Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

PubMed Central

Thawani, Rajat; Faridi, M.M.A.; Arora, Shilpa Khanna; Kumar, Rajeev

2013-01-01

Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R=0.60), and mid-upper arm-circumference (R=0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks)=5.437×W–0.781×W2+2.815×HC–0.041×HC2+0.285×MUAC–22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R=0.76. On validation, the predictability of this equation is 46% (±1 week), 75.5% (+2 weeks), and 91.5% (+3 weeks). This mathematical model may be used in identifying preterm neonates. PMID:24592594

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau.

PubMed

Aaby, P; Gomes, J; Fernandes, M; Djana, Q; Lisse, I; Jensen, H

1999-10-02

To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Follow up study of 3 months. Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. 422 children aged 9-23 months in 30 clusters. Mid-upper arm circumference and survival in relation to residence status. During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee's stay in Prabis compared with the period after the departure of the refugees. In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability.

Exercise effect with the wheelchair aerobic fitness trainer on conditioning and metabolic function in disabled persons: a pilot study.

PubMed

Midha, M; Schmitt, J K; Sclater, M

1999-03-01

To determine the effect of exercise with the wheelchair aerobic fitness trainer (WAFT) on anthropometric indices, conditioning, and endocrine and metabolic parameters in persons with lower extremity disability. Exercise sessions with the WAFT lasted 20 to 30 minutes for two to three sessions. Tertiary-care Veterans Administration medical center. Twelve subjects (3 with quadriplegia, 7 with paraplegia, 1 with cerebrovascular accident, 1 with bilateral above-knee amputation). Anthropometric indices (heart rate, blood pressure, weight, oxygen utilization, body mass index, upper arm and abdominal circumference, arm power) and endocrine and metabolic parameters (fasting serum glucose, lipids, and thyroid function) were determined before and after 10 weeks of exercise with the WAFT. All patients noted improved feelings of well-being after training. Mean resting heart rate, upper arm fat area, and fasting serum cholesterol level decreased significantly. Peak oxygen consumption, midarm circumference, and free thyroxine index increased significantly with training. WAFT improves quality of life, conditioning, and endocrine-metabolic parameters in disabled persons.

Usefulness of nutritional indices and classifications in predicting death of malnourished children.

PubMed Central

Briend, A; Dykewicz, C; Graven, K; Mazumder, R N; Wojtyniak, B; Bennish, M

1986-01-01

The usefulness of nutritional indices and classifications in predicting the death of children under 5 years old was evaluated by comparing measurements of 34 children with diarrhoea who died in a Dhaka hospital with those of 318 patients who were discharged in a satisfactory condition. In a logistic regression analysis mid-upper arm circumference was found to be as effective as other nutritional indices in predicting death. Combinations of different indices did not improve the prediction. Arm circumference might be preferable to more complex criteria for predicting the death of malnourished children. PMID:3089529

Body Mass and Circumference of Upper Arm Are Associated with Race Performance in Ultraendurance Runners in a Multistage Race--The Isarrun 2006

ERIC Educational Resources Information Center

Knechtle, Beat; Duff, Brida; Welzel, Ulrich; Kohler, Gotz

2009-01-01

In the present study, we investigated the association of anthropometric parameters with race performance in ultraendurance runners in a multistage ultraendurance run, in which athletes had to run 338 km within 5 consecutive days. In 17 male successful finishers, calculations of body mass, body height, skinfold thicknesses, extremity circumference,…

Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis.

PubMed

Backonja, Uba; Hediger, Mary L; Chen, Zhen; Lauver, Diane R; Sun, Liping; Peterson, C Matthew; Buck Louis, Germaine M

2017-09-01

Body mass index (BMI) and endometriosis have been inversely associated. To address gaps in this research, we examined associations among body composition, endometriosis, and physical activity. Women from 14 clinical sites in the Salt Lake City, Utah and San Francisco, California areas and scheduled for laparoscopy/laparotomy were recruited during 2007-2009. Participants (N = 473) underwent standardized anthropometric assessments to estimate body composition before surgery. Using a cross-sectional design, odds of an endometriosis diagnosis (adjusted odds ratio [aOR]; 95% confidence interval [CI]) were calculated for anthropometric and body composition measures (weight in kg; height in cm; mid upper arm, waist, hip, and chest circumferences in cm; subscapular, suprailiac, and triceps skinfold thicknesses in mm; arm muscle and fat areas in cm 2 ; centripetal fat, chest-to-waist, chest-to-hip, waist-to-hip, and waist-to-height ratios; arm fat index; and BMI in kg/m 2 ). Physical activity (metabolic equivalent of task-minutes/week) and sedentariness (average minutes sitting on a weekday) were assessed using the International Physical Activity Questionnaire-Short Form. Measures were modeled continuously and in quartiles based on sample estimates. Adjusted models were controlled for age (years, continuous), site (Utah/California), smoking history (never, former, or current smoker), and income (below, within 180%, and above of the poverty line). Findings were standardized by dividing variables by their respective standard deviations. We used adjusted models to examine whether odds of an endometriosis diagnosis were moderated by physical activity or sedentariness. Inverse relationships were observed between endometriosis and standardized: weight (aOR = 0.71, 95% CI 0.57-0.88); subscapular skinfold thickness (aOR = 0.79, 95% CI 0.65-0.98); waist and hip circumferences (aOR = 0.79, 95% CI 0.64-0.98 and aOR = 0.76, 95% CI 0.61-0.94, respectively); total upper arm and upper arm muscle areas (aOR = 0.76, 95% CI 0.61-0.94 and aOR = 0.74, 95% CI 0.59-0.93, respectively); and BMI (aOR = 0.75, 95% CI 0.60-0.93), despite similar heights. Women in the highest versus lowest quartile had lower adjusted odds of an endometriosis diagnosis for: weight; mid-upper arm, hip, and waist circumferences; total upper arm and upper arm muscle areas; BMI; and centripetal fat ratio. There was no evidence of a main effect or moderation of physical activity or sedentariness. In a surgical cohort, endometriosis was inversely associated with anthropometric measures and body composition indicators.

Influence of arm crank ergometry on development of lymphedema in breast cancer patients after axillary dissection: A randomized controlled trail.

PubMed

Schmidt, Thorsten; Berner, Jette; Jonat, Walter; Weisser, Burkhard; Röcken, Christioph; van Mackelenbergh, Marion; Mundhenke, Christoph

2017-01-19

To investigate the safety and efficacy of arm crank ergometry in breast cancer patients after axillary lymph node dissection, with regard to changes in bioelectrical impedance analysis, arm circumference, muscular strength, quality of life and fatigue. Randomized controlled clinical intervention trial. Forty-nine patients with breast cancer after axillary lymph node dissection. Arm crank ergometer training twice-weekly was compared with usual care over 12 weeks. The arm crank ergometer group improved significantly in terms of lean body mass and skeletal muscle mass, and showed a significant decrease in body fat. In the arm crank ergometer group, as well as the usual care group, a significant increase in armpit circumference was detected during the training period. The magnitude of the gain was higher in the usual care group. For all other measured regions of the arm a significant decrease in circumference was seen in both groups. Muscular strength of the upper extremity increased significantly in both groups, with a greater improvement in the arm crank ergometer group. In both groups a non-significant trend towards improvement in quality of life was observed. The arm crank ergometer group showed significant improvements in physical functioning, general fatigue and physical fatigue. These results confirm the feasibility of arm crank ergometer training after axillary lymph node dissection and highlight improvements in strength, quality of life and reduced arm symptoms with this training.

Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: A path-analytic study

PubMed Central

Abubakar, Amina; de Vijver, Fons Van; Baar, Anneloes Van; Mbonani, Leonard; Kalu, Raphael; Newton, Charles; Holding, Penny

2014-01-01

Background Sub-optimal physical growth has been suggested as a key pathway between the effect of environmental risk and developmental outcome. Aim To determine if anthropometric status mediates the relation between socioeconomic status and psychomotor development of young children in resource-limited settings. Study design A cross-sectional study design was used. Subjects A total of 204 (105 girls) children from two resource-limited communities in the Coast Province, Kenya. The mean age of these children was 29 months (SD=3.43; range: 24–35 months). Outcome measure Psychomotor functioning was assessed using a locally developed and validated measure, the Kilifi Developmental Inventory. Results A significant association was found between anthropometric status (as measured by weight-for-age, height-for-age, mid-upper arm circumference, and head circumference) and psychomotor functioning and also between socioeconomic status and anthropometric status; no direct effects were found between socioeconomic status and developmental outcome. The models showed that weight, height and to a lesser extent mid-upper arm circumference mediate the relation between socioeconomic status and developmental outcome, while head circumference did not show the same effect. Conclusion Among children under 3 years living in poverty, anthropometric status shows a clear association with psychomotor development while socioeconomic status may only have an indirect association. PMID:18499363

Improvement in arm and post-partum abdominal and flank subcutaneous fat deposits and skin laxity using a bipolar radiofrequency, infrared, vacuum and mechanical massage device.

PubMed

Brightman, Lori; Weiss, Elliot; Chapas, Anne M; Karen, Julie; Hale, Elizabeth; Bernstein, Leonard; Geronemus, Roy G

2009-12-01

Skin laxity of the body is a growing cosmetic concern. Laxity can result from chronological or photoaging and changes in body dimensions during pregnancy or weight loss. The end result is loose, sagging skin, and localized fat deposits. Liposuction and abdominoplasty or brachioplasty are established approaches to these issues. Patient desire for alternatives to surgical correction has spawned the development of non-invasive body contouring devices. The combination of infrared light (IR), bipolar radiofrequency (RF), vacuum and mechanical massage (Velashape, Syneron Medical Ltd, Israel) has demonstrated efficacy in improving skin appearance and circumference of the thighs [Goldberg et al., Derm Surg 2008; 34:204-209; Fisher et al., Derm Surg 2005; 31:1237-1241; Arnoczky and Aksan, J Am Acad Orthop Surg 2000; 8:305-313; Alster and Tanzi, J Cosmetic Laser Therapy 2005; 7:81-85; Wanitphakdeedecha and Manuskiatti, J Cosmet Dermatol 2006; 5:284-288; Nootheti et al., Lasers Surg Med 2006; 38: 908-912], but only anecdotal evidence has supported its use on other anatomic locations. This study was designed to evaluate the efficacy and safety of Velashape on additional body sites and more rigorously examine the technology's impact on upper arm as well as abdominal and flank circumference. Subjects were 28-70 years old, skin types I-V. Nineteen subjects underwent 5 weekly treatments of the upper arms, and 10 subjects underwent 4 weekly treatments of the abdomen and flanks. Treatments were performed using Velashape. Circumference measurements, photographs, and subject weights were performed prior to treatment and at 1- and 3-month follow-ups. Subjects were asked to record their treatment satisfaction level. Change in arm circumference, at the 5th treatment was statistically significant with a mean loss of 0.625 cm. At 1- and 3-month follow-ups, mean loss was 0.71 and 0.597 cm respectively. Reduction of abdominal circumference at 3rd treatment was statistically significant with a 1.25 cm mean loss. At 1- and 3-month follow-ups, average loss was 1.43 and 1.82 cm respectively. This study demonstrates with statistical significance, sustainable reduction in circumference and improvement in appearance of arms and abdomen following treatment with Velashape. Copyright 2009 Wiley-Liss, Inc.

Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm with the patient supine or with the head of the bed raised 45 degrees: a follow-up study.

PubMed

Schell, Kathleen; Lyons, Denise; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Wakai, Sandra; Carson, Elizabeth; Waterhouse, Julie; Chichester, Melanie; Bartell, Deborah; Foraker, Theresa; Simpson, E Kathleen

2006-03-01

Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient's arm. Evidence supporting this practice is limited. To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45 degrees . Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers' recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45 degrees and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects. Paired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45 degrees . The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects. Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45 degrees .

Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort.

PubMed

Pomeroy, Emma; Stock, Jay T; Cole, Tim J; O'Callaghan, Michael; Wells, Jonathan C K

2014-01-01

Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.

Relationships between Neonatal Weight, Limb Lengths, Skinfold Thicknesses, Body Breadths and Circumferences in an Australian Cohort

PubMed Central

Pomeroy, Emma; Stock, Jay T.; Cole, Tim J.; O'Callaghan, Michael; Wells, Jonathan C. K.

2014-01-01

Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life. PMID:25162658

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review.

PubMed

Irving, Greg; Holden, John; Stevens, Richard; McManus, Richard J

2016-11-03

To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria. MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. Cross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included. 4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement. BP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

PubMed Central

Holden, John

2016-01-01

Objective To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. Design Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria. Data sources MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. Eligibility criteria Cross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included. Results 4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement. Conclusions BP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered. PMID:27810973

Soy protein supplement intake for 12 months has no effect on sexual maturation and may improve nutritional status in pre-pubertal children.

