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Lee BG, Lee D, Koh JH. Relationship between the preoperative grip strength and postoperative shoulder strength of patients treated via reverse shoulder arthroplasty. J Shoulder Elbow Surg 2023; 32:2430-2435. [PMID: 37516347 DOI: 10.1016/j.jse.2023.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/11/2023] [Accepted: 06/24/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Systemic disorders including diabetes mellitus, obesity, and depression affect the outcomes of reverse shoulder arthroplasty (RSA). Sarcopenia (a general skeletal muscle disorder) is common in elderly people, but its effect on patients after RSA is not clear. We hypothesized that the preoperative sarcopenia indices of grip strength and general skeletal muscle mass would correlate with the clinical outcomes of RSA. METHODS Grip strength and general skeletal muscle mass were measured in patients scheduled (between 2016 and 2021) for primary RSA to treat cuff tear arthropathy, an unrepairable cuff tear, or osteoarthritis with a large cuff tear. Before surgery, grip strength was measured using a hydraulic dynamometer and general skeletal muscle mass was calculated from the appendicular relative skeletal muscle mass index (aRSMI) using dual-energy X-ray absorptiometry. In all, 58 patients were included; the minimal follow-up duration was 12 months. The postoperative clinical results (pain, active range of motion, shoulder strength, and functional scores) were evaluated during scheduled outpatient visits. We calculated correlations between the preoperative sarcopenia indices, and the clinical results at the final follow-up. RESULTS The mean preoperative grip strength and aRSMI were 21.6 ± 4.0 kg and 5.98 ± 0.84 kg/m2 in females and 30.6 ± 7.5 kg and 7.21 ± 0.94 kg/m2 in males, respectively; the grip strength and aRSMI were not associated with each other (P = .083). Ten females (25%) and 10 males (56%) met the criteria for sarcopenia. The postoperative abduction shoulder strength and Constant-Murley shoulder score increased significantly with higher preoperative grip strength (R = 0.420 and P = .001; and R = 0.497 and P < .001, respectively) and the American Shoulder and Elbow Surgeons score was related to the preoperative aRSMI (R = 0.320, P = .039). CONCLUSIONS The shoulder strength and functional score after RSA correlated positively with the preoperative grip strength. Measuring grip strength before RSA allows the surgeon to predict shoulder strength after RSA.
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Affiliation(s)
- Bong Gun Lee
- Department of Orthopaedic Surgery, Hanyang University, School of Medicine, Seoul, Republic of Korea
| | - DooHyung Lee
- Department of Orthopaedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea.
| | - Jeong-Hyun Koh
- Department of Orthopaedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
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Alazzam AM, Alrubaye MW, Goldsmith JA, Gorgey AS. Trends in measuring BMR and RMR after spinal cord injury: a comprehensive review. Br J Nutr 2023; 130:1720-1731. [PMID: 37092679 PMCID: PMC10587382 DOI: 10.1017/s0007114523000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/25/2023]
Abstract
Studying factors that contribute to our understanding of maintaining normal energy balance are of paramount significance following spinal cord injury (SCI). Accurate determination of energy needs is crucial for providing nutritional guidance and managing the increasing prevalence of malnutrition or obesity after SCI. BMR represents 75-80 % of the total energy expenditure in persons with SCI. Accurately measuring BMR is an important component for calculating total energetic needs in this population. Indirect calorimetry is considered the gold-standard technique for measuring BMR. However, technical challenges may limit its applications in large cohort studies and alternatively rely on prediction equations. Previous work has shown that BMR changes in response to disuse and exercise in the range of 15-120 %. Factors including sex, level of injury and type of assistive devices may influence BMR after SCI. RMR is erroneously used interchangeably for BMR, which may result in overestimation of energetic intake when developing nutritional plans. To address this concern, we comprehensively reviewed studies that conducted BMR (n=15) and RMR (n=22) in persons with SCI. The results indicated that RMR is 9 % greater than BMR in persons with SCI. Furthermore, the SCI-specific prediction equations that incorporated measures of fat-free mass appeared to accurately predict BMR. Overall, the current findings highlighted the significance of measuring BMR as well as encouraging the research and clinical community to effectively establish countermeasures to combat obesity after SCI.
