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Ramos-Campo DJ, Benito-Peinado PJ, Andreu-Caravaca L, Rojo-Tirado MA, Rubio-Arias JÁ. Efficacy of Split Versus Full-Body Resistance Training on Strength and Muscle Growth: A Systematic Review With Meta-Analysis. J Strength Cond Res 2024; 38:1330-1340. [PMID: 38595233 DOI: 10.1519/jsc.0000000000004774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
ABSTRACT Ramos-Campo, DJ, Benito-Peinado, PJ, Caravaca, LA, Rojo-Tirado, MA, and Rubio-Arias, JÁ. Efficacy of split versus full-body resistance training on strength and muscle growth: a systematic review with meta-analysis. J Strength Cond Res 38(7): 1330-1340, 2024-No previous study has systematically compared the effect of 2 resistance training routines commonly used to increase muscle mass and strength (i.e., split [Sp] and full-body [FB] routines). Our objective was to conduct a systematic review and meta-analysis following PRISMA guidelines to compare the effects on strength gains and muscle growth in healthy adults. 14 studies (392 subjects) that compared Sp and FB routines in terms of strength adaptations and muscle growth were included. Regarding the effects of the Sp or FB routine on both bench press and lower limbs strength, the magnitude of the change produced by both routines was similar (bench press: mean difference [MD] = 1.19; [-1.28, 3.65]; p = 0.34; k = 14; lower limb: MD = 2.47; [-2.11, 7.05]; p = 0.29; k = 14). Concerning the effect of the Sp vs. FB routine on muscle growth, similar effects were observed after both routines in the cross-sectional area of the elbow extensors (MD = 0.30; [-2.65, 3.24]; p = 0.84; k = 4), elbow flexors (MD = 0.17; [-2.54, 2.88]; p = 0.91; k = 5), vastus lateralis (MD = -0.08; [-1.82, 1.66]; p = 0.93; k = 5), or lean body mass (MD = -0.07; [-1.59, 1.44]; p = 0.92; k = 6). In conclusion, the present systematic review and meta-analysis provides solid evidence that the use of Sp or FB routines within a resistance training program does not significantly impact either strength gains or muscle hypertrophy when volume is equated. Consequently, individuals are free to confidently select a resistance training routine based on their personal preferences.
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Affiliation(s)
- Domingo J Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Pedro J Benito-Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Luis Andreu-Caravaca
- Sports Physiology Department, Faculty of Health Sciences, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
- Facultad de Deporte. UCAM Universidad Católica de Murcia, Murcia, Spain; and
| | - Miguel A Rojo-Tirado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Jacobo Á Rubio-Arias
- Health Research Center, Department of Education, Faculty of Educational Sciences, University of Almería, Almería, Spain
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Rodrigues GF, Francisquinho ML, Deminice R, Oliveira VHFD, Gonçalves EM, Guariglia DA. Validity of equations for estimating fat-free mass in people living with the human immunodeficiency virus. Clin Nutr ESPEN 2024; 63:226-233. [PMID: 38970787 DOI: 10.1016/j.clnesp.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 05/28/2024] [Accepted: 06/17/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND & AIMS Equations estimating fat-free mass (FFM) in people living with the human immunodeficiency virus (HIV) show differences in the validation process. The current study aimed to verify the validity of FFM estimation equations derived from bioelectrical impedance (BIA) in people living with HIV aged 40 years and older. METHODS A cross-sectional study was conducted with 68 participants evaluated using dual-energy X-ray absorptiometry (DXA) and by two BIA devices (Analyzer and Biodynamics). The study aimed to determine the validity of six different FFM equations from four different studies by Lukaski and Bolonchuk (1987), Kotler et al. (1996), Beraldo et al. (2015) and Hegelund et al. (2017). Comparisons were made using the t-test or Wilcoxon test. To verify the validity between DXA and two BIA devices, the following statistical analyses were performed: Lin's concordance correlation coefficient, intraclass correlation coefficient, coefficient of determination, standard error of the estimate, differences in the limits of agreement by Bland and Altman analysis, correlation between the average and the differences of the methods by Pearson or Spearman correlation. RESULTS Only equation 2 of Kotler et al. (1996) for males by Biodynamics BIA showed no difference in FFM. The Lin's concordance correlation coefficient was excellent (0.96), irrespective of sex, for Equation 2 of Kotler et al. (1996) by BIA Analyzer. All equations were reproducible (>0.85). The coefficient of determination ranged from 68% to 92%, and the standard error of the estimates ranged from 1.8 kg to 5.0 kg. The differences between the limits of agreement ranged from 7.2 kg to 14.9 kg, and the correlations between the average and the differences of the methods showed differences in FFM for three equations (p < 0.01). CONCLUSION The choice of equations must consider the equipment used and the sex of the sample investigated. Only Equation 2 of Kotler et al. (1996) was considered valid, irrespective of sex, to estimate the FFM by BIA Analyzer.
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Affiliation(s)
- Geisa Franco Rodrigues
- Universidade Estadual do Norte do Paraná, Avenida Manoel Ribas, n° 215, Jacarezinho - Paraná, Brasil.
| | | | - Rafael Deminice
- Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, Pr 445 Km 380, Londrina - Paraná, Brasil.
| | | | | | - Débora Alves Guariglia
- Universidade Estadual do Norte do Paraná, Avenida Manoel Ribas, n° 215, Jacarezinho - Paraná, Brasil.
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Pinheiro-Castro N, Ramos-Silva T, de Carvalho Rondó PH, Ward LC. Determination of resistance at zero and infinite frequencies in bioimpedance spectroscopy for assessment of body composition in babies. Physiol Meas 2024; 45:05NT01. [PMID: 38604189 DOI: 10.1088/1361-6579/ad3dc0] [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: 12/05/2023] [Accepted: 04/11/2024] [Indexed: 04/13/2024]
Abstract
Objective. Bioimpedance spectroscopy (BIS) is a popular technique for the assessment of body composition in children and adults but has not found extensive use in babies and infants. This due primarily to technical difficulties of measurement in these groups. Although improvements in data modelling have, in part, mitigated this issue, the problem continues to yield unacceptably high rates of poor quality data. This study investigated an alternative data modelling procedure obviating issues associated with BIS measurements in babies and infants.Approach.BIS data are conventionally analysed according to the Cole model describing the impedance response of body tissues to an appliedACcurrent. This approach is susceptible to errors due to capacitive leakage errors of measurement at high frequency. The alternative is to model BIS data based on the resistance-frequency spectrum rather than the reactance-resistance Cole model thereby avoiding capacitive error impacts upon reactance measurements.Main results.The resistance-frequency approach allowed analysis of 100% of data files obtained from BIS measurements in 72 babies compared to 87% successful analyses with the Cole model. Resistance-frequency modelling error (percentage standard error of the estimate) was half that of the Cole method. Estimated resistances at zero and infinite frequency were used to predict body composition. Resistance-based prediction of fat-free mass (FFM) exhibited a 30% improvement in the two-standard deviation limits of agreement with reference FFM measured by air displacement plethysmography when compared to Cole model-based predictions.Significance.This study has demonstrated improvement in the analysis of BIS data based on the resistance frequency response rather than conventional Cole modelling. This approach is recommended for use where BIS data are compromised by high frequency capacitive leakage errors such as those obtained in babies and infants.
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Affiliation(s)
| | - Tamiris Ramos-Silva
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Australia
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Rae LS, Rand JS, Ward LC. Measuring body composition in dogs using bioelectrical impedance spectroscopy. Vet J 2024; 304:106067. [PMID: 38266810 DOI: 10.1016/j.tvjl.2024.106067] [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: 08/17/2023] [Revised: 12/11/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
Assessment of body composition is an essential aspect of veterinary canine care, particularly as prevalence of overweight and obesity in dogs is increasing. Few quantitative objective methods for body composition measurement are available for routine clinical use. Bioelectrical impedance analysis is widely used in human medicine and nutritional assessment and although it has shown promise in production animals it has not yet been adopted for companion animals. The present study validated bioimpedance spectroscopy (BIS) against the reference method of dual-energy X-ray absorptiometry. Resistivity coefficients for use in BIS were determined: ρe = 444.8 and ρi = 1477.8 ohm.cm and used to predict fat-free mass (FFM) in a cohort of 35 mixed breed dogs. Overall, FFM was predicted to within 3.5% of reference values. At an individual level, FFM was predicted within 2 standard deviations (95% confidence) of 10%. BIS provides an objective quantitative alternative to the widely used semi-quantitative body condition scoring. In addition, BIS provides estimates of body water volumes (total, extra-and intracellular), information that can be useful in fluid management. BIS is inexpensive, and simple to perform but does require brief (<5 min) sedation of the animal.
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Affiliation(s)
- L S Rae
- School of Veterinary Science, The University of Queensland, Gatton, Queensland 4343 Australia
| | - J S Rand
- Australian Pet Welfare Foundation, Kenmore, Queensland 4069 Australia
| | - L C Ward
- School of Chemistry and Molecular Bioscience, The University of Queensland, St Lucia, Queensland 4072 Australia.
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Chen R, Yang M, Peng C, Yin D, Zhang Y, Xu F. Pharmacodynamics Research on Danggui-Shaoyao-San through Body Fluid Indexes of Spleen Deficiency-water Dampness Rats using Bio-impedance Technology. Curr Pharm Biotechnol 2024; 25:1602-1616. [PMID: 37921128 DOI: 10.2174/0113892010243018231025065109] [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: 01/29/2023] [Revised: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Spleen deficiency-water dampness symptom is closely related to body fluid-mediated organism metabolism and circulation. However, previous clinical evaluation of spleen deficiency-water dampness model was based only on body weight, D-xylose excretion rate, serum gastrin content, etc. Therefore, we established a large sample of normal rats and model rats experiment to verify the scientific nature of bio-impedance measuring body fluid indexes for evaluation of the modeling state. Pharmacodynamics research on Danggui-Shaoyao- San (DSS) was conducted through body fluid index changes of rats using bio-impedance technology. METHODS A spleen deficiency-water dampness symptom rat model was established through an inappropriate diet combined with excess fatigue. Experimental rats were divided into a normal control group, a model control group, a positive drug control group (hydrochlorothiazide), a blood-activating group, a water-disinhibiting group, and a DSS group. Total Body Water/Body Weight (TBW%), extracellular fluid/total body water content (ECF%), intracellular fluid/total body water content (ICF%), extracellular fluid/intracellular fluid (ECF/ICF), fat mass/body weight (FM%), fat-free mass/body weight (FFM%), and fat mass/fat-free mass (FM/FFM) of 150 rats were detected by a Bio-Imp Vet Body analyzer. RESULTS The TBW% of the model control group increased significantly, and the FM/FFM was significantly reduced compared with the normal group (P < 0.05) (P < 0.01), showing symptoms of spleen deficiency and diarrhea; the TBW% of the blood-activating group, and the waterdisinhibiting group decreased significantly, and the FM/FFM increased significantly (P < 0.05) (P < 0.01). The TBW% and FM/FFM in the water-disinhibiting group had returned to nearnormal values compared with the model control group. The blood-activating and waterdisinhibiting split prescriptions in DSS are both effective in treating spleen deficiency-water dampness rats. Comparatively, the fluid-regulating effect of split prescriptions in DSS was even stronger than that of DSS as shown in the present study. CONCLUSIONS These findings suggest that using bio-impedance technology to measure body fluid indexes can pave a road for further exploring the molecular mechanism of the reason why the blood-activating and disinhibit-water split prescriptions in DSS are both effective in treating spleen deficiency-water dampness rats.