PubMed

Duitama, Sandra M; Zurita, Javier; Cordoba, Diana; Duran, Paola; Ilag, Leopold; Mejia, Wilson

2018-05-20

To evaluate the intake of a soy protein-based supplement (SPS) and its effects on the sexual maturation and nutritional status of prepubertal children who consumed it for a year. Healthy children (n = 51) were recruited and randomly assigned to consume the lunch fruit juice with (n = 29) or without (n = 22) addition of 45 g of a commercial soy protein-based supplement (SPS) over 12 months. Nutritional assessment including anthropometry (bodyweight, height, triceps skinfold thickness, mid-upper arm circumference), body mass index (BMI), upper arm muscle area, arm muscle circumference, upper arm area, upper arm fat area data were derived from measures using usual procedures; age and gender-specific percentiles were used as reference. Sexual maturation was measured by Tanner stage. Isoflavones were quantified using liquid chromatography and tandem mass spectrometry. Height, BMI/age, weight/age and height/age were significantly different (P < 0.05) at 12 months between girls in the control and intervention groups. Statistically significant differences between groups by gender (P < 0.05) were found in boys in the control group for the triceps skinfold thickness and fat area. Nutritional status was adequate according to the World Health Organization parameters. On average, 0.130 mg/kg body weight/day of isoflavones were consumed by children, which did not show significant differences in their sexual maturation. Consumption of SPS for 12 months did not affect sexual maturation or the onset of puberty in prepubertal boys and girls; however, it may have induced an increase in height, BMI/age, height/age and weight/age of the girls, associated with variations in fat-free mass. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Stump sensibility in children with upper limb reduction deficiency.

PubMed

Reinkingh, Marianne; Reinders-Messelink, Heleen A; Dijkstra, Pieter U; Maathuis, Karel G B; van der Sluis, Corry K

2014-01-01

To compare stump sensibility in children with upper limb reduction deficiency with sensibility of the unaffected arm and hand. In addition, to evaluate the associations between stump sensibility, stump length and activity level. Cross-sectional study. Children and young adults aged 6-25 years with upper limb reduction deficiency. Threshold of touch was measured with Semmes-Weinstein monofilaments, stereognosis was measured with the Shape-Texture Identification test and kinaesthesia and activity level was measured with the Child Amputee Prosthetics Project - Functional Status Inventory and the Prosthetic Upper Extremity Functional Index. A total of 31 children with upper limb reduction deficiency (mean age 15 years, 3 prosthesis wearers) were investigated. The threshold of touch of the stump circumference was lower (indicating higher sensibility) than of the unaffected arm (p = 0.006), hand (p = 0.004) and stump end-point (p = < 0.001). Long stumps had higher threshold of touch (indicating lower sensibility) than short stumps (p = 0.046). Twenty-nine children recognized 1 or more shapes or textures with the stump. Kinaesthesia in the affected and unaffected sides was comparable. Sensibility was not correlated with activity level. Threshold of touch, stereognosis and kinaesthesia of the affected sides were excellent. Threshold of touch of the stump circumference was lower (indicating higher sensibility) than of the unaffected arm and hand. High stump sensibility may clarify good functioning in the children without prostheses and contribute to prosthesis rejection.

Reference ranges for midupper arm circumference, upper arm muscle area, and upper arm fat area in US children and adolescents aged 1-20 y.

PubMed

Addo, O Yaw; Himes, John H; Zemel, Babette S

2017-01-01

Midupper arm circumference (MUAC) has long been used in anthropometric assessments of nutritional status in field settings, especially in emergency situations, but percentile ranges for healthy, well-nourished children are currently unavailable. We developed reference curves for MUAC and derived measures of arm muscle area (AMA) and arm fat area (AFA) on the basis of the population used in the current CDC body mass index growth charts. We analyzed cross-sectional MUAC and triceps (triceps skinfold thickness) data from 32,952 US children aged 1-20 y. Generalized additive models for location, scale, and shape were used to calculate semiparametric smoothed percentiles and L, M, and S coefficients needed for z-score estimation by age and sex. Equations were developed with the use of the height-for-age z score (HAZ) to adjust for the associations of stature with upper arm measures. MUAC increased with age steadily throughout the growing period. For children <5 y old, lower percentile ranges varied markedly across age and sex such that the single cutoff (<11.5 or 12.5 cm) for field screening of acute malnutrition did not track along the same percentile. AFA and AMA growth patterns exhibited sex-specific trends including multiple distinct age-related inflections that were more pronounced in males for AFA-for-age than in females. HAZ and age were substantially and independently related with all arm measures. The new reference percentile ranges for midupper arm measures for healthy children provide a useful nutritional assessment tool in a wide variety of settings. Height status (HAZ) has complex independent associations with arm measures irrespective of the distributional ranking by age and sex. Prediction equations that account for these effects further extend the practical use of the new curves. © 2017 American Society for Nutrition.

The impact of maternal adiposity specialization on infant birthweight: upper versus lower body fat.

PubMed

Sundermann, Alexandra C; Abell, Troy D; Baker, Lisa C; Mengel, Mark B; Reilly, Kathryn E; Bonow, Michael A; Hoy, Gregory E; Clover, Richard D

2016-11-01

The specialization of human fat deposits is an inquiry of special importance in the study of fetal growth. It has been theorized that maternal lower-body fat is designated specifically for lactation and not for the growth of the fetus. Our goal was to compare the contributions of maternal upper-body versus lower-body adiposity to infant birth weight. We hypothesized that upper-body adiposity would be strongly associated with infant birth weight and that lower-body adiposity would be weakly or negligibly associated with infant birth weight-after adjusting for known determinants. In this prospective cohort study, 355 women initiated medical pre-natal care during the first trimester of pregnancy at The University of Oklahoma Health Sciences Center during 1990-1993. Maternal anthropometric measurements were assessed at the first clinic visit: (a) height; (b) weight; (c) circumferences of the upper arm, forearm, and thigh; and, (d) skin-fold measurements of the bicep, subscapular region, and thigh. Infant birth weight was regressed on known major determinants to create the foundational model. Maternal anthropometric variables subsequently were added one at a time into this multiple regression model. The highest contribution by a single anthropometric variable to infant birthweight was, in order: subscapular skin-fold, forearm circumference, and thigh circumference. With one upper-body (subscapular skin-fold) and one lower-body (circumference of the thigh) adiposity measure in the model, the z-score regression coefficient (s.e.) was 85.7g (30.8) [p=0.0057] for maternal subscapular skin-fold and 19.0g (31.6) [p=0.5477] for circumference of the thigh. When the second-best upper-body contributor to infant birthweight (circumference of the forearm) was entered with one lower-body measure into the model, the z-score regression coefficient (s.e.) was 77.5g (38.5) [p=0.0451] for maternal forearm circumference and 14.1g (38.5) [p=0.7146] for circumference of the thigh. When both subscapular skinfold and forearm circumference were added to the model in place of BMI, the explained variance (r 2 =0.5478) was similar to the model using BMI (r 2 =0.5487). Upper-body adiposity - whether operationalized by subscapular skin-fold or circumference of the forearm - was a markedly larger determinant of infant birth weight than lower-body adiposity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dietary acculturation and body composition predict American Hmong children's blood pressure.

PubMed

Smith, Chery; Franzen-Castle, Lisa

2012-01-01

Determine how dietary acculturation, anthropometric measures (height, weight, circumferences, and skinfolds), body mass index (BMI), and waist hip ratios (WHRs) are associated with blood pressure (BP) measures in Hmong children living in Minnesota. Acculturation was measured using responses to questions regarding language usage, social connections, and diet. Dietary assessment was completed using the multiple-pass 24-h dietary recall method on two different days. Anthropometric and BP measurement were taken using standard procedures, and BMI and WHR were calculated. Data analyses included descriptive statistics, ANOVA, and stepwise regression analyses. Using stepwise regression analysis, hip circumference (HC) predicted boys' systolic (S)BP (R(2) = 0.55). For girls' SBP, mid-upper arm circumference, WHR, low calcium consumption, and height percentile jointly explained 41% of the total variation. Mid upper arm circumference (MAC) and carbohydrate consumption predicted 35% of the variance for boys' diastolic (D)BP, and HC, dairy consumption, and calcium intake predicted 31% of the total variance for girls' DBP. Responses to dietary acculturation questions revealed between group differences for breakfast with half of the younger Born-Thailand/Laos (Born-T/L) consuming mostly Hmong food, while at dinner Born-US consumed a mixed diet and Born-T/L were more likely to consume Hmong food. Dietary acculturation and body composition predict Hmong children's BP. Copyright © 2012 Wiley Periodicals, Inc.

Association between anthropometric measures of obesity and subclinical atherosclerosis in Bangladesh.

PubMed

Ge, Wenzhen; Parvez, Faruque; Wu, Fen; Islam, Tariqul; Ahmed, Alauddin; Shaheen, Ishrat; Sarwar, Golam; Demmer, Ryan T; Desvarieux, Moise; Ahsan, Habibul; Chen, Yu

2014-01-01

Anthropometric measures such as waist-hip-ratio (WHR), waist-height-ratio (WHtR), waist circumference, Mid-upper arm circumference (MUAC), and upper thigh circumference, have been linked to the risk of cardiovascular disease (CVD). However, their relationships with subclinical atherosclerosis are unclear. Studies in normal-weight populations, especially in Asian countries where leanness is prevalent, are lacking. We conducted a cross-sectional study to assess the associations of WHR, WHtR, waist circumference, hip circumference, body mass index (BMI), MUAC and upper thigh circumference with carotid intima-media thickness (cIMT) among 562 middle-aged participants free of CVD in rural Bangladesh. After adjusting for age and sex, WHR and waist circumference but not BMI showed a positive significant association with cIMT. In multivariate analysis, each standard deviation (SD) increase of WHR (0.08) or WHtR (0.07) was associated with an 8.96 μm (95% CI, 1.12-16.81) or 11.45 μm (95%CI, 0.86-22.04) difference in cIMT, respectively, after controlling for age, sex, BMI, smoking status, education level, and systolic blood pressure (SBP). The associations of WHR and WHtR with cIMT were independent of the influence of other anthropometric measures. The associations of other anthropometric measures and cIMT were not apparent. In our relatively lean, healthy Asian population, WHR and WHtR appear to be better predictors of early atherosclerosis than other common surrogates of adiposity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study.

PubMed

Elizabeth, Nabiwemba L; Christopher, Orach Garimoi; Patrick, Kolsteren

2013-04-12

Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth.Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson's correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Birth weights ranged from 1370-5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns.

Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study.

PubMed

Di Blasio, Andrea; Morano, Teresa; Napolitano, Giorgio; Bucci, Ines; Di Santo, Serena; Gallina, Sabina; Cugusi, Lucia; Di Donato, Francesco; D'Arielli, Alberto; Cianchetti, Ettore

2016-12-01

The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method). 16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups. 10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not. Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap.

Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study

PubMed Central

Di Blasio, Andrea; Morano, Teresa; Napolitano, Giorgio; Bucci, Ines; Di Santo, Serena; Gallina, Sabina; Cugusi, Lucia; Di Donato, Francesco; D'Arielli, Alberto; Cianchetti, Ettore

2016-01-01

Background The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method). Methods 16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups. Results 10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not. Conclusions Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap. PMID:28228712

Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

PubMed

Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

2016-06-01

Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, <20 kg/m), middle BMI (BMI, 20-25 kg/m), and high BMI (BMI, >25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P < 0.001]. There was no significant difference in UEL index between BMI groups [low BMI vs middle BMI vs high BMI, 97.2 (4.2) vs 96.6 (4.6) vs 96.7 (9.9), P > 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

Assessing body composition in infants and toddlers

USDA-ARS?s Scientific Manuscript database

The objective of this study was to compare different body composition techniques in infants and toddlers. Anthropometric measures including mid-upper arm circumference (MAC), triceps skinfold thickness (TSF), and weight-for-height or -length Z-scores (WHZ), and measures of body fat mass assessed wit...

Sexual relationship power and malnutrition among HIV-positive women in rural Uganda.