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Affiliation(s)
- Ahmad M. Alazzam
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
| | - Malak W. Alrubaye
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
| | - Jacob A. Goldsmith
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
| | - Ashraf S. Gorgey
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
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3
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Tanaka M, Kanayama M, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Hashimoto T, Nojiri H, Ishijima M. Potential of whole-body dual-energy X-ray absorptiometry to predict muscle size of psoas major, gluteus maximus and back muscles. BMC Musculoskelet Disord 2023; 24:917. [PMID: 38012671 PMCID: PMC10680309 DOI: 10.1186/s12891-023-07051-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Measurement of trunk muscle cross-sectional area (CSA) using axial magnetic resonance imaging (MRI) is considered clinically meaningful for understanding several spinal pathologies, such as low back pain and spinal sagittal imbalance. However, it remains unclear whether trunk muscle mass (TMM) measured using dual-energy X-ray absorptiometry (DXA) can predict the trunk muscle CSA. The aim of this study is to determine if DXA-derived TMM is associated and predicts with CSA of paraspinal muscles and gluteus maximus measured using MRI in healthy volunteers. METHODS A total of 48 healthy volunteers underwent whole-body DXA and MRI of the spinopelvic region. The CSA of the psoas major, back muscles, and gluteus maximus were measured on axial MRI. Correlations and linear regressions between the TMM measured using DXA and the CSA of each musculature were investigated. RESULTS There was a weak correlation between TMM and CSA of the psoas major in men (r = 0.39, P = 0.0678), and the linear regression was y = 301.74x - 401.24 (R2 = 0.2976, P = 0.0070). A moderate correlation was found in women (r = 0.58, P = 0.0021), and the linear regression was y = 230.21x - 695.29 (R2 = 0.4445, P = 0.0003). Moderate correlations were observed between TMM and CSA of the back muscles in both men (r = 0.63, P = 0.0012) and women (r = 0.63, P = 0.0007), the linear regression was y = 468.52x + 3688.5 (R2 = 0.5505, P < 0.0001) in men and y = 477.39x + 2364.1 (R2 = 0.564, P < 0.0001) in women. There was a strong correlation between TMM and CSA of the gluteus maximus in men (r = 0.72, P < 0.0001), and the linear regression was y = 252.69x - 880.5 (R2 = 0.6906, P < 0.0001). A moderate correlation was found in women (r = 0.69, P < 0.0001), and the linear regression was y = 230.74x - 231.32 (R2 = 0.6542, P < 0.0001). CONCLUSIONS The DXA-derived TMM was able to predict the CSA of the psoas major, back muscles, and gluteus maximus, and significantly correlated with the CSA of the back muscles and gluteus maximus. It might be a safer and cheaper alternative for evaluating the size of the back muscles and gluteus maximus.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
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Qi S, Horii N, Kishigami K, Miyachi M, Iemitsu M, Sanada K. Effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity. J Phys Ther Sci 2023; 35:24-30. [PMID: 36628145 PMCID: PMC9822826 DOI: 10.1589/jpts.35.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/03/2022] [Indexed: 01/01/2023] Open
Abstract
[Purpose] Very few studies have been conducted on the benefits of water exercise for older adults with sarcopenic obesity. Whether the water exercise intervention is effective for improving sarcopenia and/or obesity remains unclear. This study aimed to investigate the effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity. [Participants and Methods] Participants (aged ≥60 years) were divided into a water exercise group and a control group. Water-based strength and endurance exercises were performed three times a week for 12 weeks. Lean soft tissue mass, fat mass, and body fat percentage were measured by dual-energy x-ray absorptiometry. [Results] Two-way analysis of variance revealed significant interactions (time × group) for total body fat percentage and leg body fat percentage. In the exercise group, leg body fat percentage significantly decreased after the intervention, but no significant change was observed in the control group. The components of metabolic syndrome showed no significant interactions in either group (time × group). [Conclusion] No significant changes were observed in the components of metabolic syndrome. However, 12-week water exercise may be effective for reducing fat mass in females with sarcopenic obesity.