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Affiliation(s)
- Ran Chen
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Key Laboratory of Chinese Medicine Formula of Anhui Province, Hefei, 230012, PR China
| | - Mo Yang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Key Laboratory of Chinese Medicine Formula of Anhui Province, Hefei, 230012, PR China
| | - Can Peng
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application
| | - Dengke Yin
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application
| | - Yunjing Zhang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Key Laboratory of Chinese Medicine Formula of Anhui Province, Hefei, 230012, PR China
| | - Fan Xu
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, PR China
- Key Laboratory of Chinese Medicine Formula of Anhui Province, Hefei, 230012, PR China
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Vicente-Campos D, Sánchez-Jorge S, Martí L, Buffet J, Mendoza-Laiz N, Rodriguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicarro JL, Calvo-Lobo C. Skin Bioimpedance Analysis to Determine Cellular Integrity by Phase Angle in Women with Fibromyalgia: A Cross-Sectional Study. Biomedicines 2023; 11:3321. [PMID: 38137542 PMCID: PMC10741687 DOI: 10.3390/biomedicines11123321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Oxidative stress has been proposed as a significant part of the pathogenesis of fibromyalgia, and the phase angle in bioelectrical impedance analysis has been explored as a potential technique to screen oxidative abnormalities. This study recruited 35 women with fibromyalgia and 35 healthy women, who underwent bioelectrical impedance analysis and maximum isometric handgrip strength tests. Women with fibromyalgia showed lower bilateral handgrip strength (right hand: 16.39 ± 5.87 vs. 27.53 ± 4.09, p < 0.001; left hand: 16.31 ± 5.51 vs. 27.61 ± 4.14, p < 0.001), as well as higher body fat mass (27.14 ± 10.21 vs. 19.94 ± 7.25, p = 0.002), body fat percentage (37.80 ± 8.32 vs. 30.63 ± 7.77, p < 0.001), and visceral fat area (136.76 ± 55.31 vs. 91.65 ± 42.04, p < 0.01) compared with healthy women. There was no statistically significant difference in muscle mass between groups, but women with fibromyalgia showed lower phase angles in all body regions when compared with healthy control women (right arm: 4.42 ± 0.51 vs. 4.97 ± 0.48, p < 0.01; left arm: 4.23 ± 0.48 vs. 4.78 ± 0.50, p < 0.001; trunk: 5.62 ± 0.77 vs. 6.78 ± 0.84, p < 0.001; right leg: 5.28 ± 0.56 vs. 5.81 ± 0.60, p < 0.001; left leg: 5.07 ± 0.51 vs. 5.69 ± 0.58, p < 0.001; whole body: 4.81 ± 0.47 vs. 5.39 ± 0.49, p < 0.001). Moreover, whole-body phase-angle reduction was only predicted by the presence of fibromyalgia (R2 = 0.264; β = 0.639; F(1,68) = 24.411; p < 0.001). Our study revealed significantly lower phase angle values, lower handgrip strength, and higher fat levels in women with fibromyalgia compared to healthy controls, which are data of clinical relevance when dealing with such patients.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Sandra Sánchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Luis Martí
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Jorge Buffet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Nuria Mendoza-Laiz
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - J. L. Chicarro
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
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Ozmen GC, Mabrouk S, Nichols C, Berkebile J, Goossens Q, Gazi AH, Inan OT. Mid-Activity and At-Home Wearable Bioimpedance Elucidates an Interpretable Digital Biomarker of Muscle Fatigue. IEEE Trans Biomed Eng 2023; 70:3513-3524. [PMID: 37405890 PMCID: PMC11092386 DOI: 10.1109/tbme.2023.3290530] [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] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Muscle health and decreased muscle performance (fatigue) quantification has proven to be an invaluable tool for both athletic performance assessment and injury prevention. However, existing methods estimating muscle fatigue are infeasible for everyday use. Wearable technologies are feasible for everyday use and can enable discovery of digital biomarkers of muscle fatigue. Unfortunately, the current state-of-the-art wearable systems for muscle fatigue tracking suffer from either low specificity or poor usability. METHODS We propose using dual-frequency bioimpedance analysis (DFBIA) to non-invasively assess intramuscular fluid dynamics and thereby muscle fatigue. A wearable DFBIA system was developed to measure leg muscle fatigue of 11 individuals during a 13-day protocol consisting of exercise and unsupervised at-home portions. RESULTS We derived a digital biomarker of muscle fatigue, fatigue score, from the DFBIA signals that was able to estimate the percent reduction in muscle force during exercise with repeated-measures Pearson's r = 0.90 and mean absolute error (MAE) of 3.6%. This fatigue score also estimated delayed onset muscle soreness with repeated-measures Pearson's r = 0.83 and MAE = 0.83. Using at-home data, DFBIA was strongly associated with absolute muscle force of participants (n = 198, p < 0.001). CONCLUSION These results demonstrate the utility of wearable DFBIA for non-invasively estimating muscle force and pain through the changes in intramuscular fluid dynamics. SIGNIFICANCE The presented approach may inform development of future wearable systems for quantifying muscle health and provide a novel framework for athletic performance optimization and injury prevention.
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Elkalawy H, Sekhar P, Abosena W. Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review. Acute Crit Care 2023; 38:409-424. [PMID: 38052508 DOI: 10.4266/acc.2023.00703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/17/2023] [Indexed: 12/07/2023] Open
Abstract
Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.
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Affiliation(s)
- Hanan Elkalawy
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Pavan Sekhar
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Wael Abosena
- Department of Surgery, Faculty of Medicine, Tanta University, Gharbeya, Egypt
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Koch EB, Madsen JM, Wichmann S, Bestle MH, Itenov TS. Bioimpedance and Duration of Organ Dysfunction in Septic Shock-A Prospective Observational Study. J Intensive Care Med 2023; 38:966-974. [PMID: 37186782 DOI: 10.1177/08850666231175819] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Rationale: Bioimpedance may be a useful tool to guide fluid treatment and avoid organ dysfunction related to fluid overload. Objective: We examined the correlation between bioimpedance and organ dysfunction in patients with septic shock. Methods: Prospective observational study of adult intensive care unit patients fulfilling the sepsis-3 criteria. Bioimpedance was measured using a body composition monitor (BCM) and BioScan Touch i8 (MBS). We measured impedance at inclusion and after 24 h and reported the impedance, change in impedance, bioimpedance-derived fluid balance, and changes in bioimpedance-derived fluid balance. Organ markers on respiratory, circulatory, and kidney function and overall disease severity were ascertained on days 1-7. The effect of bioimpedance on the change in organ function was assessed by mixed effects linear models. We considered P < .01 as significant. Measurements and Main Results: Forty-nine patients were included. None of the single baseline measurements or derived fluid balances were associated with the course of organ dysfunction. Changes in impedance were associated with the course of overall disease severity (P < .001; with MBS), and with changes in noradrenaline dose (P < .001; with MBS) and fluid balance (P < .001; with BCM). The changes in bioimpedance-derived fluid balance were associated with changes in noradrenaline dose (P < .001; with BCM), cumulative fluid balances (P < .001; with MBS), and lactate concentrations (P < .001; with BCM). Conclusions: Changes in bioimpedance were correlated with the duration of overall organ failure, circulatory failure, and fluid status. Single measurements of bioimpedance were not associated with any changes in organ dysfunction.
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Affiliation(s)
- Ellen Bjerre Koch
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Janne M Madsen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sine Wichmann
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Copenhagen, Denmark
| | - Morten H Bestle
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Theis S Itenov
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Bellido D, García-García C, Talluri A, Lukaski HC, García-Almeida JM. Future lines of research on phase angle: Strengths and limitations. Rev Endocr Metab Disord 2023; 24:563-583. [PMID: 37043140 PMCID: PMC10090740 DOI: 10.1007/s11154-023-09803-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/13/2023]
Abstract
Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.
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Affiliation(s)
- Diego Bellido
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Ferrol, 15405, Ferrol, A Coruña, Spain
| | - Cristina García-García
- PhD Program in Biomedicine, Translational Research and New Health Technologies, Faculty of Medicine, Málaga University, 29010, Málaga, Spain
| | | | - Henry C Lukaski
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND, 58202, USA
| | - José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Virgen de La Victoria Hospital, Malaga University, 29010, Malaga, Spain.
- Centro de Investigación Biomédica en Red de La Fisiopatología de La Obesidad Y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010, Malaga, Spain.
- Málaga University, 29010, Málaga, Spain.
- Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, 29004, Málaga, Spain.
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11
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Türkmen M, Lauwigi T, Fechter T, Gries F, Fischbach A, Gries T, Rossaint R, Bleilevens C, Winnersbach P. Bioimpedance Analysis as Early Predictor for Clot Formation Inside a Blood-Perfused Test Chamber: Proof of Concept Using an In Vitro Test-Circuit. BIOSENSORS 2023; 13:394. [PMID: 36979606 PMCID: PMC10046027 DOI: 10.3390/bios13030394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
Clot formation inside a membrane oxygenator (MO) due to blood-to-foreign surface interaction represents a frequent complication during extracorporeal membrane oxygenation. Since current standard monitoring methods of coagulation status inside the MO fail to detect clot formation at an early stage, reliable sensors for early clot detection are in demand to reduce associated complications and adverse events. Bioimpedance analysis offers a monitoring concept by integrating sensor fibers into the MO. Herein, the feasibility of clot detection via bioimpedance analysis is evaluated. A custom-made test chamber with integrated titanium fibers acting as sensors was perfused with heparinized human whole blood in an in vitro test circuit until clot formation occurred. The clot detection capability of bioimpedance analysis was directly compared to the pressure difference across the test chamber (ΔP-TC), analogous to the measurement across MOs (ΔP-MO), the clinical gold standard for clot detection. We found that bioimpedance measurement increased significantly 8 min prior to a significant increase in ΔP-TC, indicating fulminant clot formation. Experiments without clot formation resulted in a lack of increase in bioimpedance or ΔP-TC. This study shows that clot detection via bioimpedance analysis under flow conditions in a blood-perfused test chamber is generally feasible, thus paving the way for further investigation.
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Affiliation(s)
- Muhammet Türkmen
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Tobias Lauwigi
- Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany
| | - Tamara Fechter
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Fabienne Gries
- Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany
| | - Anna Fischbach
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Thomas Gries
- Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Christian Bleilevens
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Patrick Winnersbach
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
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12
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Abstract
Measurement of phase angle using bioimpedance analysis (BIA) has become popular as an index of so-called "cellular health". What precisely is meant by this term is not always clear but strong relationships have been found between cellular water status (the relative amounts of extra- and intracellular water), cell membrane integrity and cellular mass. Much of the current research is empirical observation and frequently pays little regard to the underlying biophysical models that underpin the BIA technique or attempts to provide mechanistic explanations for the observations. This brief review seeks to provide a basic understanding of the electrical models frequently used to describe the passive electrical properties of tissues with particular focus on phase angle. In addition, it draws attention to some practical concerns in the measurement of phase angle and notes the additional understanding that can be gained when phase angle are obtained with bioimpedance spectroscopy (BIS) rather than single frequency BIA (SFBIA) along with the potential for simulation modelling.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Steven Brantlov
- Department of Procurement and Clinical Engineering, Central Denmark Region, Aarhus, Denmark
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13
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Schneditz D, Mussnig S, Krenn S, Hecking M. Revisiting the concept of constant tissue conductivities for volume estimation in dialysis patients using bioimpedance spectroscopy. Int J Artif Organs 2023; 46:67-73. [PMID: 36550616 DOI: 10.1177/03913988221145457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
RATIONALE Current estimation of body fluid volumes in hemodialysis patients using bioimpedance analysis assumes constant specific electrical characteristics of biological tissues despite a large variation in plasma Na+ concentrations [Na+], ranging from 130 to 150 mmol/L. Here, we examined the potential effect of variable [Na+] on bioimpedance-derived volume overload. METHOD Volumes were calculated from published whole-body extra- and intracellular resistance data and relationships using either "standard" or "revised" specific electrical characteristics modeled as functions of [Na+]. RESULT With "standard" assumptions, volumes increased with increasing [Na+]. The increase in volume overload was about 0.5 dm3 and 3% of extracellular volume per 10 mmol/dm3 of [Na+] in a 75 kg patient. This increase was abolished when the same bioimpedance data were analyzed under "revised" conditions. DISCUSSION The overestimation in extracellular volume overload in the range of 0.5 dm3 per 10 mmol/dm3 [Na+] perfectly matches the positive relationship determined in a large cohort of hemodialysis patients. The bias may be considered moderate when interpreting data of individual patients, but may become important when comparing data of larger patient groups. The bias disappears when analysis of bioimpedance data accounts for differences in tissue electrical properties, using individual [Na+].