PubMed

Siedner, Mark J; Tsai, Alexander C; Dworkin, Shari; Mukiibi, Nozmo F B; Emenyonu, Nneka I; Hunt, Peter W; Haberer, Jessica E; Martin, Jeffrey N; Bangsberg, David R; Weiser, Sheri D

2012-08-01

Inequality within partner relationships is associated with HIV acquisition and gender violence, but little is known about more pervasive effects on women's health. We performed a cross-sectional analysis of associations between sexual relationship power and nutritional status among women in Uganda. Participants completed questionnaires and anthropometric measurements. We assessed sexual relationship power using the Sexual Relationship Power Scale (SRPS). We performed logistic regression to test for associations between sexual relationship power and poor nutritional status including body mass index, body fat percentage, and mid-upper arm circumference. Women with higher sexual relationship power scores had decreased odds of low body mass index (OR 0.29, p = 0.01), low body fat percentage (OR 0.54, p = 0.04), and low mid-upper arm circumference (OR 0.22, p = 0.01). These relationships persisted in multivariable models adjusted for potential confounders. Targeted interventions to improve intimate partner relationship equality should be explored to improve health status among women living with HIV in rural Africa.

Efficacy of Slimming Cream Containing 3.5% Water-Soluble Caffeine and Xanthenes for the Treatment of Cellulite: Clinical Study and Literature Review

PubMed Central

Byun, Sang-Young; Kwon, Soon-Hyo; Heo, Su-Hak; Shim, Jae-Seong; Du, Mi-Hee

2015-01-01

Background Cellulite is a 'cottage cheese-like' cutaneous change caused by subcutaneous fat bulging into the dermis that usually leads to cosmetic problems. Slimming cream containing 3.5% water-soluble caffeine and xanthenes exhibits a lipolytic effect with penetration into the dermis. Objective To evaluate the efficacy and safety of slimming cream for the treatment of cellulite. Methods Fifteen subjects with cellulite applied slimming cream to the thighs and inner side of the upper arms twice daily for 6 weeks. Efficacy was assessed using a standard visual scale, changes in the circumferences of the thighs and upper arms, and patient satisfaction by a questionnaire at baseline, week 3, and week 6. Safety was assessed by inquiring about adverse events through questionnaires. Results The standard visual scale score improved significantly by 0.49 points (19.8%) at week 6. Thigh and upper-arm circumferences decreased by 0.7 cm (1.7%) and 0.8 cm (2.3%), respectively, at week 6. Slight itching and transient flushing were commonly reported, but no serious adverse event occurred. Conclusion The slimming cream tested appears to be effective for the treatment of cellulitis without serious adverse effects. However, additional large clinical trials are required to confirm the efficacy and safety of slimming cream for the treatment of cellulitis. PMID:26082579

Reference values of anthropometric measurements in Dutch children. The Oosterwolde Study.

PubMed

Gerver, W J; Drayer, N M; Schaafsma, W

1989-03-01

In the period 1979-1980 the following anthropometric measurements were recorded in 2351 healthy Dutch children from 0-17 years of age: height, weight, sitting height, arm span, lengths of upper-arm, lower-arm and hand, tibial length, foot length, biacromial diameter, biiliacal diameter, and head circumference. Corresponding percentile values were constructed on the basis of normality assumptions, the mean and standard deviation at age t being determined by a cubic spline approximation. The results are compared with other studies and given in the form of growth charts.

Indirect calorimetry in obese female subjects: Factors influencing the resting metabolic rate.

PubMed

Hagedorn, Theresa; Poggiogalle, Eleonora; Savina, Claudia; Coletti, Cecilia; Paolini, Maddalena; Scavone, Luciano; Neri, Barbara; Donini, Lorenzo Maria

2012-06-20

To evaluate selected factors influencing resting energy expenditure (REE) in obese female subjects. Seventy seven 61 obese Caucasian women [mean age of 52.93 ± 13.45 years, and mean body mass index (BMI) of 41.78 ± 11.54 kg/m(2)] were enrolled; measurements of resting metabolic rate (RMR) by a ventilated, open-circuit system, indirect calorimeter were performed after an overnight fast. Body composition as well as medications, physical parameters, blood samples, disease pattern, and smoking were considered. RMR was significantly associated with body weight (r = 0.732, P < 0.001), body height (r = 0.401, P = 0.008), BMI (r = 0.504, P < 0.001), waist circumference (r = 0.602, P < 0.001), mid-upper arm circumference (r = 0.417, P = 0.006), mid-upper arm muscle circumference (r = 0.344, P = 0.028), total body water (r = 0.339, P = 0.035), body temperature (r = 0.409, P = 0.007), smoking (P = 0.031), serum T4 levels (r = 0.331, P = 0.036), obstructive sleep apnoea syndrome (OSAS; P = 0.023), impaired glucose tolerance (IGT; P = 0.017) and impaired glycaemic status, including hyperinsulinism, IGT and diabetes mellitus (P = 0.003). Future research should be prompted to optimize the procedure of indirect calorimetry to achieve clinical benefits in obese subjects.

ASSESSMENT OF NUTRITIONAL STATUS OF CHILDREN AND ADOLESCENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY.

PubMed

Caselli, Thaisa Barboza; Lomazi, Elizete Aparecida; Montenegro, Maria Augusta Santos; Bellomo-Brandão, Maria Angela

2017-01-01

Due to several factors, such as gastrointestinal's diseases and difficulty in feeding, children with Spastic Quadriplegic Cerebral Palsy tend to present nutritional deficits. To assess the nutritional status of pediatric patients with Spastic Quadriplegic Cerebral Palsy according to reference curves for this population and with the measures of folds and circumferences, obtained by the upper arm circumference and triceps skin fold. The data were obtained from: knee-height, estimated height, weight, upper arm circumference, and triceps skin fold. Values of folds and circumferences were compared with Frisancho, and specific curves for these patients were used as reference. The relationship between the values in the growth curve for healthy children, Z-Score, and comparison with the reference curve were verified by Fisher's exact test. We adopted the significance level of 5%. We evaluated 54 patients. The mean age was 10.2 years, and 34 were male, 25 fed by gastrostomy and 29, orally. The frequency of low weight by the reference curve was 22.22%. More than half of the patients presented the parameters indicating lean mass below the 5th percentile. The height of all patients was classified as adequate for the age by the reference curve. Low weight was found in 22% of patients, and there is a greater tendency to present reduced muscle mass and increased fat mass, showing the need for evaluation and appropriate interventions for patients with Spastic Quadriplegic Cerebral Palsy.

[Effects of massage on delayed-onset muscle soreness].

PubMed

Bakowski, Paweł; Musielak, Bartosz; Sip, Paweł; Biegański, Grzegorz

2008-01-01

Delayed onset muscle soreness (DOMS) is the pain or discomfort often felt 12 to 24 hours after exercising and subsides generally within 4 to 6 days. Once thought to be caused by lactic acid buildup, a more recent theory is that it is caused by inflammatory process or tiny tears in the muscle fibers caused by eccentric contraction, or unaccustomed training levels. Exercises that involve many eccentric contractions will result in the most severe DOMS. Fourteen healthy men with no history of upper arm injury and no experience in resistance training were recruited. The mean age, height, and mass of the subjects were 22.8 +/- 1.2 years, 178.3 +/- 10.3 cm, and 75.0 +/- 14.2 kg, respectively. Subjects performed 8 sets of concentric and eccentric actions of the elbow flexors with each arm according to Stay protocol. One arm received 10 minutes of massage 30 minutes after exercise, the contralateral arm received no treatment. Measurements were taken at 9 assessment times: pre-exercise and postexercise at 10 min, 6, 12, 24, 36, 48, 72 and 96 hours. Dependent variables were range of motion, perceived soreness and upper arm circumference. There was noticed difference in perceived soreness across time between groups. The analysis indicated that massage resulted in a 10% to 20% decrease in the severity of soreness, but the differences were not significant. Difference in range of motion and arm circumference was not observed. Massage administered 30 minutes after exercises could have a beneficial influence on DOMS but without influence on muscle swelling and range of motion.

Nutritional status and dietary intake of children with acute leukaemia during induction or consolidation chemotherapy.

PubMed

Tan, S Y; Poh, B K; Nadrah, M H; Jannah, N A; Rahman, J; Ismail, M N

2013-07-01

The assessment of nutritional status among paediatric patients is important for the planning and execution of nutritional strategies that strive to optimise the quality of life and growth among sick children. The present study aimed to evaluate the nutritional status and dietary intake among children with acute leukaemia. This cross-sectional study included 53 paediatric patients aged 3-12 years old, who were diagnosed with either acute lymphoblastic leukaemia or acute myelogenous leukaemia and were undergoing chemotherapy treatments (induction or consolidation phase). Patients were matched for sex, age (±6 months) and ethnicity with healthy children as controls. Weight, height, body mass index, waist circumference, mid-upper arm circumference, triceps skinfold thickness, mid-upper arm muscle area and fat area were determined. Dietary intake was assessed using 3-day food records. Anthropometric variables were generally higher among patients compared to controls, although the differences were not statistically significant (P > 0.05). The prevalence of overnutrition among patients according to body mass index-for-age, waist circumference-for-age, mid-upper arm circumference-for-age and triceps skinfold-for-age were 24.5%, 29.1%, 17.0% and 30.2%, respectively. Mean energy [5732 ± 1958 kJ (1370 ± 468 kcal) versus 6945 ± 1970 kJ (1660 ± 471 kcal), P < 0.01], protein (50.0 ± 19.7 g versus 62.3 ± 22.3 g, P < 0.01) and fat (43.6 ± 18.9 g versus 58.3 ± 16.7, P < 0.001) intakes of patients were significantly lower than controls. The prevalence of being overweight and obesity in children with acute leukaemia was higher despite lower energy intake compared to controls. Studies assessing physical activity, the complex interaction and the effects of treatment drugs are warranted to better manage malnutrition among paediatric patients. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Evaluation of physical growth in cerebral palsied children and its possible relationship with gross motor development.

PubMed

Ibrahim, Alaa I; Hawamdeh, Ziad M

2007-03-01

The object of this study was to detect any possible relation between the current gross motor function score for cerebral palsy children and their physical growth parameters. We measured 71 children with spastic cerebral palsy (35 diplegic, 25 quadriplegic and 11 hemiplegic) and a control group of 80 normal children. Measures taken for cerebral palsy and normal children included stature, weight, head circumference and mid upper-arm circumference, and, additionally for the cerebral palsied children, duration of the disease, birth weight, presence or absence of orofacial dysfunction, distribution of paralysis and degree of spasticity. Motor abilities were measured using the Gross Motor Function Measure. Results showed a significant decrease in the stature, current weight, head circumference and mid upper-arm circumference of both sexes of the quadriplegic children, and significant decreases in the current weight of the diplegic girls and the head circumference of the hemiplegic girls. There were also significant decreases in all scores of the quadriplegic children compared to the diplegic and hemiplegic children. Diplegic children had significantly decreased standing, walking and running, and total scores, compared to the hemiplegic children. Total score at age of testing was independently predicted by the duration of the disease, distribution of paralysis, presence or absence of orofacial dysfunction, spasticity index and the current body weight. Our findings indicate that in spastic cerebral palsy the physical growth parameters were markedly decreased in the quadriplegic form compared to other forms. Only current body weight, from the growth parameters, in addition to other relevant clinical data, can be considered predictors of the current gross motor abilities of those children.

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study

PubMed Central

2013-01-01

Background Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. Methods This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth. Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson’s correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Results Birth weights ranged from 1370–5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. Conclusions This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns. PMID:23587297

Laser-assisted lipolysis for arm contouring in Teimourian grades I and II: a prospective study of 45 patients.

PubMed

Leclère, Franck Marie; Alcolea, Justo M; Vogt, Peter; Moreno-Moraga, Javier; Mordon, Serge; Casoli, Vincent; Trelles, Mario A

2015-04-01

Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures. We conducted this study to objectively assess if, in Teimourian low-grade upper arm remodelling, one session of laser-assisted lypolisis (LAL) could result in full patient satisfaction. Between 2011 and 2013, 45 patients were treated for unsightly fat arm Teimourian grade I (15 patients), grade IIa (15 patients) and grade IIb (15 patients) with one session of LAL. The laser used in this study was a 1470-nm diode laser (Alma Lasers, Cesarea, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600-μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Treatment parameters and adverse effects were recorded.The arm circumference and skin pinch measurements were assessed pre and postoperatively. Patients were asked to file a satisfaction questionnaire. Pain during the anaesthesia and discomfort after the procedure were minimal. Complications included prolonged oedema in 11 patients. The average arm circumference decreased by 4.9 ± 0.4 cm in the right arm (p < 0.01) and 4.7 ± 0.5 cm in the left arm (p < 0.01) in grade I patients, 5.5 ± 0.6 cm in the right arm (p < 0.01) and 5.2 ± 0.5 cm in the left arm (p < 0.01) in grade IIa patients and 5.4 ± 0.5 cm in the right arm (p < 0.01) and 5.3 ± 0.5 cm in the left arm (p < 0.01) in grade IIB patients. The skin tightening effect was confirmed by the reduction of the skin calliper measurements in all three groups. Overall mean opinion of treatment was high for both patients and investigators. Of the 45 patients, all but one would recommend this treatment. A single session of LAL in upper arm remodelling for Teimourian grades I to IIb is a safe and reproducible technique. The procedure allows reduction in the amount of adipose deposits while providing full skin tightening.