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Affiliation(s)
- Shumeng Qi
- Faculty of Sport and Health Science, Ritsumeikan
University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8017, Japan
| | - Naoki Horii
- Faculty of Sport and Health Science, Ritsumeikan
University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8017, Japan
| | - Keiko Kishigami
- Faculty of Sport and Health Science, Ritsumeikan
University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8017, Japan
| | - Motohiko Miyachi
- National Institute of Biomedical Innovation, Health and
Nutrition, Japan, Faculty of Sports Sciences, Waseda University, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan
University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8017, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan
University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8017, Japan,Corresponding author. Kiyoshi Sanada (E-mail: )
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Raguindin PF, Bertolo A, Zeh RM, Fränkl G, Itodo OA, Capossela S, Bally L, Minder B, Brach M, Eriks-Hoogland I, Stoyanov J, Muka T, Glisic M. Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10173911. [PMID: 34501356 PMCID: PMC8432215 DOI: 10.3390/jcm10173911] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 12/17/2022] Open
Abstract
The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I2 statistics and the chi-squared test. Study quality was assessed using the Newcastle–Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03–14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD −3.0 kg, 95% CI −5.9, −0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm2 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD −0.9 kg/mg2, 95% CI −1.4, −0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.
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Affiliation(s)
- Peter Francis Raguindin
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland; (O.A.I.); (T.M.); (M.G.)
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
- Correspondence:
| | - Alessandro Bertolo
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
| | - Ramona Maria Zeh
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
| | - Gion Fränkl
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Oche Adam Itodo
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland; (O.A.I.); (T.M.); (M.G.)
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Simona Capossela
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
| | - Lia Bally
- Department of Diabetes, Endocrinology, Nutritional Medicine, Metabolism, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland;
| | - Beatrice Minder
- Public Health & Primary Care Library, University Library of Bern, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland;
| | - Mirjam Brach
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
| | - Inge Eriks-Hoogland
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
- Swiss Paraplegic Center, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland
| | - Jivko Stoyanov
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland; (O.A.I.); (T.M.); (M.G.)
| | - Marija Glisic
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland; (O.A.I.); (T.M.); (M.G.)
- Swiss Paraplegic Research, Guido A. Zäch Str. 1, 6207 Nottwil, Switzerland; (A.B.); (R.M.Z.); (G.F.); (S.C.); (M.B.); (I.E.-H.); (J.S.)
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Wiyanad A, Amatachaya P, Sooknuan T, Somboonporn C, Thaweewannakij T, Saengsuwan J, Amatachaya S. The use of simple muscle strength tests to reflect body compositions among individuals with spinal cord injury. Spinal Cord 2021; 60:99-105. [PMID: 34120154 DOI: 10.1038/s41393-021-00650-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A cross-sectional study. OBJECTIVES To investigate the correlation between simple muscle strength tests (including handgrip test and upper limb loading during a seated push-up test [ULL-SPUT]) and body compositions among individuals with spinal cord injury (SCI). SETTING A tertiary rehabilitation center. METHODS Twenty-four participants with SCI (average age of 40 years) were cross-sectionally assessed using handgrip test, ULL-SPUT, and body compositions (including skeletal muscle mass, bone mineral content, and fat mass) using dual-energy X-ray absorptiometry scan. RESULTS The handgrip data had low-to-moderate correlation to body compositions of the arms (rs = 0.474-0.515, p < 0.05), while the ULL-SPUT data were low-to-excellently correlated to all body compositions of the arms, legs, and trunk (rs, r = 0.467-0.921, p < 0.05). CONCLUSIONS The findings extend clinical benefit of a SPUT apart from being a rehabilitation strategy to promote mobility of individuals with SCI. Simple measurement of the ULL-SPUT, which can be done using digital bathroom scales placed on a hard and even surface, appears to be strongly correlated with body compositions in a small sample of predominantly middle age, normal weight, men with paraplegia. More research is required to understand whether this test can be used clinically to assess body compositions in a more diverse SCI population, and whether it is responsive to changes in body compositions over time.