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Affiliation(s)
- Daniel Schneditz
- Otto Loewi Research Center, Division of Physiology, Medical University of Graz, Graz, Austria
| | - Sebastian Mussnig
- Department of Medicine III, Division for Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - Simon Krenn
- Department of Medicine III, Division for Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.,Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Manfred Hecking
- Department of Medicine III, Division for Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
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14
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Schotman J, Rolleman N, van Borren M, Wetzels J, Kloke H, Reichert L, de Boer H. Accuracy of Bioimpedance Spectroscopy in the Detection of Hydration Changes in Patients on Hemodialysis. J Ren Nutr 2023; 33:193-200. [PMID: 34922812 DOI: 10.1053/j.jrn.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/16/2021] [Accepted: 11/03/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The body composition monitor (BCM) is a bioimpedance spectroscopy device, specifically developed for patients on hemodialysis (HD) to improve ultrafiltration (UF) programming, based on an objective assessment of the degree of overhydration (OH) at the start of HD. However, its acceptance in clinical practice remains limited because of concerns about the accuracy at the individual level. The aim of this study is to examine the performance of the BCM and to identify means of improvement. METHODS Precision of the OH estimate was assessed by 6 consecutive measurements in 24 patients on HD. Accuracy was examined in 45 patients, by comparing the change in OH (ΔOH) during HD with UF volume. Accuracy was considered acceptable if the volume error in individual patients was ≤0.5 L. RESULTS The OH estimate had an analytical precision of 1.0 ± 0.4%. The correlation between UF volume and ΔOH was moderate (Slope = 0.66, R2 = 0.44, P < .001) and indicated underestimation of UF volume, in particular for high UF volumes. Accuracy at individual level was highly variable. A volume error >0.5 L occurred in 44% of patients. Accuracy improved over the course of HD, with a decrease in total error range from 2.3 L in the first hour to 1.1 L in the final hour of HD. CONCLUSIONS The accuracy of BCM volume change estimates is highly variable and below requirements of daily practice. Improvement may be achieved by a switch to an end-of-HD measurement.
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Affiliation(s)
- Jantine Schotman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
| | - Nick Rolleman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Marcel van Borren
- Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, the Netherlands
| | - Jack Wetzels
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Heinrich Kloke
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Louis Reichert
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Hans de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
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15
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Garr Barry V, Chiang JL, Bowman KG, Johnson KD, Gower BA. Bioimpedance-Derived Membrane Capacitance: Clinically Relevant Sources of Variability, Precision, and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:686. [PMID: 36613010 PMCID: PMC9819400 DOI: 10.3390/ijerph20010686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Membrane capacitance (CM), a bioimpedance-derived measure of cell membrane health, has been suggested as an indicator of health status. However, there are few published data to support its use in clinical settings. Hence, this study evaluated clinically relevant sources of variation, precision, and reliability of CM measurements. This longitudinal study included 60 premenopausal women. Sources of variability (e.g., demographics, body composition, serum measures, diet) were identified by stepwise regression. Precision and reliability were assessed by the coefficient of variation (CV), intraclass correlation coefficients (ICC), and technical error of the measurement (TEM) for intra-day (30 min apart) and inter-day measurements (7-14 days apart). Body composition, temperature, and metabolic activity were identified as sources of variability. CM measurements had high precision (CV = 0.42%) and high reliability for intra-day (ICC = 0.996) and inter-day (ICC = 0.959) measurements, independent of menstrual cycle and obesity status. Our results showed that CM measurements are sensitive to clinical factors and have high precision and reliability. The results of this study suggest that CM is sufficiently reliable for health status monitoring in conditions with variation in body composition, metabolic activity, or body temperature among premenopausal women.
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Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Division of Clinical Research, School of Medicine in St. Louis, Washington University, St. Louis, MO 63108, USA
| | - Jasmine L. Chiang
- Department of Obstetrics and Gynecology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Kaylan G. Bowman
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Kristina D. Johnson
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Barbara A. Gower
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
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16
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Abasi S, Aggas JR, Garayar-Leyva GG, Walther BK, Guiseppi-Elie A. Bioelectrical Impedance Spectroscopy for Monitoring Mammalian Cells and Tissues under Different Frequency Domains: A Review. ACS MEASUREMENT SCIENCE AU 2022; 2:495-516. [PMID: 36785772 PMCID: PMC9886004 DOI: 10.1021/acsmeasuresciau.2c00033] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 05/13/2023]
Abstract
Bioelectrical impedance analysis and bioelectrical impedance spectroscopy (BIA/BIS) of tissues reveal important information on molecular composition and physical structure that is useful in diagnostics and prognostics. The heterogeneity in structural elements of cells, tissues, organs, and the whole human body, the variability in molecular composition arising from the dynamics of biochemical reactions, and the contributions of inherently electroresponsive components, such as ions, proteins, and polarized membranes, have rendered bioimpedance challenging to interpret but also a powerful evaluation and monitoring technique in biomedicine. BIA/BIS has thus become the basis for a wide range of diagnostic and monitoring systems such as plethysmography and tomography. The use of BIA/BIS arises from (i) being a noninvasive and safe measurement modality, (ii) its ease of miniaturization, and (iii) multiple technological formats for its biomedical implementation. Considering the dependency of the absolute and relative values of impedance on frequency, and the uniqueness of the origins of the α-, β-, δ-, and γ-dispersions, this targeted review discusses biological events and underlying principles that are employed to analyze the impedance data based on the frequency range. The emergence of BIA/BIS in wearable devices and its relevance to the Internet of Medical Things (IoMT) are introduced and discussed.
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Affiliation(s)
- Sara Abasi
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Cell
Culture Media Services, Cytiva, 100 Results Way, Marlborough, Massachusetts 01752, United States
| | - John R. Aggas
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Test
Development, Roche Diagnostics, 9115 Hague Road, Indianapolis, Indiana 46256, United
States
| | - Guillermo G. Garayar-Leyva
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Electrical and Computer Engineering, Texas A&M University, 400 Bizzell Street, College Station, Texas 77843, United States
| | - Brandon K. Walther
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Cardiovascular Sciences, Houston Methodist
Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Anthony Guiseppi-Elie
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Electrical and Computer Engineering, Texas A&M University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Cardiovascular Sciences, Houston Methodist
Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
- ABTECH Scientific,
Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, Virginia 23219, United
States
- . Tel.: +1(804)347.9363.
Fax: +1(804)347.9363
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17
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Cancello R, Brunani A, Brenna E, Soranna D, Bertoli S, Zambon A, Lukaski HC, Capodaglio P. Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment. Rev Endocr Metab Disord 2022; 24:451-464. [PMID: 36484943 PMCID: PMC9735068 DOI: 10.1007/s11154-022-09774-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Phase angle (PhA) is a recently proposed marker of nutritional status in many clinical conditions. Its use in patients with obesity presents different critical concerns due to the higher variability of the two measured parameters (resistance, R, and reactance, Xc) that contribute to the determination of PhA. Controversial is the relation between PhA and BMI that might vary with graded levels of obesity due to the variation in fat and free fat mass. Obesity is frequently associated with metabolic, hepatic, cardiovascular and kidney diseases that introduce variations in PhA values, in relation to multimorbidity and severity degree of these diseases. It is reported that the improvement of clinical condition is associated with a positive change in PhA. Also, the treatment of obesity with weight loss might confirm this effect, but with different responses in relation to the type and duration of the intervention applied. In fact, the effect appears not only related to the percentage of weight loss but also the possible loss of free fat mass and the nutritional, metabolic and structural modifications that might follow each therapeutic approach to decrease body weight. We can conclude that the PhA could be used as marker of health status in patients with obesity supporting an appropriate weight loss intervention to monitor efficacy and fat free mass preservation.
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Affiliation(s)
- Raffaella Cancello
- grid.418224.90000 0004 1757 9530Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Amelia Brunani
- grid.418224.90000 0004 1757 9530Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, Piancavallo Verbania, Italy
| | - Ettore Brenna
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Davide Soranna
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Simona Bertoli
- grid.418224.90000 0004 1757 9530Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- grid.4708.b0000 0004 1757 2822Department of Food, Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy
| | - Antonella Zambon
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
- grid.7563.70000 0001 2174 1754Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Henry C. Lukaski
- grid.266862.e0000 0004 1936 8163Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, USA
| | - Paolo Capodaglio
- grid.418224.90000 0004 1757 9530Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, Piancavallo Verbania, Italy
- grid.7605.40000 0001 2336 6580Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Torino, 10126 Torino, Italy
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18
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Ozmen GC, Nichols C, Mabrouk S, Berkebile J, Lan L, Inan OT. Wearable Mid-Activity Measurement of Lower Limb Electrical Bioimpedance Estimates Vertical Ground Reaction Force Features. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:91-94. [PMID: 36085606 DOI: 10.1109/embc48229.2022.9871267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In recent years, wearable mid-activity electrical bioimpedance (EBI) sensing has been used to non-invasively track changes in edema and swelling levels within human joints. While the physiological origin of the changes in mid-activity EBI measurements have been demonstrated, EBI waveform patterns during activity have not been explored. In this work, we present a novel approach to extract waveform features from EBI measurements during gait to estimate the changes in vertical ground reaction forces (vGRF) corresponding to fatigue. Wearable EBI and vGRF data were measured from six healthy subjects during an asymmetric fatiguing protocol. For the exercised leg, the first peak of vGRF corresponding to the initial phase of simple support, decreased significantly and the loading rate increased significantly between the beginning and the end of the protocol. No significant change in these parameters were observed for the control leg. The first peak of vGRF and loading rate during the protocol (15 walking sessions) were correlated to the multi-frequency EBI features with mean Pearson's r=0.81 and r=0.777, respectively. The results of this proof-of-concept study demonstrate the feasibility of estimating biomechanical parameters during activity with wearable EBI. Clinical Relevance - The proposed wearable system and associated signal processing could enable convenient tracking of changes in vGRFs during daily living activities, allowing physiotherapists and doctors to remotely monitor the progress and adherence of their patients and thereby reducing the number of clinical visits.
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19
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Mohamed M, Matthie J, Fan SL. Bioimpedance spectroscopy: Is a picture worth a thousand words? Semin Dial 2022. [PMID: 35466475 DOI: 10.1111/sdi.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/22/2022] [Accepted: 04/01/2022] [Indexed: 11/29/2022]
Abstract
Volume status can be difficult to assess in dialysis patients. Peripheral edema, elevated venous pressure, lung crackles, and hypertension are taught as signs of fluid overload, but sensitivity and specificity are poor. Bioimpedance technology has evolved from early single frequency to multifrequency machines which apply spectroscopic analysis (BIS), modeling data to physics-based mixture theory. Bioimpedance plots can aid the evaluation of hydration status and body composition. The challenge remains how to use this information to manage dialysis populations, particularly as interventions to improve over hydration, sarcopenia, and adiposity are not without side effects. It is therefore of no surprise that validation studies for BIS use in peritoneal dialysis patients are limited, and results from clinical trials are inconsistent and conflicting. Despite these limitations, BIS has clinical utility with potential to accurately evaluate small changes in body tissue components. This article explains the information a BIS plot ("picture") can provide and how it can contribute to the overall clinical assessment of a patient. However, it remains the role of the clinician to integrate information and devise treatment strategies to optimize competing patient risks, fluid and nutrition status, effects of high glucose PD fluids on membrane function, and quality of life issues.