Upper arm circumference development in Chinese children and adolescents: a pooled analysis.

PubMed

Tong, Fang; Fu, Tong

2015-05-30

Upper arm development in children is different in different ethnic groups. There have been few reports on upper arm circumference (UAC) at different stages of development in children and adolescents in China. The purpose of this study was to provide a reference for growth with weighted assessment of the overall level of development. Using a pooled analysis, an authoritative journal database search and reports of UAC, we created a new database on developmental measures in children. In conducting a weighted analysis, we compared reference values for 0~60 months of development according to the World Health Organization (WHO) statistics considering gender and nationality and used Z values as interval values for the second sampling to obtain an exponential smooth curve to analyze the mean, standard deviation, and sites of attachment. Ten articles were included in the pooled analysis, and these articles included participants from different areas of China. The point of intersection with the WHO curve was 3.5 years with higher values at earlier ages and lower values at older ages. Boys curve was steeper after puberty. The curves in the studies had a merged line compatible. The Z values of exponential smoothing showed the curves were similar for body weight and had a right normal distribution. The integrated index of UAC in Chinese children and adolescents indicated slightly variations with regions. Exponential curve smoothing was suitable for assessment at different developmental stages.

Echogenicity and ultrasound visibility of peripheral nerves of the upper extremity.

PubMed

Stolz, Lori A; Acuna, Josie Galarza; Gaskin, Kevin; Murphy, Amanda M; Friedman, Lucas; Stears-Ellis, Summer; Javedani, Parisa; Stolz, Uwe; Adhikari, Srikar

2018-05-02

Regional anesthesia with ultrasound-guidance is an excellent option for pain control if nerves are adequately visualized. Gender, body mass index (BMI), history of diabetes, neck and forearm circumference may affect echotexture and visualization. This study evaluates patient characteristics for their ability to predict the echogenicity or visibility of upper extremity peripheral nerves. This is a prospective observational study. A convenience sample of adult emergency department patients were enrolled. Gender, BMI, history of diabetes, neck circumference and arm circumference were recorded. Sonographic images of the brachial plexus at interscalene and supraclavicular levels, the median, the radial and ulnar nerves were recorded. Three reviewers independently graded the echogenicity and visibility using subjective scales. 395 peripheral nerves were included. Nerves of the forearm (median, ulnar, radial nerves) were found to be more echogenic (OR=9.3; 95% CI: 5.7, 15.3) and visible (OR=10.0; 6.3, 16.0) than more proximal nerves (brachial plexus at interscalene and supraclavicular levels). Gender, BMI, and history of diabetes mellitus were not significantly related to nerve visibility (p=0.9, 0.2, 0.2, respectively) or echogenicity (p=0.3, 0.8, 0.3). Neck circumference was not related to visibility or echogenicity of proximal nerves. Increased forearm circumference improved echogenicity (OR=1.25; 1.09, 1.43) but not visibility of forearm nerves. Gender, BMI and presence of diabetes were not related to echogenicity or visibility of upper extremity nerves. Increasing forearm circumference was associated with increased echogenicity of the adjacent nerves, but not visibility. Neck circumference was not associated with either nerve visibility or echogenicity of brachial plexus nerve bundles.

Anthropometric and body frame size characteristics in relation to body mass index and percentage body fat among adult Bengalee male brick-kiln workers from Murshidabad, West Bengal, India.

PubMed

Banik, Sudip Datta; Ghosh, Mihir; Bose, Kaushik

2016-11-01

Anthropometric and body frame size parameters (ABFSP) are used to interpret body mass and to evaluate nutritional status. Objective of the present study was to investigate the interrelationships between ABFSP, percentage body fat (BF%) and body mass index (BMI). The study was carried out in a sample of 141 adult Bengalee healthy male brick-kiln workers (age range 18-59 years) from Murshidabad district in West Bengal, India. Body weight was recorded; anthropometric measurements included height, breadth (elbow, wrist, hand, foot, ankle, knee), circumferences (mid-upper arm, chest, waist, hip, thigh, medial calf) and skinfolds (biceps, triceps, subscapular, suprailiac). Derived ABFSP included sum of breadth and circumferences, frame index, BMI, BF%, sum of skinfolds, ratio of central and peripheral skinfolds, arm muscle area, arm muscle circumference, arm fat area and brachial adipo-muscular ratio. Correlations (age-controlled) between ABFSP, BMI and BF% were highly significant ( p < 0.001). The ABFSP and BF% varied significantly ( p < 0.0001) in relation to BMI-based nutritional status (BNS). Multinomial logistic regression analysis (age-adjusted) showed ABFSP had statistically significant ( p < 0.01) relationships with BNS. There were strong interrelationships between ABFSP, BMI and BF% independent of age. The ABFSP in individuals with normal BMI, suffering from undernutrition (low BMI) or overweight are different.

Reliability of the Inverse Water Volumetry Method to Measure the Volume of the Upper Limb.

PubMed

Beek, Martinus A; te Slaa, Alexander; van der Laan, Lijckle; Mulder, Paul G H; Rutten, Harm J T; Voogd, Adri C; Luiten, Ernest J T; Gobardhan, Paul D

2015-06-01

Lymphedema of the upper extremity is a common side effect of lymph node dissection or irradiation of the axilla. Several techniques are being applied in order to examine the presence and severity of lymphedema. Measurement of circumference of the upper extremity is most frequently performed. An alternative is the water-displacement method. The aim of this study was to determine the reliability and the reproducibility of the "Inverse Water Volumetry apparatus" (IWV-apparatus) for the measurement of arm volumes. The IWV-apparatus is based on the water-displacement method. Measurements were performed by three breast cancer nurse practitioners on ten healthy volunteers in three weekly sessions. The intra-class correlation coefficient, defined as the ratio of the subject component to the total variance, equaled 0.99. The reliability index is calculated as 0.14 kg. This indicates that only changes in a patient's arm volume measurement of more than 0.14 kg would represent a true change in arm volume, which is about 6% of the mean arm volume of 2.3 kg. The IWV-apparatus proved to be a reliable and reproducible method to measure arm volume.

Indirect calorimetry in obese female subjects: Factors influencing the resting metabolic rate

PubMed Central

Hagedorn, Theresa; Poggiogalle, Eleonora; Savina, Claudia; Coletti, Cecilia; Paolini, Maddalena; Scavone, Luciano; Neri, Barbara; Donini, Lorenzo Maria

2012-01-01

AIM: To evaluate selected factors influencing resting energy expenditure (REE) in obese female subjects. METHODS: Seventy seven 61 obese Caucasian women [mean age of 52.93 ± 13.45 years, and mean body mass index (BMI) of 41.78 ± 11.54 kg/m2] were enrolled; measurements of resting metabolic rate (RMR) by a ventilated, open-circuit system, indirect calorimeter were performed after an overnight fast. Body composition as well as medications, physical parameters, blood samples, disease pattern, and smoking were considered. RESULTS: RMR was significantly associated with body weight (r = 0.732, P < 0.001), body height (r = 0.401, P = 0.008), BMI (r = 0.504, P < 0.001), waist circumference (r = 0.602, P < 0.001), mid-upper arm circumference (r = 0.417, P = 0.006), mid-upper arm muscle circumference (r = 0.344, P = 0.028), total body water (r = 0.339, P = 0.035), body temperature (r = 0.409, P = 0.007), smoking (P = 0.031), serum T4 levels (r = 0.331, P = 0.036), obstructive sleep apnoea syndrome (OSAS; P = 0.023), impaired glucose tolerance (IGT; P = 0.017) and impaired glycaemic status, including hyperinsulinism, IGT and diabetes mellitus (P = 0.003). CONCLUSION: Future research should be prompted to optimize the procedure of indirect calorimetry to achieve clinical benefits in obese subjects. PMID:24520534

Validation of the Microlife WatchBP Home blood pressure device in pregnancy for medium and large arm circumferences.

PubMed

Clark, Katherine; Snowball, Olivia; Nzelu, Diane; Kay, Polly; Kametas, Nikos A

2018-06-01

The Microlife WatchBP Home automated blood pressure device was assessed for accuracy in pregnant women of medium (<32 cm) and large (≥32 cm) arm circumference. The British Hypertension Society validation protocol was modified for the purpose of this study to include women with arm circumference of less than 32 cm (N=51) and greater than or equal to 32 cm (N=46) as two separate arms. The device achieved an overall A/A grade for medium arm circumference and B/A grade for large arm circumference. The mean±SD device-observer difference was 1.7±6.2 and -0.4±4.4 for systolic and diastolic blood pressure, respectively, for medium arm circumference and 3.0±8.5 and 1.5±5.1, respectively, for large arm circumference. When all women with pre-eclampsia from both groups were pooled (N=23), the device achieved an overall grade of A/A with mean differences of 2.1±7.2 for systolic blood pressure and 1.0±5.6 for diastolic blood pressure. The Microlife WatchBP Home automated blood pressure device can be recommended for use in pregnant women of all gestations, including those with pre-eclampsia. However, caution is needed for women with large arm circumferences.

Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: a prospective observational cohort study: part 2.

PubMed

Maneval, Rhonda E; Clemence, Bonnie J

2014-01-01

This is the second part of a 2-part series that reports on the results of a prospective observational cohort study designed to examine risk factors associated with symptomatic upper extremity deep vein thrombosis (UEDVT) in patients with peripherally inserted central catheters (PICCs). Part 1, published in the May/June 2014 issue of the Journal of Infusion Nursing, provided an extensive review and critique of the literature regarding risk factors associated with catheter-related UEDVT and identified 28 suspected risk factors. A study was undertaken to examine each of the risk factors among 203 acute care patients with PICCs, 13 of whom experienced a UEDVT, yielding an incidence of 6.4%. The most common reason for admission was infection (33.5%), and the primary reason for insertion of the PICC was venous access (58.6%). Hypertension (P = .022) and obesity (P = .008), defined as a body mass index ≥30, were associated with UEDVT. The clinical symptoms of edema (P < .001) and a 3-cm or more increase in arm circumference (P < .001) in the PICC arm after PICC placement were associated with UEDVT. All other variables were not statistically significant. The results suggest that patients who are obese and hypertensive may be at greater risk for the development of UEDVT and that the physical finding of edema and increased arm circumference in the PICC arm are possibly suggestive of UEDVT.

Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study.

PubMed

Thi, Hai Nguyen; Khanh, Dung Khu Thi; Thu, Ha Le Thi; Thomas, Emma G; Lee, Katherine J; Russell, Fiona M

2015-01-01

The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age. An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared. 485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96). The optimal cut-points for measurements within 24 h of birth were ≤ 7.4 cm for foot length; ≤ 30.4 cm for chest circumference; and ≤ 9.0 cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm). All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable in community settings.

Effect of standard cuff on blood pressure readings in patients with obese arms. How frequent are arms of a 'large circumference'?

PubMed

Fonseca-Reyes, Salvador; de Alba-García, Javier García; Parra-Carrillo, José Z; Paczka-Zapata, José Antonio

2003-06-01

To measure the effect on blood pressure readings when a standard cuff is used on patients with arms of a large circumference, and to determine the frequency of arms of a large circumference. Blood pressures were taken in 120 subjects with an arm circumference greater than 33 cm. Also, the arm circumference was determined in 244 patients from a family health unit, and in 216 patients from a hypertension clinic. A mercury sphygmomanometer and two different cuff sizes were used in a random sequence; therefore, 60 patients' blood pressure were first measured with a large cuff, followed by a standard cuff; the opposite sequence was then applied for another 60 patients. With the obtained values and using a regression analysis, the difference in blood pressure overestimation was calculated. Arm circumference measurement percentages were used to determine the frequency of arms of a large circumference. Both systolic and diastolic blood pressures were significantly greater when the standard cuff was used. For every 5 cm increase in arm circumference, starting at 35 cm, a 2-5 mmHg increase in systolic blood pressure, and a 1-3 mmHg increase in diastolic blood pressure was observed. The prevalence of arms with a large circumference in the family medicine unit and hypertension clinic was 42% and 41.8%, respectively. There is an overestimation of blood pressure when a standard cuff is used in obese subjects. The high prevalence of these individuals in our environment, both in the hypertensive and normotensive population, makes it necessary to have on hand different sizes of cuffs for taking blood pressure in order to avoid incorrect decisions.

