Bedside quantification of fat-free mass in acute spinal cord injury using bioelectrical impedance analysis: a psychometric study

Panisset, Maya G.; Desneves, Katherine J.; Ward, Leigh C.; Rafferty, Jillian; Rodi, Helena; Roff, G; El-Ansary, Doa; Galea, Mary P.

doi:10.1038/s41393-017-0035-1

Cited by 15 publications

(18 citation statements)

References 33 publications

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“…As detailed in Table 2 , a total number of 1,154 participants were included across the 42 articles, comprised of men (n = 1011) and women (n = 143) aged 16 to 71 years with cervical, thoracic or lumber lesion levels (C1 to L5), complete or incomplete SCI (American Spinal Injury Association Impairment Scale [AIS] A, B, C and D), mostly with a relatively long-standing SCI (all studies included participants ranging from 1 to 36 years post-injury [‘chronic’ SCI], except for three studies [ 38 , 56 , 60 ] including participants ranging from 3 days to 4 months post-injury [‘acute’ SCI]). All studies included SCI-only samples, except for one study that included a sample of at least 50% people with SCI mixed with participants with spinal bifida [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…A two-compartment model of whole-body composition (total body electrical conductivity) in which participants were positioned in a whole-body cylinder was assessed for its test-retest reliability and was found to be acceptable (55). While no validity studies are available for this conductance method, seven other studies have assessed convergent validity of BIA compared to DXA [ 34 , 41 , 54 , 62 ] or total body water [ 32 , 38 , 56 , 62 ]; the majority were found to be inconclusive or not acceptable. Another two-compartment model of whole-body composition (skinfold thickness) showed acceptable test-retest reliability [ 33 ], however only three of the eight studies assessing whole-body convergent validity of skinfold thicknesses were acceptable when compared to DXA [ 41 , 49 , 54 , 62 , 69 ], total body water (38, 62), conductance [ 55 , 62 ], or hydrostatic weighing [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

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Assessment of body composition in spinal cord injury: A scoping review

et al. 2021

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The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate ‘gold standard’ tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessment of body composition in spinal cord injury: A scoping review

et al. 2021

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“…FFM derived from BIS or DLW can be used in this equation. BIS may be the more practical alternative owing to its simplicity of use and lower cost [32]. Identification of hypermetabolism is important in order to individualise stress factors and could be the focus of future research.…”

Section: Discussionmentioning

confidence: 99%

“…FFM DLW and FM DLW were calculated from TBW derived from deuterium elimination rates by assuming a hydration fraction for FFM of 0.732 [31]. FM BIA was also predicted from whole body impedance measurements as described previously [32] using the prediction equation of Kocina and Heyward [33]. Fat mass predicted from impedance measurements (FM BIA ) was calculated as the difference between body weight and FFM BIA .…”

Section: Body Compositionmentioning

confidence: 99%

Comparison of estimated energy requirements using predictive equations with total energy expenditure measured by the doubly labelled water method in acute spinal cord injury

et al. 2019

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Study design Prospective, observational Objectives To evaluate agreement between a reference method (doubly labelled water, DLW) of total energy expenditure (TEE) and published equations for estimating energy requirements in acute spinal cord injury (SCI). Setting Victoria, Australia Methods Twenty participants (18 male) within 8 weeks of traumatic SCI completed DLW, anthropometric and dietary intake assessments. Energy requirements were predicted using Harris-Benedict, Schofield, Henry, Nelson, Buchholz and Chun equations, multiplied by a combined activity and stress factor of 1.3, and the ratio method (kJ/kg body weight). Fatfree mass (FFM) and fat mass (FM) were calculated from TBW-derived DLW and from bioelectrical impedance spectroscopy (BIS). Results Median time since injury was 41 days. Median TEE was 9.1 MJ. Fair agreement was found between TEE and predicted energy requirements for the Chun (r c = 0.39), the Harris-Benedict equation (r c = 0.30), the ratio method (r c = 0.23) and the Buchholz (r c = 0.31) and Nelson equations (r c = 0.35), which incorporate measures of FFM and/or FM. Other equations showed weak concordance with DLW. When two hypermetabolic patients were removed, agreement between TEE and predicted energy requirements using the Buchholz equation increased to substantial (r c = 0.72) and using the Nelson (r c = 0.53) and Chun equations (r c = 0.53) increased to moderate. The Buchholz equation had the smallest limits of agreement (−2.4-2.3 MJ/d). Conclusion The population-specific Buchholz equation that incorporates FFM, predicted from either BIS or DLW, demonstrated the best agreement in patients with acute SCI.

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“…Reproducibility of the measurement was found to be worsened in individuals with higher body fat or lower muscle mass [35], which are prevalent in those with SCI. In addition, Panisset et al [36] reported that DEXA could underestimate muscle mass in individuals with acute SCI. To improve the accuracy of DEXA measurements, participants who were very obese or lean (BMI>30 or <15 kg/m 2 , respectively) were excluded from this study.…”

Section: Discussionmentioning

confidence: 99%

Spasticity and preservation of skeletal muscle mass in people with spinal cord injury

et al. 2018

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Study design Cross-sectional Objective To investigate the association between skeletal muscle mass and spasticity in people with spinal cord injury (SCI). Setting Tertiary level hospital in Seoul, Korea Methods Spasticity was evaluated in 69 participants with SCI using the spasticity sum score (SSS), Penn Spasm Frequency Scale (PSFS), and Spinal Cord Assessment Tool for Spastic Reflexes (SCATS). Skeletal muscle mass was measured using a dual-energy X-ray absorptiometry scanner, and skeletal muscle index was calculated by dividing skeletal muscle mass by height squared. Laboratory parameters including hemoglobin, albumin, creatinine, fasting glucose, and cholesterol were measured. Spearman's correlation analysis was performed to assess the association between the skeletal muscle mass and spasticity scales. Multiple linear regression analysis was used to present the independent association between them. Results The participants' mean age was 41.8 years; 54 (78.3%) were male, and 46 (66.7%) were tetraplegic. Skeletal muscle index of lower extremities was significantly correlated with all spasticity scales. Spearman's correlation coefficients were 0.468, 0.467, 0.555, 0.506, and 0.474 for SSS, PSFS, SCATS clonus, SCATS flexor, and SCATS extensor with pvalues < 0.001, respectively. After adjustment for age, sex, level of injury, body mass index, and serum creatinine, all spasticity scales were significantly associated with skeletal muscle index of lower extremities in multiple regression analysis. Standardized coefficients were 0.228, 0.274, 0.294, 0.210, and 0.227 for SSS, PSFS, SCATS clonus, SCATS flexor, and SCATS extensor. Conclusions Spasticity was significantly correlated with the skeletal muscle mass even after adjusting for possible confounders. Spasticity may need to be considered as an influencing factor in interventions such as electrical stimulation to preserve skeletal muscle mass.

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Bedside quantification of fat-free mass in acute spinal cord injury using bioelectrical impedance analysis: a psychometric study

Abstract: The present study was funded by a grant from the Institute for Safety, Compensation and Recovery Research (ISCRR Project #NGE-E-13-078). M Panisset was supported by an Australian Postgraduate Award. K Desneves was supported by the Austin Medical Research Foundation.

Cited by 15 publications

References 33 publications

Assessment of body composition in spinal cord injury: A scoping review

Assessment of body composition in spinal cord injury: A scoping review

Comparison of estimated energy requirements using predictive equations with total energy expenditure measured by the doubly labelled water method in acute spinal cord injury

Spasticity and preservation of skeletal muscle mass in people with spinal cord injury

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