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Affiliation(s)
- Maha Mohamed
- Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK
| | | | - Stanley L Fan
- Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK
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20
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de Borba EL, Ceolin J, Ziegelmann PK, Bodanese LC, Gonçalves MR, Cañon-Montañez W, Mattiello R. Phase angle of bioimpedance at 50 kHz is associated with cardiovascular diseases: systematic review and meta-analysis. Eur J Clin Nutr 2022; 76:1366-1373. [PMID: 35414661 DOI: 10.1038/s41430-022-01131-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 01/19/2023]
Abstract
The phase angle of bioimpedance is an important prognostic tool in clinical practice. The aim of this study was to investigate the association between phase angle and cardiovascular diseases. Electronic searches were carried out on MEDLINE, EMBASE, Cochrane, SCIELO, LILACS, CINAHL, Scopus, and the Web of Science. The PECO was "P" adults over 18 years of age, "E" the presence of cardiovascular disease, "C" absence of cardiovascular disease, and "O" phase angle values. The phase-angle means difference (MD) was analyzed separately by sex. Subgroup metanalysis with age, body mass index, and heart failure disease and meta-regressions were analyzed with random-effects models. Sensitivity analysis was performed considering only studies with high quality. The heterogeneity among studies was assessed using the Q-Cochran test and I² statistics. Four-hundred-thirty-nine articles were identified, and 22 studies were included in this systematic review, totaling 10.010 participants. Eight studies met the criteria for the meta-analysis, involving 2164 participants. The phase angle (PA) was measured at 50 kHz frequency in all studies. Individuals with cardiovascular disease had a smaller PA compared to the control group, for both males (MD -0.70; 95% CI -1.01 to -0.39) and females (MD -0.76; 95% CI -1.39 to -0.13). In the sensitivity analysis, in men, the quality of studies (P < 0.01), and in women, heart failure (P < 0.01) was significantly different between groups.The values of the phase angle were lower in individuals with cardiovascular disease than in control subjects. This result reinforces the importance of this tool in clinical practice, highlighting its potential to assess health status. Registration: The systematic review protocol was registered in the PROSPERO database as CRD42020164178.
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Affiliation(s)
| | - Jamile Ceolin
- Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brasil
| | | | - Luiz Carlos Bodanese
- Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brasil
| | | | | | - Rita Mattiello
- Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brasil.
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21
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Preoperative volume assessment using bioelectrical impedance analysis for minimizing blood loss during hepatic resection. HPB (Oxford) 2022; 24:568-574. [PMID: 34702628 DOI: 10.1016/j.hpb.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Maintaining low central venous pressure (CVP) is an effective strategy to reduce blood loss during hepatic resection. As an alternative to measuring CVP, which requires the placement of a central venous catheter, bioelectrical impedance analysis (BIA) is a noninvasive method recently used for monitoring volume status in critically ill patients. METHODS We investigated 192 patients who underwent hepatic resection from January 2017 to December 2020. The ratio of extracellular water:total body water (ECW/TBW), as an index of volume status, was measured using InBody S10 (Biospace, Seoul, Korea). The correlation between the ECW/TBW and CVP was determined, and their influences on operative outcomes were analyzed. RESULTS ECW/TBW and CVP showed a significant correlation; an ECW/TBW <0.378 correlated with a CVP <5 mmHg (R2 = 0.839, P<0.001). Estimated blood loss (EBL) was significantly increased in patients with an ECW/TBW ≥0.378 compared to those with a ratio <0.378 (508 ± 321 vs. 324 ± 193, mL, P<0.001). Identified predictors for an EBL ≥500 mL were operative time (odds ratio [OR], 1.008; 95% confidence interval [CI], 1.001-1.015; P = 0.021) and an ECW/TBW <0.378 (OR, 0.263; 95% CI, 0.121-0.572; P = 0.001). CONCLUSIONS BIA can be utilized for preoperative volume assessment to minimize blood loss during hepatic resection.
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22
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Ward LC, Wells JCK, Lyons-Reid J, Tint MT. Individualized body geometry correction factor (K B) for use when predicting body composition from bioimpedance spectroscopy. Physiol Meas 2022; 43. [PMID: 35294931 DOI: 10.1088/1361-6579/ac5e83] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Prediction of body composition from bioimpedance spectroscopy (BIS) measurements using mixture theory-based biophysical modelling invokes a factor (KB) to account for differing body geometry (or proportions) between individuals. To date, a single constant value is commonly used. The aim of this study was to investigate variation in KB across individuals and to develop a procedure for estimating an individualized KBvalue. APPROACH Publicly available body dimension data, primarily from the garment industry, were used to calculate KBvalues for individuals of varying body sizes across the life-span. The 3-D surface relationship between weight, height and KB, was determined and used to create look-up tables to enable estimation of KBin individuals based on height and weight. The utility of the proposed method was assessed by comparing body composition predictions from BIS using either a constant KBvalue or the individualized value. RESULTS Computed KB values were well fitted to height and weight by a 3-D surface (R2 = 0.988). Body composition was predicted more accurately compared to reference methods when using individualized KBthan a constant value in infants and children but improvement in prediction was less in adults particularly those with high body mass index. SIGNIFICANCE Prediction of body composition from BIS and mixture theory is improved by using an individualized body proportion factor in those of small body habitus, e.g. children. Improvement is small in adults or non-existent in those of large body size. Further improvements may be possible by incorporating a factor to account for trunk size, i.e., waist circumference.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD 4072, Brisbane, 4072, AUSTRALIA
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, London, London, WC1N1EH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Jaz Lyons-Reid
- The University of Auckland Liggins Institute, University of Auckland, 85 Park Road,, Grafton, Auckland, Auckland, Auckland, 1023, NEW ZEALAND
| | - Mya Thway Tint
- Agency for Science , Technology and Research (A*STAR), Singapore Institute for Clinical Sciences, #20-10 Fusionopolis Way,, Connexis, North Tower,, Singapore, 138632, SINGAPORE
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Sun L, Li Q, Sun Z, Duan S, Nie G, Dong J, Zhang C, Zeng M, Sun B, Yuan Y, Wang N, Mao H, Xing C, Zhang B. Impact of Overhydration on Left Ventricular Hypertrophy in Patients With Chronic Kidney Disease. Front Nutr 2022; 9:761848. [PMID: 35284436 PMCID: PMC8916701 DOI: 10.3389/fnut.2022.761848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveVolume overload is a frequent feature related to left ventricular hypertrophy (LVH) in dialysis patients, but its influence on patients with chronic kidney disease (CKD) not on dialysis has not been accurately uncovered. This article was to examine the relationship between overhydration (OH) and LVH in patients with CKD not yet on dialysis.MethodsA total of 302 patients with CKD stages 1–4 were included. Participants were divided into different subgroups according to occurring LVH or not, and OH tertiles. Clinical and laboratory parameters were compared among groups. Spearman correlation analyses were adopted to explore the relationships of echocardiographic findings with the clinical and laboratory characteristics. Binary logistic regression models were performed to estimate the odds ratios (ORs) for the associations between OH and LVH. Restricted cubic splines were implemented to assess the possible non-linear relationship between OH and LVH. LVH was defined as left ventricular mass index (LVMI) >115 g/m2 in men and >95 g/m2 in women.ResultsOf the enrolled patients with CKD, the mean age was 45.03 ± 15.14 years old, 165 (54.6%) cases were men, and 65 (21.5%) cases had LVH. Spearman correlation analyses revealed that OH was positively correlated with LVMI (r = 0.263, P < 0.001). After adjustment for age, gender, diabetes, body mass index (BMI), systolic blood pressure (SBP), hemoglobin, serum albumin, estimated glomerular filtration rate (eGFR), and logarithmic transformation of urinary sodium and urinary protein, multivariate logistic regression analyses demonstrated that both the middle and highest tertile of OH was associated with increased odds of LVH [OR: 3.082 (1.170–8.114), P = 0.023; OR: 4.481 (1.332–15.078), P = 0.015, respectively], in comparison to the lowest tierce. Restricted cubic spline analyses were employed to investigate the relationship between OH and LVH, which unfolded a significant non-linear association (P for non-linear = 0.0363). Furthermore, patients were divided into two groups according to CKD stages. The multivariate logistic regression analyses uncovered that increased odds of LVH were observed in the middle and the highest tertile of OH [OR: 3.908 (0.975–15.670), P = 0.054; OR: 6.347 (1.257–32.054), P = 0.025, respectively] in patients with stages 1–2.ConclusionThese findings suggest that a higher level of OH was associated with a higher occurrence of LVH in patients with CKD not on dialysis, especially in patients with CKD stages 1–2.
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Hu C, Wang T, Leung KWC, Li L, Tong RKY. Muscle Electrical Impedance Properties and Activation Alteration After Functional Electrical Stimulation-Assisted Cycling Training for Chronic Stroke Survivors: A Longitudinal Pilot Study. Front Neurol 2022; 12:746263. [PMID: 34975713 PMCID: PMC8716001 DOI: 10.3389/fneur.2021.746263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Electrical impedance myography (EIM) is a sensitive assessment for neuromuscular diseases to detect muscle inherent properties, whereas surface electromyography (sEMG) is a common technique for monitoring muscle activation. However, the application of EIM in detecting training effects on stroke survivors is relatively few. This study aimed to evaluate the muscle inherent properties and muscle activation alteration after functional electrical stimulation (FES)-assisted cycling training to chronic stroke survivors. Fifteen people with chronic stroke were recruited for 20 sessions of FES-assisted cycling training (40 min/session, 3–5 sessions/week). The periodically stimulated and assessed muscle groups were quadriceps (QC), tibialis anterior (TA), hamstrings (HS), and medial head of gastrocnemius (MG) on the paretic lower extremity. EIM parameters [resistance (R), reactance (X), phase angle (θ), and anisotropy ratio (AR)], clinical scales (Fugl-Meyer Lower Extremity (FMA-LE), Berg Balance Scale (BBS), and 6-min walking test (6MWT)] and sEMG parameters [including root-mean square (RMS) and co-contraction index (CI) value] were collected and computed before and after the training. Linear correlation analysis was conducted between EIM and clinical scales as well as between sEMG and clinical scales. The results showed that motor function of the lower extremity, balance, and walking performance of subjects improved after the training. After training, θ value of TA (P = 0.014) and MG (P = 0.017) significantly increased, and AR of X (P = 0.004) value and AR of θ value (P = 0.041) significantly increased on TA. The RMS value of TA decreased (P = 0.022) and a significant reduction of CI was revealed on TA/MG muscle pair (P < 0.001). Significant correlation was found between EIM and clinical assessments (AR of X value of TA and FMA-LE: r = 0.54, P = 0.046; X value of TA and BBS score: 0.628, P = 0.016), and between sEMG and clinical scores (RMS of TA and BBS score: r = −0.582, P = 0.029). This study demonstrated that FES-assisted cycling training improved lower limb function by developing coordinated muscle activation and facilitating an orderly myofiber arrangement. The current study also indicated that EIM can jointly evaluate lower extremity function alteration with sEMG after rehabilitation training. Clinical Trail Registration: The study was registered on the Clinical Trial Registry (trial registration number: NCT 03208439, https://clinicaltrials.gov/ct2/show/NCT03208439).
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Affiliation(s)
- Chengpeng Hu
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tong Wang
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kenry W C Leung
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
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Assessment of volemia status using ultrasound examination of the inferior vena cava and spectroscopic bioimpendance in hemodialysis patients. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200513131l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Hypervolemia is an important risk factor for the development of cardiovascular morbidity and mortality in patients treated with regular hemodialysis. There is still no reliable method for assessing the status of volemia in these patients. The aim of the study was to assess the status of volemia in patients treated with regular hemodialysis by measuring the parameters of the inferior vena cava (IVC) and bioimpedance. Methods. The effect of hemodialysis treatment on ultrasound parameters of the IVC, as well as on the parameters measured by bioimpedance, was examined before and after hemodialysis. The values of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured both before and after hemodialysis. Forty-five patients were involved in this non-interventional cross-section study, including the patients treated with standard bicarbonate dialysis. According to the interdialytic yield, the patients were divided into three groups: I (up to 2,000 mL), II (2,000?3,000 mL), and III (over 3,000 mL). Results. The values of the IVC parameters and the parameters measured with bioimpedance were significantly lower after treatment with hemodialysis (p < 0.005). The third group of patients had a significantly higher total fluid volume in the body com-pared to the group I, as well as a significantly greater volume of extracellular fluid (p < 0.005). The significantly lower values of NT-proBNP in all groups (p < 0.005) were detected after hemodialysis. After treatment with hemodialysis, a positive correlation was observed between the concentration of NT-proBNP in the serum and the extracellular/intracellular water ratio. However, the correlation between NT-proBNP concentration and total fluid measured by bioimpedance spectroscopy did not reach statistical significance. Conclusion. Measurement of the IVC ultrasound parameters and volemia parameters using bioimpedance significantly contributes to the assessment of the status of volemia. Nevertheless, it cannot be used as a separate parameter, only in combination with all other methods.