Nutritional status in parasitized and nonparasitized children from two districts of Buenos Aires, Argentina.

PubMed

Orden, Alicia B; Apezteguía, María C; Ciarmela, María L; Molina, Nora B; Pezzani, Betina C; Rosa, Diana; Minvielle, Marta C

2014-01-01

The Program for the Control of Intestinal Parasites and Nutrition was designed to intervene in small communities to prevent and control the effects of parasitic infections on children's health. To analyze the association between nutritional status and parasitic infection in suburban and rural children from Buenos Aires, Argentina. Nutritional status was assessed by anthropometric (weight, height, BMI, skinfolds, upper arm circumference, muscle, and fat upper arm areas) and biochemical (Hb, Ca, Mg, Zn, and Cu) indicators. Parasitological analysis were made on both serial stool and perianal swab samples. A total of 708 children aged 3-11 were measured. The biochemical analysis included 217 blood samples and the parasitological study included 284 samples. Anthropometric status was similar in both settings with low rates of underweight and stunting (<6%), and high rates of overweight (~17%) and obesity (~12%). Ca deficiency was significantly higher in suburban children where 80% of them were hypocalcemic. Around 70% of fecal samples contained parasites. Among infected children, the most prevalent species were Blastocystis hominis and Enterobius vermicularis (~43%) followed by Giardia lamblia (~17%). Differences in parasitological status between districts were not significant. In the suburban district parasitized children were lighter, shorter, and had a lower upper arm circumference than their non-infected peers. No differences in anthropometric status were seen among infected and uninfected rural children. The results suggest an association between intestinal parasites and physical growth in suburban children. Rural children seem to be protected against the effects of parasitic infection. Copyright © 2013 Wiley Periodicals, Inc.

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau

PubMed Central

Aaby, Peter; Gomes, Joaquim; Fernandes, Manuel; Djana, Queba; Lisse, Ida; Jensen, Henrik

1999-01-01

Objective To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Design Follow up study of 3 months. Setting Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. Participants 422 children aged 9-23 months in 30 clusters. Main outcome measures Mid-upper arm circumference and survival in relation to residence status. Results During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee’s stay in Prabis compared with the period after the departure of the refugees. Conclusion In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability. Key messagesDuring the war in Guinea-Bissau, most of the population fled from the capital and moved in with relatives, friends, or strangersInternational agencies insisted on only providing help to refugees (internally displaced people)During the first month of conflict, there were already profound effects on the nutritional status and mortality of young childrenFood consumption was higher in resident families, but resident children were more malnourished and had higher mortality than refugee childrenNutritional status and survival improved for both refugee and resident children once the refugees returned to Bissau PMID:10506040

Correlations of Handgrip Strength with Selected Hand-Arm-Anthropometric Variables in Indian Inter-university Female Volleyball Players

PubMed Central

Koley, Shyamal; Pal Kaur, Satinder

2011-01-01

Purpose The purpose of this study was to estimate the dominant handgrip strength and its correlations with some hand and arm anthropometric variables in 101 randomly selected Indian inter-university female volleyball players aged 18-25 years (mean age 20.52±1.40) from six Indian universities. Methods Three anthropometric variables, i.e. height, weight, BMI, two hand anthropometric variables, viz. right and left hand width and length, four arm anthropometric variables, i.e. upper arm length, lower arm length, upper extremity length, upper arm circumference and dominant right and non-dominant handgrip strength were measured among Indian inter-university female volleyball players by standard anthropometric techniques. Results The findings of the present study indicated that Indian female volleyball players had higher mean values in eleven variables and lesser mean values in two variables than their control counterparts, showing significant differences (P<0.032-0.001) in height (t=2.63), weight (t=8.66), left hand width (t=2.10), left and right hand length (t=9.99 and 10.40 respectively), right upper arm length (t=8.48), right forearm length (t=5.41), dominant (right) and non-dominant (left) handgrip strength (t=9.37 and 6.76 respectively). In female volleyball players, dominant handgrip strength had significantly positive correlations (P=0.01) with all the variables studied. Conclusion It may be concluded that dominant handgrip strength had strong positive correlations with all the variables studied in Indian inter-university female volleyball players. PMID:22375242

Severe acute malnutrition.

PubMed

Nel, E D

2016-05-01

The mortality and morbidity associated with severe acute malnutrition (SAM) remain high. A summary of recent studies that are of interest to clinicians treating children with SAM is provided. Three important themes emerged in 2015: the use of anthropometry in the diagnosis of SAM and its correlation with body composition; the composition of ready-to-use therapeutic feeds (RUTF); and an improved understanding of the pathophysiology of SAM. Standard anthropometry does not accurately predict body composition and mid-upper arm circumference more accurately reflects fat mass in children. As single measure, mid-upper arm circumference identifies those children who are most likely to die from SAM and is not influenced by dehydration. However, a significant proportion of SAM children requiring treatment will not be detected. Present RUTF formulations are deficient in long chain polyunsaturated fatty acids. Current evidence suggests that preformed docosahexaenoic acid should be added and/or the content of linoleic acid reduced in RUTF. In contrast to an animal model, stabile children with SAM have the same cardiac index as children without SAM. The situation in haemodynamically unstable children is unknown, continued conservative use of intravenous fluids seems advisable. A reduction in variability of the faecal DNA virome may account for increased susceptibility to malnutrition in vulnerable children.

Intra-abdominal fat: Comparison of computed tomography fat segmentation and bioimpedance spectroscopy.

PubMed

Finch, Peter

2017-06-01

Intra-abdominal fat is an important factor in determining the metabolic syndrome/insulin resistance, and thus the risk of diabetes and ischaemic heart disease. Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with attendant radiation risks. Bioimpedance spectroscopy may offer a method of assessment without any risks to the patients. A comparison is made of these two methods. This was a preliminary study of the utility of multifrequency bioimpedance spectroscopy of the mid abdomen as a measure of intra-abdominal fat, by comparison with fat segmentation of an abdominal CT scan in the -30 to -190 HU range. There was a significant (P < 0.01) correlation between intra-abdominal fat and mid-upper arm circumference, as well as the bioimpedance parameter, the R/S ratio. Multivariate analysis showed that these were the only independant variables and allowed the derivation of a formula to estimate intra-abdominal fat: IAF = 0.02 × MAC - 0.757 × R/S + 0.036. Circumabdominal bioimpedance spectroscopy may prove a useful method of assessing intra-abdominal fat, and may be suitable for use in studies to enhance other measures of body composition, such as mid-upper arm circumference.

Normal values for segmental bioimpedance spectroscopy in pediatric patients.

PubMed

Avila, Maria Laura; Ward, Leigh C; Feldman, Brian M; Montoya, Madeline I; Stinson, Jennifer; Kiss, Alex; Brandão, Leonardo R

2015-01-01

Localized limb edema is a clinically relevant sign in diseases such as post-thrombotic syndrome and lymphedema. Quantitative evaluation of localized edema in children is mainly done by measuring the absolute difference in limb circumference, which includes fat and fat-free mass. Bioimpedance spectroscopy (BIS) provides information on the fluid volume of a body segment. Our objective was to determine normal ranges for segmental (arm and leg) BIS measurements in healthy children. Additionally, we determined the normal ranges for the difference in arm and ankle circumference and explored the influence of handedness and the correlation between techniques. Healthy children aged 1-18 years were recruited. The ratio of extracellular fluid content between contralateral limbs (estimated as the inter-arm and inter-leg extracellular impedance ratio), and the ratio of extracellular to intracellular fluid content for each limb (estimated as the intracellular to extracellular impedance ratio) were determined with a bioimpedance spectrometer. Arm and ankle circumference was determined with a Gulick II tape. We recruited 223 healthy children (48 infants, 54 preschoolers, 66 school-aged children, and 55 teenagers). Normal values for arm and leg BIS measurements, and for the difference in arm and ankle circumference were estimated for each age category. No influence of handedness was found. We found a statistically significant correlation between extracellular impedance ratio and circumference difference for arms among teenagers. We determined normal BIS ranges for arms and legs and for the difference in circumference between arms and between ankles in children. There was no statistically significant correlation between extracellular impedance ratio and difference in circumference, except in the case of arms in adolescents. This may indicate that limb circumference measures quantities other than fluid, challenging the adequacy of this technique to determine the presence of localized edema in most age groups.

Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults: A prospective longitudinal study.

PubMed

Sanson, Gianfranco; Bertocchi, Luca; Dal Bo, Eugenia; Di Pasquale, Carmen Luisa; Zanetti, Michela

2018-06-01

Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identifying malnourished patients at hospital admission and effectively monitoring their food intake. The primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. Prospective observational longitudinal study. Internal Medicine Ward of an Academic Teaching University Hospital. Acute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference <23.5 cm or impaired self-feeding ability) at admission. The effective energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. Eighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p < 0.01), and experienced longer hospital stays (p ≤ 0.04) and higher in-hospital and 30-day post-discharge mortality (p < 0.001). In the multivariate analysis, lower middle-upper arm circumference, higher C-reactive protein/albumin ratio, and impaired self-feeding at admission were independently associated with critically reduced energy and protein intake. Middle-upper arm circumference, C-reactive protein/albumin ratio, and impaired self-feeding are easily obtainable indicators of impaired energy and protein intake and poor clinical outcomes. Such parameters should be adopted as screening criteria to assess the risk for critically reduced energy/protein intake in hospitalized older adults. These findings are relevant to improve clinical practice through the implementation of multidisciplinary strategies, given the adverse clinical outcomes related to hospital malnutrition. Copyright © 2018 Elsevier Ltd. All rights reserved.

Do dominant and non-dominant arms respond similarly to maximal eccentric exercise of the elbow flexors?

PubMed

Newton, Michael J; Sacco, Paul; Chapman, Dale; Nosaka, Kazunori

2013-03-01

Two common models to investigate the effect of interventions on muscle damage include using two groups in which one group receives an intervention while the other acts as control, and using contralateral limbs of one group. The latter model is based on the assumption that changes in markers of muscle damage are similar between limbs, but this has not been examined systematically. This study compared changes in muscle damage markers between dominant and non-dominant arms following maximal eccentric exercise of the elbow flexors. Eighteen men performed 60 maximal eccentric elbow flexions of each arm separated by 4 weeks with the order of testing between arms randomised. Maximal voluntary isometric torque, range of motion, upper arm circumference, plasma creatine kinase (CK) activity and muscle soreness before and for 7 days following exercise were compared between arms using two-way repeated measures ANOVA. No significant differences between arms were evident for any of the markers, but significant (P<0.05) differences between first and second bouts were evident for changes in strength, circumference and CK with smaller changes following the second bout. A poor correlation was found for the magnitude of changes in the markers between dominant and non-dominant arms, suggesting that responses to eccentric exercise were not necessarily the same between arms. These results show that the order affected the responses of dominant and non-dominant arms to the eccentric exercise; however, the contralateral limb design appears to be usable if bout order is counterbalanced and randomised among participants. Copyright © 2012. Published by Elsevier Ltd.

IMPACT OF PARTIAL KANGAROO MOTHER CARE ON GROWTH RATES AND DURATION OF HOSPITAL STAY OF LOW BIRTH WEIGHT INFANTS AT THE KENYATTA NATIONAL HOSPITAL, NAIROBI.

PubMed

Mwendwa, A C; Musoke, R N; Wamalwa, D C

2012-02-01

To determine the effect of partial Kangaroo Mother Care (KMC) on growth rates and duration of hospital stay of Low Birth Weight (LBW) infants. Unblinded, randomised clinical controlled trial. Kenyatta National Hospital, Nairobi, Kenya. Over a nine month period, consecutive recruitment of eligible LBW infants weighing 1000 g to 1750 g was done until a sample of 166 infants was reached. Kangaroo mother care was practised over an eight hour period per day for the intervention group while the controls remained in incubators or cots. Weight, head circumference, and mid upper arm circumference were monitored for all infants till discharge at 1800 g. Of the 166 infants recruited 157 were followed up to discharge. Baseline characteristics were similar for the two groups except for mother's age, with the KMC group mothers having a mean age of 26.5 years while the control group mothers had a mean age of 24 years, (p = 0.04). The KMC group had significantly higher growth rates as shown by the higher mean weight gain of 22.5 g/kg/day compared with 16.7g/kg/day for the control group, (p < 0.001); higher mean head circumference gain of 0.91 cm/week compared with 0.54 cm/week for the control group, (p < 0.001) and higher mean mid upper arm circumference gain of 0.76 cm/week compared with 0.48 cm/week for the control group, (p = 0.002). Although overall duration of stay was similar between study arms, when infants were stratified into those above or below 1500 g KMC infants' duration of stay was significantly shorter than those in regular care. Using logistic regression, KMCwas the strongest predictor formeanweight, meanhead circumference and mean MUAC gain while mother's age (older) was the strongest predictor for mean duration of stay with KMC being an independent predictor of duration of stay. Low birth weight infants in this cohort achieved rates of growth within the recommended intrauterine growth but babies managed using partial KMC grew faster and were thus discharged earlier than those on standard of care. Since partial KMC was beneficial, it should be fully implemented for all eligible infants.

