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Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
There are several objective measures of secondary lymphedema which vary in time to administer, associated costs, necessary equipment, and level of convenience. Current strategies include bioelectrical impedance or bioimpedance analysis (BIA), and volume measurements such as circumferential measurement (CM), water displacement (WD), and perometry. A clinical practice guideline (CPG) on lymphedema assessment from the Academy of Oncologic Physical Therapy of the American Physical Therapy Association by Levenhagen et al.65 provided recommendations for the assessment of individuals who: (1) are at risk for lymphedema (Norman Questionnaire, the Morbidity Screening Tool, and volume measurements); (2) have subclinical/early stage lymphedema (BIA and volume measurements); (3) are in moderate to late stages (CM and WD); or (4) are in the early/late stages (perometry).65 Following a diagnosis of lymphedema, severity is labeled based on levels established by the International Society of Lymphology in Table 17.4.66
Hydrometry, Hydration Status, and Performance
Published in Henry C. Lukaski, Body Composition, 2017
Ronald J. Maughan, Susan M. Shirreffs
Bioimpedance analysis (BIA) has been widely used to estimate both body water content and other aspects of body composition. The attractions of the method are based largely on its ease of use and its relatively low cost rather than on precision and validity. The principle of operation depends on the fact that the total volume of a conductor can be estimated from its length (L) and the resistance (R) to a single frequency electric current (L2/R). The key assumption is that the conductor has a uniform shape and that the current is distributed throughout the conductor uniformly (Chumlea and Sun 2005). The National Institute of Health 1994 Technology Assessment Conference on Bioelectrical Impedance (National Institutes of Health 1994) concluded that “BIA provides a reliable estimate of total body water under most conditions. It carried on to state that “BIA values are affected by numerous variables including… hydration status” and that “Reliable BIA requires standardization and control of these variables. Much work in this area has generally highlighted the limitations of the technique. For example, Asselin et al. (1998) concluded that with acute dehydration and rehydration of 2%–3% of body mass, standard equations failed to predict changes in total body water as determined by changes in body mass. Shirreffs and Maughan (1994) found a progressive change in measured impedance over time when subjects went from an upright to a supine position, though there was clearly no change in total body water over this period. Berneis and Keller (2000), after inducing extracellular volume and tonicity alterations by infusion and drinking, concluded that BIA may not be reliable. Moon et al. (2010), however, found that some of the variability could be reduced by standardization of electrode placement, allowing smaller changes to be detected. Controlling other variables, such as posture, body temperature, prior food and fluid intake, and prior exercise may also help to reduce the variability, but the assumptions involved in the conversion of an impedance measurement to a body water content remain problematic.
Nutritional Assessment in Early Allogenic Hematopoietic Stem Cell Transplant Patients, a Cross-Sectional Study
Published in Nutrition and Cancer, 2023
Pan Yang, Yaya Song, Xiuchen Jing, Yongqin Ge, Minghong Liu, Fang Tang, Ying Chen, Qin Li, Feng Wei, Yanqin Mao, Xiang Xu, Xiaming Zhu, Yin Lu
Body composition parameters were measured using bioimpedance analysis (BIA, In Body720, Korea), a quick, noninvasive method to estimate body composition (16). With the subject lying supine, four surface electrodes were placed on the patient’s right hand and ankle with BIA measurements. The main indicators of body composition measurement include Fat Mass (FM), Fat Free Mass (FFM), Fat Free Mass Index (FFMI), Percent Body Fat (PBF), Appendicular Skeletal Mass (ASM), Appendicular Skeletal Mass Index (ASMI), Visceral Fat Area (VFA), Phase Angle (PhA). FM and FFM were assessed by the BI-Index (height in cm2)/resistance ohm using the Sun BIA equation (17). Low fat‐free mass index is described as < 17 kg/m2 for men, < 15 kg/m2 for women (15). PBF was determined as total body fat mass/total body mass × 100 (18). Normal values for FBF are defined as 15%–18% for men and 20%–25% for women. ASM was defined as the total fat‐free lean body mass from four limbs, and ASMI was derived from appendicular skeletal mass divided by height squared (kg/m2) (5). According to the Asian Working Group on Sarcopenia (AWGS) (15), a low ASMI was defined as ≤ 7.0 kg/m2 in men and ≤ 5.7 kg/m2 in women. A cutoff of VFA to classify visceral obesity has not been standardized yet; our study defined visceral obesity as an area of visceral fat > 100 cm2. PhA derived from BIA was determined as follows: PhA = arctangent (reactance/resistance) ∗ (180/π) (19). A cutoff value of <5° was used for the phase angle in females and males.
Associations between obesity, self-reported weakness and their combinations with mortality in nursing home residents
Published in Acta Clinica Belgica, 2023
Gulistan Bahat, Birkan Ilhan, Nezahat Muge Catikkas, Asli Tufan, Savaş Ozturk, Hafize Dogan, Mehmet Akif Karan
The study was conducted among residents of the most crowded NH in the city. It was the largest NH in the city and was subordinated to Metropolitan Municipality. The acceptance depended only on the lack of adequate support for the older adults to stay in their homes. The Metropolitan Municipality met all health expenses and maintenance of the NH residents. We excluded the residents who did not give informed consent or had conditions that might interfere with bioimpedance analysis (BIA) measurement (e.g. having metal implants, cardiac pacemaker, presence of the edematous state, or major disorders of fluid disturbance). We collected the baseline data in September 2009 and assessed the mortality outcome in June 2013. We recently reported longitudinal follow-up data examining the success of the Simpler Modified Fried Frailty Scale proposed by our group to predict mortality in this cohort [10]. We considered that a period would need to pass the emergence of the adverse effect of chronic disease (e.g. diabetes, hypertension, etc.). As such, we considered that a period would be needed for body phenotypes to exert any effect on mortality. Hence, we excluded the participants who died within the period less than six months of the study entry (Only ten participants had died in the first six months.) considering that an interval would be required for the effect of a recent change in fat or muscle strength to become apparent on the mortality risk. We aimed to increase the reliability of our analysis by this consideration.
Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study
Published in Nutrition and Cancer, 2020
Adeleh Khodabakhshi, Mohammad Esmaeil Akbari, Hamid Reza Mirzaei, Hassan Mehrad-Majd, Miriam Kalamian, Sayed Hossein Davoodi
Body composition and biochemical parameters were measured at different time-points during the study. Prior to commencing chemotherapy, body weight, body mass index (BMI), and fat mass were measured by bioimpedance analysis (BIA) (Tanita BC-418, Illinois, USA). At regular intervals of 3 weeks for 3 months, patients were asked to be in fast and should not have drunk for at least 10 h to minimize systematic errors. In order to investigate the possible effects of KDs on metabolic profile, fasting blood levels of ketone bodies and glucose were also checked using novamax plus (Nova bio medical, USA) on days of BIA measurement. A stable ketosis was defined when serum ketone body concentrations >0.3 mmol/l (8). Serum levels of ALT, AST, blood urea nitrogen (BUN), Cr, were also measured every 3 weeks. Fasting triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), and Chol were analyzed at baseline, middle of follow-up, and end of each arm using Auto Analyzer (Hitachi, Germany) photometry method.