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Madsen JM, Wichmann S, Bestle MH, Itenov TS. Bioimpedance as a measure of fluid status in critically ill patients: A systematic review. Acta Anaesthesiol Scand 2021; 65:1155-1167. [PMID: 34036559 DOI: 10.1111/aas.13924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Precise measurements of fluid status lack valid methods. Bioimpedance is an attractive diagnostic tool because it is noninvasive, quick, and relatively cheap. This systematic review aims to assess the existing evidence of bioimpedance as an accurate measure of fluid status in critically ill patients. DATA SOURCES PubMed and Embase up till March 2021 were systematically searched (PROSPERO: CRD42020157436). STUDY SELECTION Eligibility criteria were studies reporting original data from cohorts of adult patients in intensive care units and doing at least one whole-body bioimpedance and one reference test. In addition, studies assessing internal reproducibility were included. DATA EXTRACTION An extraction form was designed for the purpose. DATA SYNTHESIS Nine hundred five studies were screened for eligibility, and 28 studies, comprising 1482 individual patients, were included in the final analysis. Eight studies compared bioimpedance with a gold standard, and two of those reported the results adequate. We found a low mean difference, but the 95% limits of agreements had wide limits. The remaining studies applied different surrogates as reference tests. Correlations ranged from 0.05 to 0.99. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty of evidence for all outcomes was very low. CONCLUSIONS The accuracy of bioimpedance as a measure for fluids in critically ill patients in the intensive care unit cannot be determined. Due to the lack of a gold standard, numerous studies compared bioimpedance with surrogate outcomes with great variability in both designs and results. Assessing the internal reproducibility of bioimpedance had the same limitations, but the studies overall reported good internal reproducibility.
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Affiliation(s)
- Janne M. Madsen
- Department of Anaesthesiology Copenhagen University Hospital—North Zealand Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Sine Wichmann
- Department of Anaesthesiology Copenhagen University Hospital—North Zealand Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Morten H. Bestle
- Department of Anaesthesiology Copenhagen University Hospital—North Zealand Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Theis S. Itenov
- Department of Anaesthesiology Copenhagen University Hospital—North Zealand Copenhagen Denmark
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Lyons-Reid J, Derraik JGB, Ward LC, Tint MT, Kenealy T, Cutfield WS. Bioelectrical impedance analysis for assessment of body composition in infants and young children-A systematic literature review. Clin Obes 2021; 11:e12441. [PMID: 33565254 DOI: 10.1111/cob.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 01/10/2023]
Abstract
Bioelectrical impedance analysis (BIA) is an easy to use, portable tool, but the accuracy of the technique in infants and young children (<24 months) remains unclear. A systematic literature review was conducted to identify studies that have developed and validated BIA equations in this age group. MEDLINE, Scopus, EMBASE, and CENTRAL were searched for relevant literature published up until June 30, 2020, using terms related to bioelectrical impedance, body composition, and paediatrics. Two reviewers independently screened studies for eligibility, resulting in 15 studies that had developed and/or validated equations. Forty-six equations were developed and 34 validations were conducted. Most equations were developed in young infants (≤6 months), whereas only seven were developed among older infants and children (6-24 months). Most studies were identified as having a high risk of bias, and only a few included predominantly healthy children born at term. Using the best available evidence, BIA appears to predict body composition at least as well as other body composition tools; however, among younger infants BIA may provide little benefit over anthropometry-based prediction equations. Currently, none of the available equations can be recommended for use in research or in clinical practice.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- NCD Centre of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- A Better Start-National Science Challenge, University of Auckland, Auckland, New Zealand
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Bellafronte NT, Vega-Piris L, Cuadrado GB, Chiarello PG. Performance of Bioelectrical Impedance and Anthropometric Predictive Equations for Estimation of Muscle Mass in Chronic Kidney Disease Patients. Front Nutr 2021; 8:683393. [PMID: 34095195 PMCID: PMC8177428 DOI: 10.3389/fnut.2021.683393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Patients with chronic kidney disease (CKD) are vulnerable to loss of muscle mass due to several metabolic alterations derived from the uremic syndrome. Reference methods for body composition evaluation are usually unfeasible in clinical settings. Aims: To evaluate the accuracy of predictive equations based on bioelectrical impedance analyses (BIA) and anthropometry parameters for estimating fat free mass (FFM) and appendicular FFM (AFFM), compared to dual energy X-ray absorptiometry (DXA), in CKD patients. Methods: We performed a longitudinal study with patients in non-dialysis-dependent, hemodialysis, peritoneal dialysis and kidney transplant treatment. FFM and AFFM were evaluated by DXA, BIA (Sergi, Kyle, Janssen and MacDonald equations) and anthropometry (Hume, Lee, Tian, and Noori equations). Low muscle mass was diagnosed by DXA analysis. Intra-class correlation coefficient (ICC), Bland-Altman graphic and multiple regression analysis were used to evaluate equation accuracy, linear regression analysis to evaluate bias, and ROC curve analysis and kappa for reproducibility. Results: In total sample and in each CKD group, the predictive equation with the best accuracy was AFFMSergi (men, n = 137: ICC = 0.91, 95% CI = 0.79–0.96, bias = 1.11 kg; women, n = 129: ICC = 0.94, 95% CI = 0.92–0.96, bias = −0.28 kg). AFFMSergi also presented the best performance for low muscle mass diagnosis (men, kappa = 0.68, AUC = 0.83; women, kappa = 0.65, AUC = 0.85). Bias between AFFMSergi and AFFMDXA was mainly affected by total body water and fat mass. None of the predictive equations was able to accurately predict changes in AFFM and FFM, with all ICC lower than 0.5. Conclusion: The predictive equation with the best performance to asses muscle mass in CKD patients was AFFMSergi, including evaluation of low muscle mass diagnosis. However, assessment of changes in body composition was biased, mainly due to variations in fluid status together with adiposity, limiting its applicability for longitudinal evaluations.
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Affiliation(s)
- Natália Tomborelli Bellafronte
- Post-graduate Program in Health Sciences, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Lorena Vega-Piris
- Methodology Unit, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Paula Garcia Chiarello
- Department of Health Sciences, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, Brazil
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Lyons-Reid J, Ward LC, Tint MT, Kenealy T, Godfrey KM, Chan SY, Cutfield WS. The influence of body position on bioelectrical impedance spectroscopy measurements in young children. Sci Rep 2021; 11:10346. [PMID: 33990622 PMCID: PMC8121940 DOI: 10.1038/s41598-021-89568-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022] Open
Abstract
Bioelectrical impedance techniques are easy to use and portable tools for assessing body composition. While measurements vary according to standing vs supine position in adults, and fasting and bladder voiding have been proposed as additional important influences, these have not been assessed in young children. Therefore, the influence of position, fasting, and voiding on bioimpedance measurements was examined in children. Bioimpedance measurements (ImpediMed SFB7) were made in 50 children (3.38 years). Measurements were made when supine and twice when standing (immediately on standing and after four minutes). Impedance and body composition were compared between positions, and the effect of fasting and voiding was assessed. Impedance varied between positions, but body composition parameters other than fat mass (total body water, intra- and extra-cellular water, fat-free mass) differed by less than 5%. There were no differences according to time of last meal or void. Equations were developed to allow standing measurements of fat mass to be combined with supine measurements. In early childhood, it can be difficult to meet requirements for fasting, voiding, and lying supine prior to measurement. This study provides evidence to enable standing and supine bioimpedance measurements to be combined in cohorts of young children.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand.,School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
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Covi E, Donati E, Liang X, Kappel D, Heidari H, Payvand M, Wang W. Adaptive Extreme Edge Computing for Wearable Devices. Front Neurosci 2021; 15:611300. [PMID: 34045939 PMCID: PMC8144334 DOI: 10.3389/fnins.2021.611300] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/24/2021] [Indexed: 11/13/2022] Open
Abstract
Wearable devices are a fast-growing technology with impact on personal healthcare for both society and economy. Due to the widespread of sensors in pervasive and distributed networks, power consumption, processing speed, and system adaptation are vital in future smart wearable devices. The visioning and forecasting of how to bring computation to the edge in smart sensors have already begun, with an aspiration to provide adaptive extreme edge computing. Here, we provide a holistic view of hardware and theoretical solutions toward smart wearable devices that can provide guidance to research in this pervasive computing era. We propose various solutions for biologically plausible models for continual learning in neuromorphic computing technologies for wearable sensors. To envision this concept, we provide a systematic outline in which prospective low power and low latency scenarios of wearable sensors in neuromorphic platforms are expected. We successively describe vital potential landscapes of neuromorphic processors exploiting complementary metal-oxide semiconductors (CMOS) and emerging memory technologies (e.g., memristive devices). Furthermore, we evaluate the requirements for edge computing within wearable devices in terms of footprint, power consumption, latency, and data size. We additionally investigate the challenges beyond neuromorphic computing hardware, algorithms and devices that could impede enhancement of adaptive edge computing in smart wearable devices.
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Affiliation(s)
| | - Elisa Donati
- Institute of Neuroinformatics, University of Zurich, Eidgenössische Technische Hochschule Zürich (ETHZ), Zurich, Switzerland
| | - Xiangpeng Liang
- Microelectronics Lab, James Watt School of Engineering, University of Glasgow, Glasgow, United Kingdom
| | - David Kappel
- Bernstein Center for Computational Neuroscience, III Physikalisches Institut–Biophysik, Georg-August Universität, Göttingen, Germany
| | - Hadi Heidari
- Microelectronics Lab, James Watt School of Engineering, University of Glasgow, Glasgow, United Kingdom
| | - Melika Payvand
- Institute of Neuroinformatics, University of Zurich, Eidgenössische Technische Hochschule Zürich (ETHZ), Zurich, Switzerland
| | - Wei Wang
- The Andrew and Erna Viterbi Department of Electrical Engineering, Technion–Israel Institute of Technology, Haifa, Israel
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Anand G, Yu Y, Lowe A, Kalra A. Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges. Physiol Meas 2021; 42. [PMID: 33607637 DOI: 10.1088/1361-6579/abe80e] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022]
Abstract
Recent advances in hemodynamic monitoring have seen the advent of non-invasive methods which offer ease of application and improve patient comfort. Bioimpedance Analysis or BIA is one of the currently employed non-invasive techniques for hemodynamic monitoring. Impedance Cardiography (ICG), one of the implementations of BIA, is widely used as a non-invasive procedure for estimating hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Even though BIA is not a new diagnostic technique, it has failed to gain consensus as a reliable measure of hemodynamic parameters. Several devices have emerged for estimating CO using ICG which are based on evolving methodologies and techniques to calculate SV. However, the calculations are generally dependent on the electrode configurations (whole body, segmental or localised) as well as the accuracy of different techniques in tracking blood flow changes. Blood volume changes, concentration of red blood cells, pulsatile velocity profile and ambient temperature contribute to the overall conductivity of blood and hence its impedance response during flow. There is a growing interest in investigating limbs for localised BIA to estimate hemodynamic parameters such as pulse wave velocity. As such, this paper summarises the current state of hemodynamic monitoring through BIA in terms of different configurations and devices in the market. The conductivity of blood flow has been emphasized with contributions from both volume and velocity changes during flow. Recommendations for using BIA in hemodynamic monitoring have been mentioned highlighting the suitable range of frequencies (1 kHz-1 MHz) as well as safety considerations for a BIA setup. Finally, current challenges in using BIA such as geometry assumption and inaccuracies have been discussed while mentioning potential advantages of a multi-frequency analysis to cover all the major contributors to blood's impedance response during flow.