Nutritional risk and anthropometric evaluation in pediatric liver transplantation.

PubMed

Zamberlan, Patrícia; Leone, Cláudio; Tannuri, Uenis; Carvalho, Werther Brunow de; Delgado, Artur Figueiredo

2012-12-01

To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome. Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease. We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/ length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization. Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation.

Somatotype characteristics of male patients with type 2 diabetes mellitus.

PubMed

Baltadjiev, Atanas G

2012-01-01

Type 2 diabetes is a metabolic disorder and as such it no doubt affects the components of somatotype of diabetics. The aim of this study was to determine the somatotype of males with type 2 diabetes. In the study we assessed anthropometrically 169 male patients with type 2 diabetes. The patients were Bulgarian; they were allocated into two age groups: group 1 included 40-60-year-old patients and group 2--61-80-year olds. Healthy Bulgarian men without any history of metabolic, neoplastic, or other diseases were used as controls divided into age matched groups. Measurements obtained directly were height, body weight, biepicondylar breadth of humerus, biepicondylar breadth of femur, relaxed upper arm circumference, contracted upper arm circumference, forearm circumference, waist circumference, hip circumference, thigh circumference, calf circumference. Skin folds: subscapular, over rib 10, suprailiac, over abdomen, triceps, biceps, forearm, thigh, calf. Calculated parameters: Heath-Carter anthropometric somatotype components. Mean somatotype of 40-60-year-old male diabetics was endomorphic mesomorph (endo-mesomorph), (endo 5.03; meso 6.57; ecto 2.01). Mean somatotype 61-80-year-old diabetic males was endomorphic mesomorph (endo-mesomorph), (endo 4.14; meso 5.88; ecto 1.64). The between-age comparison showed the somatotype in both age groups of diabetic males to be endomorphic mesomorph. The mesomorphy was dominant, followed by endomorphy and ectomorphy was far behind. The differences in the ratings of the somatotype components were of high statistical significance (P < 0.001). The mesomorphy and endomorphy ratings in patients with type 2 diabetes aged 40-60 years were greater than those of patients aged 61-80 years with the difference reaching statistical significance (P < 0.001). Both age groups of male diabetics presented with endomorphic mesomorph somatotype. Mesomorphy was the highest, followed by endomorphy. Ectomorphy lagged substantially behind, leading to a shift in the somatoplot upward to mesomorphy and leftward to endomorphy. Unlike the findings of studies in foreign countries presenting markedly dominating endomorphy, in our study Bulgarian diabetic males presented with dominating mesomorphy. This can be regarded as a characteristic feature of Bulgarian diabetic patients. This could be accounted for by the role played by factors such as lifestyle, habits, environment, diet, methods of treatment, etc. The somatotype of Bulgarian diabetic males (endomorphic mesomorph) is more favourable with regard to the risk, course and prognosis of the disease.

Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study

PubMed Central

Thi, Hai Nguyen; Khanh, Dung Khu Thi; Thu, Ha Le Thi; Thomas, Emma G.; Lee, Katherine J.; Russell, Fiona M.

2015-01-01

Background The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age. Materials and Methods An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared. Results 485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96–0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92–0.96). The optimal cut-points for measurements within 24 h of birth were ≤7.4cm for foot length; ≤30.4cm for chest circumference; and ≤ 9.0cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm). Conclusions All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable in community settings. PMID:26555356

Is mid-upper arm circumference alone sufficient for deciding admission to a nutritional programme for childhood severe acute malnutrition in Bangladesh?

PubMed

Ali, Engy; Zachariah, Rony; Shams, Zubair; Vernaeve, Lieven; Alders, Petra; Salio, Flavio; Manzi, Marcel; Allaouna, Malik; Draguez, Bertrand; Delchevalerie, Pascale; Harries, Anthony D

2013-05-01

Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2. Report on morbidity and mortality. Children underwent 2-weekly prospective follow-up home visits for 3 months and their anthropometric evolution, morbidity and mortality were monitored. Of 158 children, 21 did not complete follow-up (six were lost to follow-up and 15 changed residence). Of the remaining 137 children, nine (7%) required admission to the nutrition programme because of: MUAC dropping to <115 mm (5/9 children), weight loss ≥ 10% (1/9 children) and severe medical complications (3/9 children, of whom one died). Of the remaining 128 children who completed follow-up, 91 (66%) improved in nutritional status while 37 (27%) maintained a WHZ of <-3. Cough was less frequent among those whose nutritional status improved. It seems acceptable to rely on MUAC as a single assessment tool for case finding and for admission of children with SAM to nutritional programmes.

Blood pressure measurement in obese patients: comparison between upper arm and forearm measurements.

PubMed

Pierin, Angela M G; Alavarce, Débora C; Gusmão, Josiane L; Halpern, Alfredo; Mion, Décio

2004-06-01

It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms. To compare arm blood pressure measurements with an appropriate cuff and forearm blood pressure measurements (BPM) with a standard cuff, and both measurements by the Photopletismography (Finapres) method. One hundred and twenty-nine obese patients were studied (body mass index=40+/-7 kg/m2). The patients had three arm BPM taken by an automatic oscillometric device using an appropriate cuff and three forearm BPM with a standard cuff in the sitting position after a five-minute rest. Data were analysed by the analysis of variance. The correction values were obtained by the linear regression test. Systolic and diastolic arm BPM with an appropriate cuff were significantly lower (p<0.05) than forearm BPM with a standard cuff. The measurements obtained by Finapres were significantly lower (p<0.05) than those found for forearm systolic and diastolic blood pressures and upper arm diastolic blood pressure. The equation to correct BPM in forearm in obese patients with arm circumference between 32-44 cm was: systolic BPM=33.2+/-0.68 x systolic forearm BPM, and diastolic BPM=25.2+0.59 x forearm diastolic BPM. This study showed that forearm blood pressure measurement overestimates the values of arm blood pressure measurement. In addition, it is possible to correct forearm BPM with an equation.

Sexual Relationship Power and Malnutrition Among HIV-Positive Women in Rural Uganda

PubMed Central

Siedner, Mark J.; Tsai, Alexander C.; Dworkin, Shari; Mukiibi, Nozmo F. B.; Emenyonu, Nneka I.; Hunt, Peter W.; Haberer, Jessica E.; Martin, Jeffrey N.; Bangsberg, David R.; Weiser, Sheri D.

2012-01-01

Inequality within partner relationships is associated with HIV acquisition and gender violence, but little is known about more pervasive effects on women’s health. We performed a cross-sectional analysis of associations between sexual relationship power and nutritional status among women in Uganda. Participants completed questionnaires and anthropometric measurements. We assessed sexual relationship power using the Sexual Relationship Power Scale (SRPS). We performed logistic regression to test for associations between sexual relationship power and poor nutritional status including body mass index, body fat percentage, and mid-upper arm circumference. Women with higher sexual relationship power scores had decreased odds of low body mass index (OR 0.29, p = 0.01), low body fat percentage (OR 0.54, p = 0.04), and low midupper arm circumference (OR 0.22, p = 0.01). These relationships persisted in multivariable models adjusted for potential confounders. Targeted interventions to improve intimate partner relationship equality should be explored to improve health status among women living with HIV in rural Africa. PMID:22382629

Validation of the Omron HEM-7320-LA, upper arm blood pressure monitor with Intelli Wrap Technology Cuff HEM-FL1 for self-measurement and clinic use according to the European Society of Hypertension International Protocol revision 2010 in the Mexican population.

PubMed

Grover-Páez, Fernando; Cardona-Muñoz, Ernesto G; Cardona-Müller, David; Guzmán-Saldívar, Víctor H; Rodríguez-De la Cerda, Mariana; Jiménez-Cázarez, Mayra B; Totsuka-Sutto, Sylvia E; Alanis-Sánchez, Guillermo A; Ramos-Becerra, Carlos G

2017-12-01

The aim of this study was to determine the accuracy of the Omron HEM-7320-LA with Intelli Wrap technology cuff HEM-FL1 for self-measurement and clinic blood pressure (BP) measurement according to the European Society of Hypertension International Protocol revision 2010. The evaluation was performed in 39 individuals. The mean age of the participants was 47.9±14 years; systolic BP was 145.2±24.3 mmHg (range: 97-190), diastolic BP was 90.9±12.9 mmHg (range: 68-120), and arm circumference was 30.8±4 cm (range: 25-38.5). The device successfully fulfilled the established criteria of the validation protocol. The device overestimated systolic BP by 0.6±5.7 mmHg and diastolic BP by 2.2±5.1 mmHg. The specially designed cuff HEM-FL1 to cover a broad range of arm circumferences and self-placement fulfilled the requirements of the International Protocol.

Monitoring elbow isometric contraction by novel wearable fabric sensing device

NASA Astrophysics Data System (ADS)

Wang, Xi; Tao, Xiaoming; So, Raymond C. H.; Shu, Lin; Yang, Bao; Li, Ying

2016-12-01

Fabric-based wearable technology is highly desirable in sports, as it is light, flexible, soft, and comfortable with little interference to normal sport activities. It can provide accurate information on the in situ deformation of muscles in a continuous and wireless manner. During elbow flexion in isometric contraction, upper arm circumference increases with the contraction of elbow flexors, and it is possible to monitor the muscles’ contraction by limb circumferential strains. This paper presents a new wireless wearable anthropometric monitoring device made from fabric strain sensors for the human upper arm. The materials, structural design and calibration of the device are presented. Using an isokinetic testing system (Biodex3®) and the fabric monitoring device simultaneously, in situ measurements were carried out on elbow flexors in isometric contraction mode with ten subjects for a set of positions. Correlations between the measured values of limb circumferential strain and normalized torque were examined, and a linear relationship was found during isometric contraction. The average correlation coefficient between them is 0.938 ± 0.050. This wearable anthropometric device thus provides a useful index, the limb circumferential strain, for upper arm muscle contraction in isometric mode.

Localized Arm Volume Index: A New Method for Body Type-Corrected Evaluation of Localized Arm Lymphedematous Volume Change.

PubMed

Yamamoto, Takumi; Yamamoto, Nana; Yoshimatsu, Hidehiko

2017-10-01

Volume measurement is a common evaluation for upper extremity lymphedema. However, volume comparison between different patients with different body types may be inappropriate, and it is difficult to evaluate localized limb volume change using arm volume. Localized arm volumes (Vk, k = 1-5) and localized arm volume indices (LAVIk) at 5 points (1, upper arm; 2, elbow; 3, forearm; 4, wrist; 5, hand) of 106 arms of 53 examinees with no arm edema were calculated based on physical measurements (arm circumferences and lengths and body mass index [BMI]). Interrater and intrarater reliabilities of LAVIk were assessed, and Vk and LAVIk were compared between lower BMI (BMI, <22 kg/m) group and higher BMI (BMI, ≥22 kg/m) group. Interrater and intrarater reliabilities of LAVIk were all high (all, r > 0.98). Between lower and higher BMI groups, significant differences were observed in all Vk (V1 [P = 6.8 × 10], V2 [P = 3.1 × 10], V3 [P = 1.1 × 10], V4 [P = 8.3 × 10], and V5 [P = 3.0 × 10]). Regarding localized arm volume index (LAVI) between groups, significant differences were seen in LAVI1 (P = 9.7 × 10) and LAVI5 (P = 1.2 × 10); there was no significant difference in LAVI2 (P = 0.60), LAVI3 (P = 0.61), or LAVI4 (P = 0.22). Localized arm volume index is a convenient and highly reproducible method for evaluation of localized arm volume change, which is less affected by body physique compared with arm volumetry.

Nutritional status at diagnosis in children with cancer. 2. An assessment by arm anthropometry.

PubMed

Barr, Ronald; Collins, Laura; Nayiager, Trishana; Doring, Nancy; Kennedy, Charlene; Halton, Jacqueline; Walker, Scott; Sala, Alessandra; Webber, Colin

2011-04-01

Assessment of nutritional status in children with cancer is important but measures based on weight can be problematic at diagnosis, especially in those with advanced disease. Likewise, dual energy x-ray absorptiometry may be confounded by other radiological procedures and is not commonly available in low-income countries where most children with cancer live. Arm anthropometry is not subject to these constraints. In a study sample of 99 Canadian patients with cancer at diagnosis, mid-upper arm circumference correlated well with lean body mass as measured by dual energy x-ray absorptiometry but triceps skin fold thickness was a poor predictor of fat mass. Arm anthropometry can be a useful tool for the measurement of nutritional status in children with cancer. However, further studies, particularly in low-income countries and in children with solid tumors at diagnosis, are required to determine the full extent of its utility.