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Affiliation(s)
- Arpassanan Wiyanad
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Pipatana Amatachaya
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Mechanical Engineering, Faculty of Engineering and Architecture, Rajamangala University of Technology Isan, Nakhon Ratchasima, Thailand
| | - Thanat Sooknuan
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Electronics Engineering, Faculty of Engineering and Architecture, Rajamangala University of Technology Isan, Nakhon Ratchasima, Thailand
| | - Charoonsak Somboonporn
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thiwabhorn Thaweewannakij
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Jittima Saengsuwan
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Rehabilitation, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand. .,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.
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Assessment of body composition in spinal cord injury: A scoping review. PLoS One 2021; 16:e0251142. [PMID: 33961647 PMCID: PMC8104368 DOI: 10.1371/journal.pone.0251142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/21/2021] [Indexed: 11/19/2022] Open
Abstract
The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate 'gold standard' tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).
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Goldsmith JA, Ennasr AN, Farkas GJ, Gater DR, Gorgey AS. Role of exercise on visceral adiposity after spinal cord injury: a cardiometabolic risk factor. Eur J Appl Physiol 2021; 121:2143-2163. [PMID: 33891156 DOI: 10.1007/s00421-021-04688-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/10/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE Visceral adipose tissue (VAT) is associated with cardiometabolic disease risk in able-bodied (AB) populations. However, the underlying mechanisms of VAT-induced disease risk are unknown in persons with spinal cord injury (SCI). Potential mechanisms of VAT-induced cardiometabolic dysfunction in persons with SCI include systemic inflammation, liver adiposity, mitochondrial dysfunction, and anabolic deficiency. Moreover, how exercise interventions impact these mechanisms associated with VAT-induced cardiometabolic dysfunction are still being explored. METHODS A search for relevant scientific literature about the effects of exercise on VAT and cardiometabolic health was conducted on the PubMed database. Literature from reference lists was also included when appropriate. RESULTS Both aerobic and resistance exercise training beneficially impact health and VAT mass via improving mitochondrial function, glucose effectiveness, and inflammatory signaling in SCI and AB populations. Specifically, aerobic exercise appears to also modulate cellular senescence in AB populations and animal models, while resistance exercise seems to augment anabolic signaling in persons with SCI. CONCLUSIONS The current evidence supports regular engagement in exercise to reduce VAT mass and the adverse effects on cardiometabolic health in persons with SCI. Future research is needed to further elucidate the precise mechanisms by which VAT negatively impacts health following SCI. This will likely facilitate the development of rehabilitation protocols that target VAT reduction in persons with SCI.
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Affiliation(s)
- Jacob A Goldsmith
- Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA
| | - Areej N Ennasr
- Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA
| | - Gary J Farkas
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - David R Gater
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Ashraf S Gorgey
- Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA. .,Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23298, USA.