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Affiliation(s)
- Gautam Anand
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Yang Yu
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Andrew Lowe
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Anubha Kalra
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
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Abstract
The body composition phenotype of an athlete displays the complex interaction among genotype, physiological and metabolic demands of a sport, diet, and physical training. Observational studies dominate the literature and describe the sport-specific physique characteristics (size, shape, and composition) of adult athletes by gender and levels of competition. Limited data reveal how body composition measurements can benefit an athlete. Thus, the objective is to identify purposeful measurements of body composition, notably fat and lean muscle masses, and determine their impact on the health and performance of athletes. Areas of interest include relationships among total and regional body composition measurements, muscle function, sport-specific performance, risk of injury, return to sport after injury, and identification of activity-induced fluid shifts. Discussion includes the application of specific uses of dual X-ray absorptiometry and bioelectrical impedance including an emphasis on the need to minimize measurement errors and standardize protocols, and highlights opportunities for future research. This focus on functional body composition can benefit the health and optimize the performance of an athlete.
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Affiliation(s)
- Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota, Grand Forks, United States
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Ibrahim B, Hall DA, Jafari R. Pulse Wave Modeling Using Bio-Impedance Simulation Platform Based on a 3D Time-Varying Circuit Model. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2021; 15:143-158. [PMID: 33577456 PMCID: PMC8054996 DOI: 10.1109/tbcas.2021.3059211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cardiovascular disease (CVD) threatens the lives of many and affects their productivity. Wearable sensors can enable continuous monitoring of hemodynamic parameters to improve the diagnosis and management of CVD. Bio-Impedance (Bio-Z) is an effective non-invasive sensor for arterial pulse wave monitoring based on blood volume changes in the artery due to the deep penetration of its current signal inside the tissue. However, the measured data are significantly affected by the placement of electrodes relative to the artery and the electrode configuration. In this work, we created a Bio-Z simulation platform that models the tissue, arterial pulse wave, and Bio-Z sensing configuration using a 3D circuit model based on a time-varying impedance grid. A new method is proposed to accurately simulate the different tissue types such as blood, fat, muscles, and bones in a 3D circuit model in addition to the pulsatile activity of the arteries through a variable impedance model. This circuit model is simulated in SPICE and can be used to guide design decisions (i.e. electrode placement relative to the artery and electrode configuration) to optimize the monitoring of pulse wave prior to experimentation. We present extensive simulations of the arterial pulse waveform for different sensor locations, electrode sizes, current injection frequencies, and artery depths. These simulations are validated by experimental Bio-Z measurements.
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Muller TL, Ward LC, Plush KJ, Pluske JR, D'Souza DN, Bryden WL, van Barneveld RJ. Use of bioelectrical impedance spectroscopy to provide a measure of body composition in sows. Animal 2020; 15:100156. [PMID: 33573950 DOI: 10.1016/j.animal.2020.100156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
The ability to accurately estimate fat mass and fat-free mass (FFM) has the potential to improve the way in which sow body condition can be managed in a breeding herd. Bioelectrical impedance spectroscopy (BIS) has been evaluated as a practical technique for assessment of body composition in several livestock species, but similar work is lacking in sows. Bioelectrical impedance uses population-specific algorithms that require values for the apparent resistivities of body fluids and body proportion factors. This study comprised three major aims: (i) to derive apparent resistivity coefficients for extracellular water (ECW) and intracellular water (ICW) required for validation of BIS predictions of total body water (TBW) in live sows against standard reference tracer dilution methods; (ii) to develop predictions of TBW to body composition prediction algorithms, namely FFM, by developing a body geometry correction factor (Kb) and (iii) to compare the BIS predictions of FFM against existing impedance predictors and published prediction equations for use in sows, based on physical measurements of back-fat depth and BW (P2-based predictors). Whole body impedance measurements and the determination of TBW by deuterium dilution and ECW by bromide dilution were performed on 40 Large White x Landrace sows. Mean apparent resistivity coefficients of body fluids were 431.1 Ω.cm for ECW and 1827.8 Ω.cm for ICW. Using these coefficients, TBW and ECW were over-estimated by 6.5 and 3.3%, respectively, compared to measured reference values, although these differences were not statistically different (P > 0.05). Mean Kb was 1.09 ± 0.14. Fat-free mass predictions were 194.9 kg, which equates to 60.9% of total sow weight, and 183.0 kg for BIS and the deuterium dilution method, respectively. Mean differences between the predicted and measured FFM values ranged from -8.2 to 32.7%, but were not statistically different (P > 0.05). Method validation (leave-one-out procedure) revealed that mean differences between predicted and measured values were not statistically significant (P > 0.05). Of the impedance-based predictors, equivalence testing revealed that BIS displayed the lowest test bias of 11.9 kg (8.2%), although the P2-based prediction equations exhibited the lowest bias and percentage equivalence, with narrow limits of agreement. Results indicate although differences between mean predicted and measured values were not significantly different, relatively wide limits of agreement suggest BIS as an impractical option for assessing body composition in individual sows compared to the use of existing prediction equations based on BW and back fat.
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Affiliation(s)
- T L Muller
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia; Agricultural Sciences, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia.
| | - L C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - K J Plush
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia
| | - J R Pluske
- Agricultural Sciences, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - D N D'Souza
- SunPork Group, Eagleview Place, Eagle Farm, Queensland, Australia
| | - W L Bryden
- School of Agriculture and Food Sciences, The University of Queensland, Gatton Campus, Gatton, Queensland, Australia
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Frank Holden M, Oczachowska-Kulik AE, Fenton RA, Bech JN. Effect of furosemide on body composition and urinary proteins that mediate tubular sodium and sodium transport-A randomized controlled trial. Physiol Rep 2020; 8:e14653. [PMID: 33356004 PMCID: PMC7757674 DOI: 10.14814/phy2.14653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/10/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
Background Furosemide inhibits the sodium potassium chloride cotransporter (NKCC2) in the thick ascending limb of the loop of Henle and increases urinary water and sodium excretion. This study investigates the effect of furosemide on body composition estimated with multifrequency bioimpedance spectroscopy (BIS) technique and urinary proteins from NKCC2. Methods This study is a randomized, placebo‐controlled, crossover study where healthy subjects received either placebo or 40 mg furosemide on two separate occasions, where body composition with BIS, renal function, proteins from tubular proteins that mediate sodium and water transport, and plasma concentrations of vasoactive hormones were measured before and after intervention. Results We observed an expected increased diuresis with a subsequent reduction in bodyweight of (−1.51 ± 0.36 kg, p < .001) and extracellular water (ECW; −1.14 ± 0.23 L, p < .001) after furosemide. We found a positive correlation between the decrease in ECW and a decrease in bodyweight and a negative correlation between the decrease in ECW and the increase in urinary output. Intracellular water (ICW) increased (0.47 ± 0.28 L, p < .001). Urinary excretion of NKCC2 increased after furosemide and the increase in NKCC2 correlated with an increase in urine output and a decrease in ECW. Conclusion We found BIS can detect acute changes in body water content but the method may be limited to estimation of ECW. BIS demonstrated that furosemide increases ICW which might be explained by an extracellular sodium loss. Finally, urinary proteins from NKCC2 increases after furosemide with a good correlation with diuresis end the decrease in ECW.
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Affiliation(s)
- Mose Frank Holden
- University Clinic in Nephrology and Hypertension, Department of Medicine, University of Aarhus and Gødstrup Hospital, Holstebro, Denmark
| | - Anna Ewa Oczachowska-Kulik
- University Clinic in Nephrology and Hypertension, Department of Medicine, University of Aarhus and Gødstrup Hospital, Holstebro, Denmark
| | | | - Jesper Nørgaard Bech
- University Clinic in Nephrology and Hypertension, Department of Medicine, University of Aarhus and Gødstrup Hospital, Holstebro, Denmark
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Edwick DO, Hince DA, Rawlins JM, Wood FM, Edgar DW. Alternate Electrode Positions for the Measurement of Hand Volumes Using Bioimpedance Spectroscopy. Lymphat Res Biol 2020; 18:560-571. [DOI: 10.1089/lrb.2019.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Dale O. Edwick
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
| | - Dana A. Hince
- Institute of Health Research, The University of Notre Dame Australia, Fremantle, Australia
| | - Jeremy M. Rawlins
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Department of Plastic and Maxillofacial Surgery, Royal Perth Hospital, Perth, Australia
| | - Fiona M. Wood
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
- Burn Injury Research Unit, The University of Western Australia, Nedlands, Australia
| | - Dale W. Edgar
- State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
- Institute of Health Research, The University of Notre Dame Australia, Fremantle, Australia
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Perteet-Jackson AD, Earthman CP, Larson-Nath CM. Body Composition Post Pediatric Liver Transplant: Implications and Assessment. Nutr Clin Pract 2020; 36:1173-1184. [PMID: 33242232 DOI: 10.1002/ncp.10601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022] Open
Abstract
Liver disease has a negative influence on growth and development of children. Measurement of body composition as a component of nutrition status assessment in children before and after transplant would facilitate tailoring of nutrition therapy. A comprehensive literature search on pediatric liver transplant and body composition assessment was performed using a modified systematic approach. This review includes evidence specific to body composition of children undergoing liver transplant and a discussion of relevant body composition assessment methods for this population. Malnutrition is commonly seen in children with liver disease prior to transplant because of the disrupted metabolic pathways from liver dysfunction; however, malnutrition is not consistently diagnosed. Within 1 year of transplant, children tend to quickly recover with weight gain and linear growth. In some children, obesity and sarcopenia have been observed as long-term posttransplant outcomes. Body composition assessment tools have been utilized in diagnosing nutrition status in adults; yet there are limited studies that use these tools in the pediatric liver-transplant population. Technologies available to assess body composition include air displacement plethysmography, dual-energy x-ray absorptiometry, bioimpedance, and ultrasound. Total body potassium has been used for body composition assessment in adults and children post liver transplant; however, this method is not applicable in a clinical setting. We conclude that understanding posttransplant body composition could help clinicians diagnose and treat malnutrition.
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Affiliation(s)
- Alissa D Perteet-Jackson
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St. Paul, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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Garr Barry V, Peterson CM, Gower BA. Membrane Capacitance from a Bioimpedance Approach: Associations with Insulin Resistance in Relatively Healthy Adults. Obesity (Silver Spring) 2020; 28:2184-2191. [PMID: 33012132 PMCID: PMC8078027 DOI: 10.1002/oby.22977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study aimed to determine whether higher membrane capacitance (CM ), a bioelectrical measure of cell membrane function, is associated with insulin resistance (IR) and/or metabolic syndrome (MetS). METHODS Cross-sectional analyses were performed on 2,191 relatively healthy adults from the National Health and Nutrition Examination Survey. The CM of those with low/no disease risk was compared with those with IR, MetS, or both IR and MetS using ANCOVA. The associations between CM and related clinical measures were assessed with multiple linear regression. RESULTS Compared with those with low/no risk, women and men with IR (P < 0.001) and IR + MetS (P < 0.001) had higher CM , whereas CM was similar in women (P = 0.4526) and men (P = 0.1126) with MetS alone. Positive associations with CM were seen with waist circumference (women and men standardized beta [STD-β] = 0.18, P < 0.0001) and fasting insulin (women STD-β = 0.15, P < 0.0001; men STD-β = 0.12, P < 0.0001). CONCLUSIONS Higher CM was associated with IR in relatively healthy adults. In the absence of IR, higher CM was not associated with MetS as defined by its clinical diagnostic criteria. This study suggests that with further investigation, CM may be a potential tool to detect IR-related cell membrane dysfunction.