Household food insecurity is associated with both body mass index and middle upper-arm circumference of mothers in northwest Ethiopia: a comparative study.

PubMed

Motbainor, Achenef; Worku, Alemayehu; Kumie, Abera

2017-01-01

Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia. This was a community-based comparative cross-sectional study conducted May 24-July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia's Productive Safety Net Programme was used for grouping the study areas. A food-security access scale developed by the Food and Nutrition Technical Assistant project was used to measure food security. Sociodemographic data were collected using a structured questionnaire. A binary logistic regression model was used to assess the association of food insecurity and maternal undernutrition. From the total participants, 12.6% (95% confidence interval [CI] 11.6%-13.6%) had a body mass index (BMI) <18.5 kg/m 2 . Comparison of maternal undernutrition in the two study areas revealed 8.8% (95% CI 7.6%-10.2%) in the program area and 16.4% (95% CI 14.8%-18.1%) in nonprogram areas were undernourished. Severe food insecurity was significantly associated with BMI of mothers (adjusted odds ratios [AORs] 3.6 and 2.31, 95% CI 2.32-5.57 and 1.52-3.5, respectively) in both program and nonprogram areas. Mild (AOR 1.77, 95% CI 1.21-2.6) and moderate (AOR 1.6, 95% CI 1.18-2.16) food insecurity significantly associated with maternal undernutrition in nonprogram areas. In the same way, all forms of food insecurity significantly associated with maternal middle upper-arm circumference in both program and nonprogram areas. The odds of mothers who did not exercise decision-making practice on the household income was also 4.13 times higher than those who did (AOR 4.13, 95% CI 2.2-7.77) in the program area. Food insecurity significantly associated with both maternal BMI and middle upper-arm circumference in both study areas. Female authority also significantly associated with BMI of the mothers in the program area. Maternal nutrition-intervention programs should focus on women-empowerment strategies that enable them to decide on the income for household-nutrition provision.

Assessment of Child Anthropometry in a Large Epidemiologic Study

PubMed Central

Louer, Amy L.; Simon, Denise N.; Switkowski, Karen M.; Rifas-Shiman, Sheryl L.; Gillman, Matthew W.; Oken, Emily

2017-01-01

A high proportion of children have overweight and obesity in the United States and other countries. Accurate assessment of anthropometry is essential to understand health effects of child growth and adiposity. Gold standard methods of measuring adiposity, such as dual X-ray absorptiometry (DXA), may not be feasible in large field studies. Research staff can, however, complete anthropometric measurements, such as body circumferences and skinfold measurements, using inexpensive portable equipment. In this protocol we detail how to obtain manual anthropometric measurements from children, including standing and sitting height, weight, waist circumference, hip circumference, mid-upper arm circumference, triceps skinfold thickness, and subscapular skinfold thickness, and procedures to assess the quality of these measurements. To demonstrate accuracy of these measurements, among 1,110 school-aged children in the pre-birth cohort Project Viva we calculated Spearman correlation coefficients comparing manual anthropometric measurements with a gold standard measure of body fat, DXA fat mass1. To address reliability, we evaluate intra-rater technical error of measurement at a quality control session conducted on adult female volunteers. PMID:28191881

Comparison of Mid-Upper Arm Circumference and Weight-for-Height to Diagnose Severe Acute Malnutrition: A Study in Southern Ethiopia

PubMed Central

Tadesse, Amare Worku; Tadesse, Elazar; Berhane, Yemane; Ekström, Eva-Charlotte

2017-01-01

Weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC) are two independent anthropometric indicators for diagnosing and admitting children with severe acute malnutrition (SAM) for treatment. While severely wasted children are at high risk of mortality, MUAC and WHZ do not always identify the same population of children as having SAM. Understanding how this discrepancy relates to age and sex may provide valuable information for care programmes for children with SAM. Age and sex distribution for differences between children identified as SAM by MUAC and WHZ were examined and the degree of agreement calculated. Children (n = 4297) aged 6–59 months with validated anthropometric measures were recruited from a population-based survey conducted in rural southern Ethiopia. MUAC < 115 mm and WHZ < −3 were used to define severe wasting as per the World Health Organization (WHO) classification. The kappa coefficient (κ) was calculated. There was fair agreement between the MUAC and WHZ definitions of severe wasting in boys (κ = 0.37) and children younger than 24 months (κ = 0.32) but poor agreement in girls (κ = 0.15) and children aged 24 months and above (κ = 0.13). More research is needed on response to treatment and prediction of mortality using different anthropometric measurements in relation to ages and sex of children. PMID:28287482

Obesity, hypertension and home sphygmomanometer cuffs.

PubMed

Akpolat, Tekin

2010-08-01

Since the increasing prevalence of obesity leads to a larger mean arm circumferences in the hypertensive population and appropriate cuff size is essential for accurate measurement of blood pressure, overweight and obese patients often require automated home sphygmomanometers with large- or extra large-sized cuffs. The aims of this study were to evaluate the information about cuff size on automated upper arm home sphygmomanometer packing boxes and compare the findings with wrist device boxes. One hundred twelve different device boxes (49 automated upper arm, 5 semi-automatic, and 58 wrist) produced by 40 manufacturers were investigated. Three different types of information were observed (written, graphical, or a combination of both). There was not any information about cuff size on 49 (44%) device boxes. Most of the information expressed on the boxes was not attractive or informative for the patients. This study showed that the information regarding cuff size on most of the device boxes was obtuse and the patients are not warned sufficiently about appropriate cuff size. Physicians and health care providers should inform and train their patients about appropriate cuff size.

Infant anthropometry, early life infection, and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study.

PubMed

Ponsonby, Anne-Louise; Pezic, Angela; Cochrane, Jennifer; Cameron, Fergus J; Pascoe, Mark; Kemp, Andrew; Dwyer, Terence

2011-06-01

Higher birthweight is associated with increased type 1 diabetes mellitus (T1DM) risk, but the contribution of higher adiposity or lean mass is unclear. In this Tasmanian infant cohort, early upper respiratory infection has been associated with higher asthma risk. Eligible infants represented one-fifth of live births in Tasmania, 1988-1995. Hospital interview data (day 6) were obtained on 96.3% (10 628/11 040), home (5 wk) visit data (38 d) on 92.9% (9876/10 628) of those, then a phone (12 wk) interview (87 d). Tricep and subscapular skinfold measures and upper arm circumference were recorded at the first two interviews. T1DM cases (n = 26) arising from the age of 16 or under in Tasmania from 1988 to 2006 were ascertained. Higher birthweight [adjusted odds ratio (AOR) 2.82 (95% CI 1.31-6.09)], lean mid-upper arm circumference [AOR 1.76 (95% CI 1.16-2.66)], not skinfold measures, were associated with T1DM risk. Children with an early upper respiratory tract infection by 5-wk visit [AOR 2.74 (95% CI 1.19-6.32)] or ear infection by 12-wk interview [AOR 3.44 (95% CI 1.00-11.79)] were also at higher risk. Putative markers of altered microbial exposure such as resident density were not associated with T1DM risk but the effect of increasing birth order on T1DM risk differed for older (AOR 0.41, p = 0.02) than young mother (AOR 2.45, p = 0.01); difference in effect, p = 0.001. In this cohort, early upper respiratory tract infection was associated with T1DM risk, as had been previously found for asthma, consistent with immunoinflammatory upregulation. Using the detailed anthropometric measures available, the link between higher birthweight and T1DM did not appear to reflect increased adiposity. © 2011 John Wiley & Sons A/S.

Can an electronic device with a single cuff be accurate in a wide range of arm size? Validation of the Visomat Comfort 20/40 device for home blood pressure monitoring.

PubMed

Stergiou, G S; Tzamouranis, D; Nasothimiou, E G; Protogerou, A D

2008-11-01

An appropriate cuff according to the individual's arm circumference is recommended with all blood pressure (BP) monitors. An electronic device for home monitoring has been developed (Visomat Comfort 20/40) that estimates the individual's arm circumference by measuring the cuff filing volume and makes an adjustment of measured BP taking into account the estimated arm circumference. Thus the manufacturer recommends the use of a single cuff for arm circumference 23-43 cm. The device accuracy was assessed using the European Society of Hypertension International Protocol. Simultaneous BP measurements were obtained in 33 adults by two observers (connected mercury sphygmomanometers) four times, sequentially with three measurements taken using the tested device. Absolute device-observer BP differences were classified into < or =5, < or =10 and < or =15 mm Hg zones. For each participant the number of measurements with a difference < or =5 mm Hg was calculated. The device produced 60/89/97 measurements within 5/10/15 mm Hg respectively for systolic BP, and 72/97/98 for diastolic. Twenty-three subjects had at least two of their systolic BP differences < or =5 mm Hg and three had no differences < or =5 mm Hg (for diastolic 27 and 1, respectively). Mean device-observer BP difference (systolic/diastolic) was 3.7 +/- 5.6/-1.5 +/- 4.7 mm Hg (4.7 +/- 4.9/ - 1.7 +/- 4.3 in arm circumference 23-29 cm [39 readings] and 3.1 +/- 5.9/-1.4 +/- 5.0 in arm 30-34 cm [60 readings], P=NS). In conclusion, the device fulfils the International Protocol requirements and can be recommended for clinical use. Interestingly, the device was accurate using a single cuff in a wide range of arm circumference (23-34 cm). This study provides no information about the device accuracy in larger arms.

Sarcopenia in diabetic nephropathy: a cross-sectional study.

PubMed

Çeliker, Meral; Selçuk, Mustafa Yavuz; Olt, Serdar

2018-06-01

To investigate the relationship between sarcopenia and diabetic nephropathy. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression). In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

A Retrospective Evaluation of Anatomical Reinsertion of the Distal Biceps Brachii Tendon Using an ACL TightRope® RT with a Titanium Cortical Button and Ultra High Molecular Weight Polyethylene Suture: A Preliminary Report.

PubMed

Witkowski, Jarosław; Kentel, Maciej; Królikowska, Aleksandra; Reichert, Paweł

2016-01-01

Various surgical techniques for treating distal biceps brachii tendon injury have been described, and to date there is no consensus regarding the preferred fixation method for the anatomic reinsertion of the ruptured tendon. The aim of the study was to clinically and functionally evaluate the upper limb after surgical anatomic reinsertion of the distal biceps brachii tendon using an ACL TightRope® RT with a titanium cortical button and ultra high molecular weight polyethylene (UHMWPE) suture, and to assess postoperative complications. The sample comprised 3 patients. Clinical examination (history, measurements of the active range of forearm motion, arm circumference, the maximum isometric forearm supination and flexion muscle torque), pain evaluation (on a visual analogue scale [VAS]) and functional assessment (the Mayo Elbow Performance Index [MEPI] and Quick Disabilities of the Arm, Shoulder and Hand [DASH]) were carried out. Complications were documented. The results of the range of motion measurements, arm circumferences and normalized isometric torque values of the muscle groups being studied were comparable in the involved and uninvolved limbs. The MEPI (x = 95.00 ± 10.42) and Quick DASH (x = 8.66 ± 18.04) scores revealed very good results. The VAS results were close to no pain (x = 3.33 ± 5.77 mm). No complications were noted. The preliminary comprehensive clinical and functional assessment of the upper limb justify the clinical use of the ACL TightRope® RT with a titanium cortical button and UHMWPE suture in surgical anatomic reinsertion of the distal biceps brachii tendon. The early results with a small sample were encouraging, but studies with a larger number of cases and longer follow-up are needed.

Assessment of socio-economic status in the context of food insecurity: Implications for field research.

PubMed

Doocy, Shannon; Burnham, Gilbert

2006-01-01

Measures of socio-economic status (SES) were compared with a measure of physical well-being, mid-upper arm circumference (MUAC), in the food insecure regions of Ethiopia. Income, housing conditions and education had the greatest correlation to MUAC, and significant differences in these measures were observed between malnourished and adequately nourished individuals. Findings indicate that in rural Ethiopia, income, education and housing quality may be better indicators of SES than wealth and measures encompassing home and landownership.

Upper and lower limbs composition: a comparison between anthropometry and dual-energy X-ray absorptiometry in healthy people.

