Use of Hand‐to‐hand Measurements for Body Composition Monitoring in Patients With Inaccessible or Amputated Feet

Keane, David; Lindley, Elizabeth

doi:10.1111/jorc.12091

Cited by 7 publications

(11 citation statements)

References 14 publications

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“…Concluiu-se que o padrão mão a mão pode proporcionar um protocolo alternativo para indivíduos nesta condição. 3 No desenvolvimento do estudo, observou-se que o padrão mão e coto obteve resultado de composição corporal mais próximo do DXA.…”

Section: Discussionunclassified

“…Para a estimativa são necessárias equações específicas para populações a ser aplicada. 2,3 Considerado padrão-ouro na avaliação da composição corporal em nível molecular, o DXA consiste na transmissão de raios-X em níveis diferentes de energia, alto e baixo. Durante a passagem pelos tecidos as energias são atenuadas, influenciadas pela intensidade da energia e pela densidade e espessura dos tecidos humanos.…”

Section: Introductionunclassified

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Avaliação da porcentagem de gordura corporal em um indivíduo com amputação transfemoral bilateral por diferentes métodos

2019

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A amputação predispõe a um risco de alterações na composição corporal, condição que interfere no equilíbrio no uso da prótese, aumenta o cansaço físico e tem como consequência menor rendimento nas terapias físicas. Nesse sentido, é fundamental eleger o método mais apropriado para avaliar a composição corporal. Objetivo: Avaliar a porcentagem de gordura corporal em um indivíduo com amputação transfemoral por diferentes métodos. Método: Trata-se de um estudo de caso de caráter clínico retrospectivo com um participante do sexo masculino, idade 67 anos com amputação transfemoral bilateral por insuficiência vascular, atendido pelo Serviço de Nutrição do Instituto de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - IMREA HCFMUSP. Utilizou-se o somatório das dobras cutâneas, absorciometria de raio-X de dupla energia (DXA) e análise de impedância bioelétrica (IB). Resultados: Os dados antropométricos apontaram porcentagem de gordura corporal de 34,3%, a IB 33% e o DXA revelou 37%. Conclusão: Para este caso, sugere-se que na inviabilidade de avaliar a porcentagem de gordura corporal em indivíduos com amputação com o DXA, o somatório das dobras é o método elegível. Estudos futuros são imprescindíveis a fim de estabelecer o método adequado para avaliação da composição corporal de pessoas com amputações bilaterais de membros inferiores, tendo em vista que este resultado contribui para o melhor desfecho clínico de pacientes em processo de reabilitação.

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Section: Discussionunclassified

Section: Introductionunclassified

Avaliação da porcentagem de gordura corporal em um indivíduo com amputação transfemoral bilateral por diferentes métodos

2019

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“…Thus, awareness of the potential benefits of bioimpedance [ 10 , 11 , 16 , 18 , 19 ] was insufficient. Recommendations for use of bioimpedance have changed over time [ 38 ], but there were diverse opinions on how to use bioimpedance, e.g. in patients with a pacemaker, amputees, or for assessing nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Perspectives on clinical use of bioimpedance in hemodialysis: focus group interviews with renal care professionals

et al. 2018

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BackgroundInadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals’ perceived barriers and facilitators for use of bioimpedance in clinical practice.MethodsQualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device. The participants were connected to each other and a moderator via equipment for telemedicine and the sessions were recorded. The interviews were semi-structured, focusing on the participants’ perceptions of use of bioimpedance in clinical practice. Thematic content analysis was performed in consecutive steps, and data were extracted by employing an inductive, interactive, comparative process.ResultsSeveral barriers and facilitators to the use of bioimpedance in clinical practice were identified, and a multilevel approach to examining barriers and incentives for change was found to be applicable to the ideas and categories that arose from the data. The determinants were categorized on five levels, and the different themes of the levels illustrated with quotations from the focus groups participants.ConclusionsDeterminants for use of bioimpedance were identified on five levels: 1) the innovation itself, 2) the individual professional, 3) the patient, 4) the social context and 5) the organizational context. Barriers were identified in the areas of credibility, awareness, knowledge, self-efficacy, care processes, organizational structures and regulations. Facilitators were identified in the areas of the innovation’s attractiveness, advantages in practice, and collaboration. Motivation, team processes and organizational capacities appeared as both barriers and facilitators.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-0907-4) contains supplementary material, which is available to authorized users.

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“…Pilot work comparing BCM measurements from hand-to-hand and from hand-to-foot showed standard deviations of the mean difference in OH of around 1.0 litres (Keane and Lindley, 2015). Recruiting 48 subjects into each cohort would allow differences of 0.3 litres to be measured between the primary two paths at the level of 5% type I error with 80% power using a two sided t-test.…”

Section: Methodsmentioning

confidence: 99%

“…The potential for the equivalence of impedance across different paths was demonstrated two decades ago using bioimpedance analysis (BIA) measurements (Lukaski et al, 1985) – although the approach to analysis in BIA differs considerably to that of bioimpedance spectroscopy (BIS) (Kyle et al, 2004), employed by the BCM. The only investigation to consider alternative paths with BIS measurements was in preliminary work for this study, where it was shown that BCM-measured overhydration (OH) from the hand-to-hand path is an acceptable alternative to the standard path (Keane and Lindley, 2015). When considering post-dialysis measurements, it is accepted that haemodialysis induced changes in fluid distributions affect whole-body bioimpedance (Zhu et al, 1999), but the clinical significance of this when using BCM needs clarification.…”

Section: Introductionmentioning

confidence: 99%

The Body Composition Monitor: a flexible tool for routine fluid management across the haemodialysis population

Keane

Baxter

Lindley

et al. 2017

Biomed. Phys. Eng. Express

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Bioimpedance measurements with the Body Composition Monitor (BCM) have been shown to improve fluid management in haemodialysis. However, there is a lack of a sufficiently robust evidence-base for use of the BCM outside of standard protocols. This study aims to characterise BCM measurement variation to allow users to make measurements and interpret the results with confidence in a range of clinical scenarios. BCM measurements were made in 48 healthy controls and in 48 stable haemodialysis patients before and immediately after dialysis. The effect of utilising alternative measurement paths was assessed using mixed effects models and the effect of measuring post-dialysis was assessed by comparing changes in BCM-measured overhydration (OH) with weight changes over dialysis. The data from healthy controls suggest that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement. Dialysis patients showed similar results other than having higher BCM-measured OH when measured across the site of a vascular access. There was good agreement between BCM-measured OH and change in weight, suggesting post-dialysis measurements can be utilised. These results suggest BCM protocols can be flexible regarding measurement paths and timing of measurement to ensure as many patients as possible can benefit from the technology.

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Use of Hand‐to‐hand Measurements for Body Composition Monitoring in Patients With Inaccessible or Amputated Feet

Cited by 7 publications

References 14 publications

Avaliação da porcentagem de gordura corporal em um indivíduo com amputação transfemoral bilateral por diferentes métodos

Avaliação da porcentagem de gordura corporal em um indivíduo com amputação transfemoral bilateral por diferentes métodos

Perspectives on clinical use of bioimpedance in hemodialysis: focus group interviews with renal care professionals

The Body Composition Monitor: a flexible tool for routine fluid management across the haemodialysis population

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