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Affiliation(s)
- Valene Garr Barry
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney M Peterson
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Time courses of urinary creatinine excretion, measured creatinine clearance and estimated glomerular filtration rate over 30 days of ICU admission. J Crit Care 2020; 63:161-166. [PMID: 32994085 DOI: 10.1016/j.jcrc.2020.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 07/19/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Baseline urinary creatinine excretion (UCE) is associated with ICU outcome, but its time course is not known. MATERIALS AND METHODS We determined changes in UCE, plasma creatinine, measured creatinine clearance (mCC) and estimated glomerular filtration (eGFR) in patients with an ICU-stay ≥30d without acute kidney injury stage 3. The Cockcroft-Gault, MDRD (modification of diet in renal disease) and CKD-EPI (chronic kidney disease epidemiology collaboration) equations were used. RESULTS In 248 patients with 5143 UCEs hospital mortality was 24%. Over 30d, UCE absolutely decreased in male survivors and non-survivors and female survivors and nonsurvivors by 0.19, 0.16, 0.10 and 0.05 mmol/d/d (all P < 0.001). Relative decreases in UCE were similar in all four groups: 1.3, 1.4, 1.2 and 0.9%/d respectively. Over 30d, mCC remained unchanged, but eGFR rose by 31% (CKD-EPI) and 73% (MDRD) and creatinine clearance estimated by Cockcroft-Gault by 59% (all P < 0.001). CONCLUSIONS Over 1 month of ICU stay, UCE declined by ≥1%/d which may correspond to an equivalent decline in muscle mass. These rates of UCE decrease were similar in survivors, non-survivors, males and females underscoring the intransigent nature of this process. In contrast to measured creatinine clearance, estimates of eGFR progressively rose during ICU stay.
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Comparison of bioimpedance spectroscopy and dual energy X-ray absorptiometry for assessing body composition changes in obese children during weight loss. Eur J Clin Nutr 2020; 75:73-84. [PMID: 32917962 DOI: 10.1038/s41430-020-00738-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity and age influence the reliability of dual energy X-ray absorptiometry scanning (DEXA) and bioimpedance spectroscopy (BIS). Both are used in clinical settings, but have not been compared for measurements in obese children. We compared DEXA and BIS for evaluating body composition and inherent changes in obese children before and after a 10-month weight loss programme. METHODS DEXA and BIS were used to evaluate 130 patients at baseline and 75 at follow-up. We tested agreement between the two techniques using Bland-Altman plots and proportional bias using Passing-Bablok regressions. RESULTS The Bland-Altman plots showed wide agreement limits before and after weight loss and when monitoring longitudinal changes. At baseline, the Passing-Bablok regressions revealed a proportional bias for all body compartments. After significant weight loss no proportional bias was found for fat mass and percentage, although BIS systematically underestimated fat mass by 2.9 kg. Longitudinally, no proportional bias was found in the measured changes of absolute fat, fat-free mass and fat-free percentage between both methods, although BIS systematically underestimated fat and fat-free mass by 2.6 and 0.7 kg, respectively. CONCLUSION While BIS and DEXA are not interchangeable at baseline, the agreement between the two improved after significant weight loss. Proportional changes in fat mass, fat-free mass and fat-free percentage were similar for both techniques. BIS is a viable alternative to DEXA for future paediatric obesity studies measuring treatment effect at group levels, but is not superior to DEXA and cannot be used for monitoring individual changes due to wide limits of agreement.
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Schoenfeld BJ, Nickerson BS, Wilborn CD, Urbina SL, Hayward SB, Krieger J, Aragon AA, Tinsley GM. Comparison of Multifrequency Bioelectrical Impedance vs. Dual-Energy X-ray Absorptiometry for Assessing Body Composition Changes After Participation in a 10-Week Resistance Training Program. J Strength Cond Res 2020; 34:678-688. [PMID: 29927888 DOI: 10.1519/jsc.0000000000002708] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schoenfeld, BJ, Nickerson, BS, Wilborn, CD, Urbina, SL, Hayward, SB, Krieger, J, Aragon, AA, and Tinsley, G. Comparison of multifrequency bioelectrical impedance vs. dual-energy x-ray absorptiometry for assessing body composition changes after participation in a 10-week resistance training program. J Strength Cond Res 34(3): 678-688, 2020-The purpose of this study was to assess the ability of multifrequency bioelectrical impedance analysis (MF-BIA) to determine alterations in total and segmental body composition across a 10-week resistance training (RT) program in comparison with the criterion reference dual-energy X-ray absorptiometry (DXA). Twenty-one young male volunteers (mean ± SD; age = 22.9 ± 3.0 years; height = 175.5 ± 5.9 cm; body mass = 82.9 ± 13.6 kg; body mass index = 26.9 ± 3.6) performed an RT program that included exercises for all major muscle groups. Body composition was assessed using both methods before and after the intervention; change scores were determined by subtracting pre-test values from post-test values for percent body fat ([INCREMENT]%BF), fat mass ([INCREMENT]FM), and fat-free mass ([INCREMENT]FFM). Mean changes were not significantly different when comparing MF-BIA with DXA for [INCREMENT]%BF (-1.05 vs. -1.28%), [INCREMENT]FM (-1.13 vs. -1.19 kg), and FFM (0.10 vs. 0.37 kg, respectively). Both methods showed strong agreement for [INCREMENT]%BF (r = 0.75; standard error of the estimate [SEE] = 1.15%), [INCREMENT]FM (r = 0.84; SEE 1.0 kg), and [INCREMENT]FFM (r = 0.71; SEE of 1.5 kg). The 2 methods were poor predictors of each other in regards to changes in segmental measurements. Our data indicate that MF-BIA is an acceptable alternative for tracking changes in FM and FFM during a combined diet and exercise program in young, athletic men, but segmental lean mass measurements must be interpreted with circumspection.
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Affiliation(s)
| | - Brett S Nickerson
- Department of Professional Programs, Texas A&M International University, Laredo, Texas
| | - Colin D Wilborn
- Exercise and Sport Science Department, University of Mary Hardin-Baylor, Belton, Texas
| | - Stacie L Urbina
- Exercise and Sport Science Department, University of Mary Hardin-Baylor, Belton, Texas
| | - Sara B Hayward
- Exercise and Sport Science Department, University of Mary Hardin-Baylor, Belton, Texas
| | | | - Alan A Aragon
- California State University, Northridge, California; and
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
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Lambell KJ, Earthman CP, Tierney AC, Goh GS, Forsyth A, King SJ. How does muscularity assessed by bedside methods compare to computed tomography muscle area at intensive care unit admission? A pilot prospective cross-sectional study. J Hum Nutr Diet 2020; 34:345-355. [PMID: 32869430 DOI: 10.1111/jhn.12804] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/18/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Low muscularity and malnutrition at intensive care unit (ICU) admission have been associated with negative clinical outcomes. There are limited data available evaluating the validity of bedside techniques to measure muscle mass in critically ill adults. We aimed to compare bedside methods for muscle mass assessment [bioimpedance spectroscopy (BIS), arm anthropometry and subjective physical assessment] against reference technology [computed tomography (CT)] at ICU admission. METHODS Adults who had CT scanning at the third lumbar area <72 h after ICU admission were prospectively recruited. Bedside methods were performed within 48 h of the CT scan. Pearson's correlation compared CT muscle area with BIS-derived fat-free mass (FFM) (kg) and FFM-Chamney (kg) (adjusted for overhydration), mid-upper arm circumference (cm) and mid-arm muscle circumference (cm). Depleted muscle stores were determined using published thresholds for each method. Cohen's kappa (κ) was used to evaluate the agreement between bedside and CT assessment of muscularity status (normal or low). RESULTS Fifty participants were enrolled. There were strong correlations between CT muscle area and FFM values and mid-arm muscle circumference (P < 0.001). Using FFM-Chamney, all six (100%) participants with low CT muscle area were detected (κ = 0.723). FFM-BIS, arm anthropometry and subjective physical assessment methods detected 28%-38% of participants with low CT muscle area. CONCLUSIONS BIS-derived FFM using an adjustment algorithm for overhydration was correlated with CT muscle area and had good agreement with muscularity status assessed by CT image analysis. Arm anthropometry and subjective physical assessment techniques were not able to reliably detect participants with low CT muscle area.
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Affiliation(s)
- K J Lambell
- Nutrition Department, Alfred Health, Melbourne, VIC, Australia.,Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - C P Earthman
- Department of Behavioural Health and Nutrition, University of Delaware, Newark, NJ, USA
| | - A C Tierney
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia.,School of Allied Health and Health Implementation Science and Technology Centre, University of Limerick, Limerick, Ireland
| | - G S Goh
- Department of Radiology, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Surgery, Monash University, Melbourne, VIC, Australia
| | - A Forsyth
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - S J King
- Nutrition Department, Alfred Health, Melbourne, VIC, Australia.,Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
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Lyons-Reid J, Ward LC, Kenealy T, Cutfield W. Bioelectrical Impedance Analysis-An Easy Tool for Quantifying Body Composition in Infancy? Nutrients 2020; 12:E920. [PMID: 32230758 PMCID: PMC7230643 DOI: 10.3390/nu12040920] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022] Open
Abstract
There has been increasing interest in understanding body composition in early life and factors that may influence its evolution. While several technologies exist to measure body composition in infancy, the equipment is typically large, and thus not readily portable, is expensive, and requires a qualified operator. Bioelectrical impedance analysis shows promise as an inexpensive, portable, and easy to use tool. Despite the technique being widely used to assess body composition for over 35 years, it has been seldom used in infancy. This may be related to the evolving nature of the fat-free mass compartment during this period. Nonetheless, a number of factors have been identified that may influence bioelectrical impedance measurements, which, when controlled for, may result in more accurate measurements. Despite this, questions remain in infants regarding the optimal size and placement of electrodes, the standardization of normal hydration, and the influence of body position on the distribution of water throughout the body. The technology requires further evaluation before being considered as a suitable tool to assess body composition in infancy.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand;
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia;
| | - Timothy Kenealy
- Department of Medicine and Department of General Practice and Primary Health Care, The University of Auckland, Auckland 1023, New Zealand;
| | - Wayne Cutfield
- Liggins Insitute and A Better Start – National Science Challenge, The University of Auckland, Auckland 1023, New Zealand
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Pingel J, Harrison A, Von Walden F, Hjalmarsson E, Bartels EM. Multi-frequency bioimpedance: a non-invasive tool for muscle-health assessment of adults with cerebral palsy. J Muscle Res Cell Motil 2020; 41:211-219. [PMID: 32221759 DOI: 10.1007/s10974-020-09579-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/14/2020] [Indexed: 12/13/2022]
Abstract
Muscle contracture development is a major complication for individuals with cerebral palsy (CP) and has lifelong implications. In order to recognize contracture development early and to follow up on preventive interventions aimed at muscle health development, non-invasive, and easy to use methods are needed. The aim of the present study was to assess whether multi-frequency Bioimpedance (mfBIA) can be used to detect differences between skeletal muscle of individuals with CP and healthy controls. The mfBIA technique was applied to the medial gastrocnemius muscle of n = 24 adults with CP and n = 20 healthy controls of both genders. The phase angle (PA) and the centre frequency (fc) were significantly lower in individuals with CP when compared to controls; PA: - 25% for women and - 31.8% for men (P < 0.0001); fc: - 5.6% for women and - 5.2% for men (P < 0.009). The reactance (Xc) and the extracellular resistance (Re) of skeletal muscle from individuals with CP were significantly higher when compared to controls; Xc: + 9.9% for women and + 28.9% for men (P < 0.0001); Re: + 39.7% for women and + 91.2% for men (P < 0.0001). The present study shows that several mfBIA parameters differ significantly between individuals with CP and healthy controls. Furthermore, these changes correlated significantly with the severity of CP, as assessed using the GMFCS scale. The present data indicate that mfBIA shows promise in terms of being a useful diagnostic tool, capable of characterizing muscle health and its development in individuals with cerebral palsy.