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Lin SF, Fan YC, Chou CC, Pan WH, Bai CH. Body composition patterns among normal glycemic, pre-diabetic, diabetic health Chinese adults in community: NAHSIT 2013-2016. PLoS One 2020; 15:e0241121. [PMID: 33147251 PMCID: PMC7641370 DOI: 10.1371/journal.pone.0241121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/08/2020] [Indexed: 11/18/2022] Open
Abstract
Background Central obesity is known to be associated with diabetes. Increasing lower extremity circumference was hypothesized in association with lower risk of diabetes. Objective This study determined which anthropometric patterns correlates the best with pre-diabetic and diabetic status among healthy adults. Design Cross-sectional study with nationwide population sampling of participants was designed. Participants In total, 1,358 ethnic Chinese adult participants were recruited from the Nutrition and Health Survey in Taiwan 2013–2016; the whole-body composition was measured through dual-energy X-ray absorptiometry. Main outcome measures Fat and lean mass in whole and specific parts of body among heathy Asian adults with normal glycemic, pre-diabetic, and diabetic states were measured, separately. Statistical analyses performed The generalized linear model was used to investigate the association between body composition (lean and fat mass) and hyperglycemic status. The reduced rank regression (RRR) was used to confirm the correlation between glycemic status and predicting factors (body composition parameters). Results Trunk fat positively correlated with the fasting glucose level (r = 0.327, P < 0.001) and HbA1c (r = 0.329, P < 0.001), whereas limb fat negatively correlated with the fasting glucose level (r = −0.325, P < 0.001) and HbA1c (ρ = −0.342, P < 0.001), respectively. In RRR analyses, fasting glucose and HbA1c exhibited a high positive association on fat amount per lean mass of the trunk (factor loading = 0.5319 and 0.5599, respectively) and of android area (0.6422 and 0.6104) and a high negative association fat amount per lean mass of the legs (−0.3863 and −0.3083) and gynoid area (−0.3414 and −0.3725). Conclusions For healthy community participants, increasing trunk fat had a greater risk of hyperglycemic status. Increasing lower extremity mass may confer lower risk of diabetes.
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Affiliation(s)
- Sheng-Feng Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Division of Hospitalist, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Chia-Chi Chou
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei City, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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Yahiro AM, Wingo BC, Kunwor S, Parton J, Ellis AC. Classification of obesity, cardiometabolic risk, and metabolic syndrome in adults with spinal cord injury. J Spinal Cord Med 2020; 43:485-496. [PMID: 30620685 PMCID: PMC7480648 DOI: 10.1080/10790268.2018.1557864] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: To describe and compare (1) classification of obesity using clinical proxies of body composition that are easily accessible in the outpatient clinic setting, (2) cardiometabolic risk using existing screening tools and staging systems, and (3) the presence of metabolic syndrome (MetS) using four commonly-used definitions in adults with spinal cord injury (SCI). Design: Retrospective chart review Setting: Outpatient Veterans Affairs (VA) SCI Annual Evaluation Clinic Participants: Patients who attended an annual evaluation appointment with demographic, anthropometric, and biochemical data documented in their medical records as part of routine medical care. Outcome measures: Obesity classification (body mass index, waist circumference, ideal body weight percentage), cardiometabolic risk scores (Framingham Risk Score, Cardiometabolic Disease Staging System, Edmonton Obesity Staging System), and MetS classification (using four commonly-used definitions) were described and compared. Results: Of the 155 veterans included in this analysis, 93% were considered "at risk" by at least one of the measurements studied. However, there was considerable variation between the different screening tools. The κ-agreement between various definitions of MetS ranged from fair to moderate. Conclusion: Screening tools that were developed for the non-SCI population produced variable assessments of risk when applied to veterans with SCI. Due to the fair to moderate inter-rater agreement between MetS definitions, it is unknown which definition is superior to identify MetS in the SCI population. An SCI-specific screening tool is needed to accurately classify obesity, cardiometabolic risk, and MetS in order to provide timely education and intervention.
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Affiliation(s)
- Amy M. Yahiro
- Nutrition and Food Services, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA,Correspondence to: Amy M. Yahiro, Nutrition and Food Services, Edward Hines, Jr. Veterans Affairs Hospital, 5000 South 5th Avenue, Hines, IL60141, USA.
| | - Brooks C. Wingo
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sujit Kunwor
- Department of Information Systems, Statistics, Management Science, University of Alabama, Tuscaloosa, Alabama, USA
| | - Jason Parton
- Department of Information Systems, Statistics, Management Science, University of Alabama, Tuscaloosa, Alabama, USA
| | - Amy C. Ellis
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama, USA
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