Physical Therapy, General Aoyama Hospital, Toyokawa, Japan
| | - Mayu Kobayashi
- Department of Physical Therapy, Ichinomiya Onsen Hospital, Huehuki, Japan
| | - Yuta Kajii
- Heimat Okazaki Long-Term Care Facility, Okazakikai Medical Corporation, Hamamatsu, Japan
| | - Ayako Satonaka
- Department of Physical Therapy, Biwako Professional University of Rehabilitation, Higashiomi, Japan.,Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Department of Physical Therapy, Tokoha University, Hamamatsu, Japan
| | - Nobuharu Suzuki
- Department of Physical Therapy, Tokoha University, Hamamatsu, Japan -
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Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update. Eur Geriatr Med 2021; 12:45-59. [PMID: 33387359 DOI: 10.1007/s41999-020-00433-9] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE In 2018, the SARCUS working group published a first article on the standardization of the use of ultrasound to assess muscle. Recommendations were made for patient positioning, system settings and components to be measured. Also, shortcomings in knowledge were mentioned. An important issue that still required standardization was the definition of anatomical landmarks for many muscles. METHODS A systematic search was performed in Medline, SCOPUS and Web of Sciences looking for all articles describing the use of ultrasound in the assessment of muscle not described in the first recommendations, published from 01/01/2018 until 31/01/2020. All relevant terms used for older people, ultrasound and muscles were used. RESULTS For 39 muscles, different approaches for ultrasound assessment were found that likely impact the values measured. Standardized anatomical landmarks and measuring points were proposed for all muscles/muscle groups. Besides the five already known muscle parameters (muscle thickness, cross-section area, pennation angle, fascicle length and echo-intensity), four new parameters are discussed (muscle volume, stiffness, contraction potential and microcirculation). The former SARCUS article recommendations are updated with this new information that includes new muscle groups. CONCLUSIONS The emerging field of ultrasound assessment of muscle mass only highlights the need for a standardization of measurement technique. In this article, guidelines are updated and broadened to provide standardization instructions for a large number of muscles.
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AlMohimeed I, Ono Y. Ultrasound Measurement of Skeletal Muscle Contractile Parameters Using Flexible and Wearable Single-Element Ultrasonic Sensor. SENSORS 2020; 20:s20133616. [PMID: 32605006 PMCID: PMC7374409 DOI: 10.3390/s20133616] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/17/2020] [Accepted: 06/23/2020] [Indexed: 12/25/2022]
Abstract
Skeletal muscle is considered as a near-constant volume system, and the contractions of the muscle are related to the changes in tissue thickness. Assessment of the skeletal muscle contractile parameters such as maximum contraction thickness (Th), contraction time (Tc), contraction velocity (Vc), sustain time (Ts), and half-relaxation (Tr) provides valuable information for various medical applications. This paper presents a single-element wearable ultrasonic sensor (WUS) and a method to measure the skeletal muscle contractile parameters in A-mode ultrasonic data acquisition. The developed WUS was made of double-layer polyvinylidene fluoride (PVDF) piezoelectric polymer films with a simple and low-cost fabrication process. A flexible, lightweight, thin, and small size WUS would provide a secure attachment to the skin surface without affecting the muscle contraction dynamics of interest. The developed WUS was employed to monitor the contractions of gastrocnemius (GC) muscle of a human subject. The GC muscle contractions were evoked by the electrical muscle stimulation (EMS) at varying EMS frequencies from 2 Hz up to 30 Hz. The tissue thickness changes due to the muscle contractions were measured by utilizing a time-of-flight method in the ultrasonic through-transmission mode. The developed WUS demonstrated the capability to monitor the tissue thickness changes during the unfused and fused tetanic contractions. The tetanic progression level was quantitatively assessed using the parameter of the fusion index (FI) obtained. In addition, the contractile parameters (Th, Tc, Vc, Ts, and Tr) were successfully extracted from the measured tissue thickness changes. In addition, the unfused and fused tetanus frequencies were estimated from the obtained FI-EMS frequency curve. The WUS and ultrasonic method proposed in this study could be a valuable tool for inexpensive, non-invasive, and continuous monitoring of the skeletal muscle contractile properties.
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Affiliation(s)
- Ibrahim AlMohimeed
- Department of Systems and Computer Engineering, Carleton University, Ottawa, ON K1S 5B6, Canada;
- Department of Medical Equipment Technology, Majmaah University, Majmaah 11952, Saudi Arabia
| | - Yuu Ono
- Department of Systems and Computer Engineering, Carleton University, Ottawa, ON K1S 5B6, Canada;
- Correspondence:
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