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Affiliation(s)
- Jessica Pingel
- Department of Neuroscience, Faculty of Health & Medical Sciences, University of Copenhagen, Blegdamsvej 3.33.3.50, 2200, Copenhagen N, Denmark.
| | - Adrian Harrison
- PAS, Physiology, Faculty of Health & Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Ferdinand Von Walden
- Division of Pediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Emma Hjalmarsson
- Division of Pediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Functional Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Else Marie Bartels
- Department of Neurology & The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Hu C, Hu H, Mai X, Lo WLA, Li L. Correlation Between Muscle Structures and Electrical Properties of the Tibialis Anterior in Subacute Stroke Survivors: A Pilot Study. Front Neurosci 2019; 13:1270. [PMID: 31849584 PMCID: PMC6902003 DOI: 10.3389/fnins.2019.01270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/08/2019] [Indexed: 12/12/2022] Open
Abstract
Electrical impedance myography (EIM) is a non-invasive diagnostic tool that assesses the muscle inherent properties, whereas ultrasonography can assess the alteration in muscle architecture. This study aimed to combine EIM with ultrasonography to assess the changes of the tibialis anterior (TA) muscle properties during passive plantar/dorsiflexion in stroke survivors. Fifteen patients with subacute stroke were recruited. The muscle structures were simultaneously assessed by EIM and ultrasonography at five different extension angles (−10°, 0°, 10°, 20°, and 30°) of the ankle joint. The EIM parameters measured were resistance (R), reactance (X), and phase angle (θ). The parameters recorded by ultrasonography were pennation angle (PA), muscle thickness (MT), and fascicle length (FL). Two-way repeated ANOVA was performed to compare the differences between the affected and unaffected sides as well as the parameters that changed with joint angle. Linear correlation analysis was conducted to assess the association between muscle parameters and clinical scores. The results showed that as the ankle was passively plantarflexed, the θ (P = 0.003) and PA (P < 0.001) values decreased, and the X (P < 0.001), R (P < 0.001), and FL (P < 0.001) values increased. Significant correlations were found between the FL and R values (r = 0.615, P = 0.015), MT and R values (r = 0.522, P = 0.046), and FL and θ values (r = 0.561, P = 0.03), as well as between the PA and the Fugl–Meyer Assessment of Lower Extremity score (r = 0.615, P = 0.015), the R and the Modified Ashworth Scale (MAS) score (r = 0.58, P = 0.023), and the PA and the manual muscle testing (MMT) score (r = −0.575, P = 0.025). This study demonstrated a correlation between the EIM and the ultrasonography parameters at different joint angles. Therefore, both methods could jointly be applied in patients with stroke to detect changes in the muscle inherent properties and muscle architecture. This could assist clinicians to quantitatively evaluate the muscle condition in people with subacute stroke. The study was registered on the Chinese Clinical Trial Registry (trial registration number: ChiCTR-IOR-17012299, http://www.chictr.org.cn/showprojen.aspx?proj=19818). Clinical Trial Registration Number: ChiCTR-IOR-17012299.
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Affiliation(s)
- Chengpeng Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huijing Hu
- Guangdong Industrial Injury Rehabilitation Center, Guangzhou, China
| | - Xiaopeng Mai
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Le Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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An evaluation of phase angle, bioelectrical impedance vector analysis and impedance ratio for the assessment of disease status in children with nephrotic syndrome. BMC Nephrol 2019; 20:331. [PMID: 31438871 PMCID: PMC6704501 DOI: 10.1186/s12882-019-1511-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Oedema, characterized by accumulation of extracellular water (ECW), is one of the major clinical manifestations in children suffering from nephrotic syndrome (NS). The lack of a simple, inexpensive and harmless method for assessing ECW may be solved by the use of the bioelectrical impedance analysis (BIA) technique. The aims of this study were to examine whether phase angle (PA), bioelectrical impedance vector analysis (BIVA) and the impedance ratio (IR) reflect change in disease status in children with NS. Methods Eight children (age range: 2–10 years) with active NS (ANS group) were enrolled. In five of these (ANS* subgroup), impedance was also measured at remission (NSR group). Thirty-eight healthy children (age range: 2–10 years) were included as healthy controls (HC group). Whole-body impedance was measured with a bioimpedance spectroscopy device (Xitron 4200) with surface electrodes placed on the wrist and ankle. Results Values of PA, BIVA and IR were found to be significantly lower (p-value range < 0.001 to < 0.01) in the ANS patients compared to the HC and NSR groups. No significant differences were observed between the NSR and HC groups. Conclusion The studied parameters can be used to assess change in disease status in NS patients. Data were consistent with NS being associated with expansion of ECW. Electronic supplementary material The online version of this article (10.1186/s12882-019-1511-y) contains supplementary material, which is available to authorized users.
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Subhan S, Ha S. A Harmonic Error Cancellation Method for Accurate Clock-Based Electrochemical Impedance Spectroscopy. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2019; 13:710-724. [PMID: 31226085 DOI: 10.1109/tbcas.2019.2923719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Electrochemical impedance spectroscopy (EIS) is a widely used method to characterize the biological materials. In traditional methods for EIS, a sinusoidal current is used to excite the material under test and the measured voltage across that material is demodulated by a linear multiplication with quadrature sinusoidal signals. From the resulting demodulated output, the impedance (magnitude and phase) can be calculated. Although this sine-wave-based impedance measurement method can produce accurate impedance measurements, it requires bulky components and suffers from poor power efficiency due to sinusoidal waveform generation and linear multiplication. Alternatively, a method using square-wave signal, which is simply a clock, for both excitation and demodulation can be much more area and power efficient, but inherently suffers from substantial errors in the result due to significant harmonics in square waves. In this paper, we propose a technique to cancel out the errors caused by such harmonics of the square-wave-based excitation and demodulation. The proposed technique, based on the fact that the magnitude ratio of all the harmonics of a square wave are known, cancels out harmonic errors by subtracting or adding the square-wave-based measured results at higher harmonic frequencies as a simple post-processing calculation. Simulations on specific and also generic impedance models demonstrate the applicability of this technique to various impedance models. Experimental results using a discrete circuit model show that this technique can provide a precise measurement of the impedance with 1% magnitude error and 0.5° phase error considering just five terms. In addition, measurements with a biological tissue show an average magnitude and phase error of 0.7% and [Formula: see text], respectively, using the proposed error cancellation. Because this method replaces sinusoidal signal generation and linear multiplication with clock generation and simple switching, it has great potential to be integrated in a wearable and implantable health monitoring device at low area and power consumption.
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Esco MR, Fedewa MV, Freeborn TJ, Moon JR, Wingo JE, Cicone Z, Holmes CJ, Hornikel B, Welborn B. Agreement between supine and standing bioimpedance spectroscopy devices and dual-energy X-ray absorptiometry for body composition determination. Clin Physiol Funct Imaging 2019; 39:355-361. [PMID: 31287228 DOI: 10.1111/cpf.12585] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/11/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Research comparing bioimpedance spectroscopy (BIS) to dual-energy X-ray absorptiometry (DXA) is limited, especially with newer BIS devices that take measures in a standing position instead of the traditional supine position. PURPOSE The purpose of this study was to compare a standing BIS device (BISSTA ) and a supine BIS device (BISSUP ) to DXA for measuring body fat percentage (BF%), fat mass (FM) and fat-free mass (FFM) in a cohort of male and female subjects displaying a wide range of ages and BMI levels. METHODS Ninety-five subjects (30 ± 15 years, 170 ± 8·0 cm, 72·6 ± 14·8 kg) participated in the study. Body composition measures were taken from BISSTA , BISSUP and DXA during a single visit to the laboratory following an 8- to 12-h fast in a euhydration state. RESULTS Supine BIS device and BISSTA produced r-values >0·91 and low SEE values for all measurements compared to DXA. Effect sizes were 'trivial' for FFM comparing both BISSUP and BISSTA to DXA (<0·1) and 'small' for FM and BF% (<0·39). Compared to DXA, BISSTA resulted in lower total (TE) and constant errors/mean differences (CE) (TE < 3·6 kg, CE < -1·82 kg) versus BISSUP (TE < 4·35 kg, CE < -3·10 kg) for FFM. CONCLUSION Fat-free mass values for BISSTA resulted in the most comparable measurements to DXA with no mean differences and the lowest total error and effect size. However, the findings indicated both BIS devices may be acceptable alternatives to DXA for BF%, FM and FFM in clinical practice.
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Affiliation(s)
- Michael R Esco
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Michael V Fedewa
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Todd J Freeborn
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL, USA
| | - Jordan R Moon
- ImpediMed, Inc. Clinical Department, Carlsbad, CA, USA
| | - Jonathan E Wingo
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Zack Cicone
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Clifton J Holmes
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Bjoern Hornikel
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Bailey Welborn
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
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Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome. ScientificWorldJournal 2019; 2019:4274856. [PMID: 31210755 PMCID: PMC6532278 DOI: 10.1155/2019/4274856] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/17/2019] [Indexed: 11/17/2022] Open
Abstract
Background Accumulation of extracellular water (ECW) is a major clinical manifestation of nephrotic syndrome (NS) in children. Bioimpedance spectroscopy (BIS) is a simple, noninvasive technique that reflects body water volumes. BIS can further measure cell membrane capacitance (CM), which may be altered in NS. The aims of the study were to explore how BIS measurements could reflect disease status in NS, while avoiding prediction equations which are often only validated in adult populations. Methods The study involved 8 children (2-10 years) with active NS (ANS group), 5 of which were also studied at NS remission (NSR group), as well as 38 healthy children of similar age (HC group). BIS measurements determined resistances RINF, RE, and RI (reflecting total body water, extracellular water, and intracellular water) and CM. Also resistance indices based on height (H) were considered, RI = H2/R. Results It was found that RE and RINF were significantly lower in the ANS group than in both NSR and HC groups (p < 0.001). Corresponding resistance indices were significantly higher in the ANS group than in the NSR (p < 0.01) and the HC (p < 0.05) groups, in accordance with elevated water volumes in NS patients. Indices of intracellular water were not significantly different between groups. CM was significantly lower in the ANS group than in NSR and HC groups (p < 0.05). Conclusion BIS could distinguish children with active NS from well-treated and healthy children. Studies with more children are warranted.
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Lukaski HC, Vega Diaz N, Talluri A, Nescolarde L. Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance. Nutrients 2019; 11:nu11040809. [PMID: 30974817 PMCID: PMC6521329 DOI: 10.3390/nu11040809] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 12/16/2022] Open
Abstract
Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity, respectively, to be clinically meaningful. Different approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in the classification of hydration status. One indirect approach utilizes single or multiple frequency bioimpedance in regression equations and theoretical models, respectively, with anthropometric measurements to predict fluid volumes (bioelectrical impedance spectroscopy-BIS) and estimate fluid overload based on the deviation of calculated to reference extracellular fluid volume. Alternatively, bioimpedance vector analysis (BIVA) uses direct phase-sensitive measurements of resistance and reactance, measured at 50 kHz, normalized for standing height, then plotted on a bivariate graph, resulting in a vector with length related to fluid content, and direction with phase angle that indexes hydration status. Comparison with healthy population norms enables BIVA to classify (normal, under-, and over-) and rank (change relative to pre-treatment) hydration independent of body weight. Each approach has wide-ranging uses in evaluation and management of clinical groups with over-hydration with an evolving emphasis on prognosis. This review discusses the advantages and limitations of BIS and BIVA for hydration assessment with comments on future applications.
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Affiliation(s)
- Henry C Lukaski
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND 58202-7166, USA.
| | - Nicanor Vega Diaz
- Nephrology Service, University Hospital of Grand Canary and Faculty of Science, University Los Palmas, 35019 Los Palmas, Grand Canary, Spain.
| | - Antonio Talluri
- Antonio Talluri, Fatbyte, Inc., 50012 Bagno a Ripoli, Florence, Italy.
| | - Lexa Nescolarde
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, 08034 Barcelona, Spain.
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