PubMed

Diano, Danila; Ponti, Federico; Guerri, Sara; Mercatelli, Daniele; Amadori, Michele; Aparisi Gómez, Maria Pilar; Battista, Giuseppe; Guglielmi, Giuseppe; Bazzocchi, Alberto

2017-09-18

The detection of changes in lean mass (LM) distribution can help to prevent disability. This study assessed the degree of association between anthropometric measurements and dual-energy X-ray absorptiometry (DXA) body composition (BC) parameters of the upper and lower limbs in a healthy general population and collected DXA age- and sex-specific values of BC that can be useful to build a reference standard. The primary aim of this study was to investigate the reliability of some widely available anthropometric measurements in the assessment of body composition (BC) at the limbs, especially in terms of muscle mass, in a large sample of healthy subjects of different age bands and sex, using fat mass (FM) and lean mass (LM) parameters derived by dual-energy X-ray absorptiometry (DXA) as the gold standard. The secondary aim was to collect DXA age- and sex-specific values of BC of left and right limbs (upper and lower) in a healthy Italian population to be used as reference standards. Two hundred fifty healthy volunteers were enrolled. Arm circumference (AC) and thigh circumference (ThC) were measured, and total and regional BC parameters were obtained by a whole-body DXA scan (Lunar iDXA, Madison, WI, USA; enCORE™ 2011 software version 13.6). FM/LM showed only fair correlation with AC and ThC in females (r = 0.649 and 0.532, respectively); in males and in the total population, the correlation was low (r = 0.360 or lower, and p non-statistically significant). AC and ThC were not well representative of arms LM in both genders (females r = 0.452, males r = 0.530) independently of age. In general, men of all age groups showed higher values of LM and lean mass index (LMI) in both total and segmental upper and lower limbs. In males, the maximum LM and LMI were achieved in the fifth decade in both upper and lower limbs and then started to decrease with aging. In females, no significant modification with aging was identified in LM and LMI. According to our results, anthropometry is not well representative of LM of arms in both genders, independently of age; therefore, a densitometric examination should be considered for a correct assessment of BC at limbs.

Nutritional status at presentation, comparison of assessment tools, and importance of arm anthropometry in children with cancer in India.

PubMed

Shah, P; Jhaveri, U; Idhate, T B; Dhingra, S; Arolkar, P; Arora, B

2015-01-01

In India, approximately 40,000 new cases of cancer in children are diagnosed each year. However, there are no good studies analyzing their nutritional status. Also, since accurate and sensitive nutritional assessment is critical for optimal clinical outcomes through timely remediation of malnutrition, it is important to assess the relative sensitivity and feasibility of commonly used nutritional screening tools. This observational study analyzed height/length (cm), weight (kg), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSFT) as well as their Z-scores or percentiles, albumin levels and history of weight loss at diagnosis in children aged 2-15 years being treated for cancer between November 2008 to December 2013. Body mass index (BMI) and arm muscle circumference (AMC) were calculated respectively from height and weight, and MUAC and TSFT. A total of 1693 new patients were enrolled; 1187 had all anthropometric measurements performed. The prevalence of malnutrition was 38%, 57%, 76%, 69% and 81% on the basis of BMI, TSFT, MUAC, AMC, and arm TSFT + MUAC respectively with the highest prevalence in solid abdominal tumours. Addition of BMI and serum albumin to arm anthropometry increased the proportion classified as severely nutritionally depleted by a mere 2% & 1.5% respectively. Positive history of significant weight loss additionally identified 16.5% at nutritional risk over arm anthropometry. The prevalence of malnutrition in Indian children with cancer at presentation is very high ranging from 40% and 80% depending on the method used for assessment, being higher with MUAC and lowest with BMI. Either MUAC alone or TSFT + MUAC (wherever feasible) should be used for screening for malnutrition in children with cancer at diagnosis to plan timely nutritional interventions, reduce the treatment-related morbidity and optimise their chance of long-term cure.

Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study.

PubMed

Chaput, J-P; Katzmarzyk, P T; Barnes, J D; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tudor-Locke, C; Zhao, P; Tremblay, M S

2017-12-01

No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data. In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings. © 2016 World Obesity Federation.

The effects of adding single-joint exercises to a multi-joint exercise resistance training program on upper body muscle strength and size in trained men.

PubMed

de França, Henrique Silvestre; Branco, Paulo Alexandre Nordeste; Guedes Junior, Dilmar Pinto; Gentil, Paulo; Steele, James; Teixeira, Cauê Vazquez La Scala

2015-08-01

The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach.

Validation of the Omron MIT Elite blood pressure device in a pregnant population with large arm circumference.

PubMed

James, Lauren; Nzelu, Diane; Hay, Anna; Shennan, Andrew; Kametas, Nikos A

2017-04-01

The aim of this study was to evaluate the accuracy of the Omron MIT Elite automated device in pregnant women with an arm circumference of or above 32 cm, using the British Hypertension Society validation protocol. Blood pressure was measured sequentially in 46 women of any gestation requiring the use of a large cuff (arm circumference ≥32 cm) alternating between the mercury sphygmomanometer and the Omron MIT Elite device. The Omron MIT Elite achieved an overall D/D grade with a mean of the device-observer difference being 7.17±6.67 and 9.31±6.59 for systolic and diastolic blood pressure respectively. Interobserver accuracy was 94.6% for systolic and 95% for diastolic readings within 5 mmHg. The Omron MIT Elite overestimates blood pressure and has failed the British Hypertension Society protocol requirements. Therefore, it cannot be recommended for use in pregnant women with an arm circumference of or above 32 cm.

[Undernutrition in humanitarian crises].

PubMed

Skau, Jutta Kloppenborg Heick; Olsen, Mette; Friis, Henrik; Michaelsen, Kim Fleischer

2010-01-11

Undernutrition is a major cause of morbidity and mortality in emergencies. The response depends on the extent and type of undernutrition in the affected population. Nutritional status is assessed by weight-for-height, mid-upper arm circumference and micronutrient deficiencies. Food aid is distributed in general or selective feeding programmes. Promotion of breastfeeding has been found to be one of the most efficient strategies to prevent undernutrition. There is a lack of evidence to support the optimal composition of food aid products, but there is an increasing focus on the importance of research in this field.

A comparison of methods for estimating the weight of preterm infants.

PubMed

Elser, A S; Vessey, J A

1995-09-01

Four methods of predicting a preterm infant's weight (upper mid-arm circumference, gestational age, tape measure nomogram, and guessing) were investigated to see which was the most accurate. The weights of 37 preterm neonates were initially guessed by an experienced clinician, then estimated by the other three approaches applied in a random order, and then confirmed through actual weighing. The correlations between the four estimated weights and the actual weights were .96, .84, .97, and .98, respectively. The tape measure nomogram method was the best overall approach for clinical use.

[Development of weight-estimation formulae for the bedridden elderly requiring care].

PubMed

Oonishi, Reiko; Fujii, Kouji; Tsuda, Hiroko; Imai, Katsumi

2012-01-01

Bedridden elderly persons requiring care need special body-weight measurement implements, and body-weighting assumes more difficult if they live at their own homes. Therefore, we tried to design a new weight-estimation formulae using various anthropometric variables. The subjects were 33 male and 132 female elderly inpatients certified to be at care level 4 or 5. The body composition included height, body weight, arm circumference, triceps skinfold thickness, subscapular skinfold thickness, calf circumference, and waist circumference. We studied the correlation between the body weight and each anthropometric variable and age. In men, the highest correlation with body weight was shown by waist circumference (r=0.891, p<0.0001), followed by age (r=0.779, p<0.0001) and calf circumference (r=0.614, p<0.0001). The variables that showed the highest correlation with body weight in women were waist circumference (r=0.806, p<0.0001), followed by triceps skinfold thickness (r=0.723, p<0.0001) and arm circumference (r=0.662, p<0.0001). The weight estimation formulae were obtained by multiple regression analysis. Formulae for men: body weight=0.660×waist circumference (cm)+0.702×calf circumference (cm)+0.096×age (years)-26.917 (R(2)=0.862, p<0.001); formulae for women: body weight=0.315×waist circumference (cm)+0.684×arm circumference (cm)+0.183×height (cm)-28.788 (R(2)=0.836, p<0.001). We successfully developed gender-specific weight-estimation formulae with high coefficients of determination. The results suggest that waist circumference, which is an index of visceral fat, is an effective anthropometric variable to estimate the body weight of bedridden elderly patients requiring care.

Genome-wide association study to identify common variants associated with brachial circumference: a meta-analysis of 14 cohorts.

PubMed

Boraska, Vesna; Day-Williams, Aaron; Franklin, Christopher S; Elliott, Katherine S; Panoutsopoulou, Kalliope; Tachmazidou, Ioanna; Albrecht, Eva; Bandinelli, Stefania; Beilin, Lawrence J; Bochud, Murielle; Cadby, Gemma; Ernst, Florian; Evans, David M; Hayward, Caroline; Hicks, Andrew A; Huffman, Jennifer; Huth, Cornelia; James, Alan L; Klopp, Norman; Kolcic, Ivana; Kutalik, Zoltán; Lawlor, Debbie A; Musk, Arthur W; Pehlic, Marina; Pennell, Craig E; Perry, John R B; Peters, Annette; Polasek, Ozren; St Pourcain, Beate; Ring, Susan M; Salvi, Erika; Schipf, Sabine; Staessen, Jan A; Teumer, Alexander; Timpson, Nicholas; Vitart, Veronique; Warrington, Nicole M; Yaghootkar, Hanieh; Zemunik, Tatijana; Zgaga, Lina; An, Ping; Anttila, Verneri; Borecki, Ingrid B; Holmen, Jostein; Ntalla, Ioanna; Palotie, Aarno; Pietiläinen, Kirsi H; Wedenoja, Juho; Winsvold, Bendik S; Dedoussis, George V; Kaprio, Jaakko; Province, Michael A; Zwart, John-Anker; Burnier, Michel; Campbell, Harry; Cusi, Daniele; Smith, George Davey; Frayling, Timothy M; Gieger, Christian; Palmer, Lyle J; Pramstaller, Peter P; Rudan, Igor; Völzke, Henry; Wichmann, H-Erich; Wright, Alan F; Zeggini, Eleftheria

2012-01-01

Brachial circumference (BC), also known as upper arm or mid arm circumference, can be used as an indicator of muscle mass and fat tissue, which are distributed differently in men and women. Analysis of anthropometric measures of peripheral fat distribution such as BC could help in understanding the complex pathophysiology behind overweight and obesity. The purpose of this study is to identify genetic variants associated with BC through a large-scale genome-wide association scan (GWAS) meta-analysis. We used fixed-effects meta-analysis to synthesise summary results across 14 GWAS discovery and 4 replication cohorts comprising overall 22,376 individuals (12,031 women and 10,345 men) of European ancestry. Individual analyses were carried out for men, women, and combined across sexes using linear regression and an additive genetic model: adjusted for age and adjusted for age and BMI. We prioritised signals for follow-up in two-stages. We did not detect any signals reaching genome-wide significance. The FTO rs9939609 SNP showed nominal evidence for association (p<0.05) in the age-adjusted strata for men and across both sexes. In this first GWAS meta-analysis for BC to date, we have not identified any genome-wide significant signals and do not observe robust association of previously established obesity loci with BC. Large-scale collaborations will be necessary to achieve higher power to detect loci underlying BC.

Genome-Wide Association Study to Identify Common Variants Associated with Brachial Circumference: A Meta-Analysis of 14 Cohorts

PubMed Central

Boraska, Vesna; Day-Williams, Aaron; Franklin, Christopher S.; Elliott, Katherine S.; Panoutsopoulou, Kalliope; Tachmazidou, Ioanna; Albrecht, Eva; Bandinelli, Stefania; Beilin, Lawrence J.; Bochud, Murielle; Cadby, Gemma; Ernst, Florian; Evans, David M.; Hayward, Caroline; Hicks, Andrew A.; Huffman, Jennifer; Huth, Cornelia; James, Alan L.; Klopp, Norman; Kolcic, Ivana; Kutalik, Zoltán; Lawlor, Debbie A.; Musk, Arthur W.; Pehlic, Marina; Pennell, Craig E.; Perry, John R. B.; Peters, Annette; Polasek, Ozren; Pourcain, Beate St; Ring, Susan M.; Salvi, Erika; Schipf, Sabine; Staessen, Jan A.; Teumer, Alexander; Timpson, Nicholas; Vitart, Veronique; Warrington, Nicole M.; Yaghootkar, Hanieh; Zemunik, Tatijana; Zgaga, Lina; An, Ping; Anttila, Verneri; Borecki, Ingrid B.; Holmen, Jostein; Ntalla, Ioanna; Palotie, Aarno; Pietiläinen, Kirsi H.; Wedenoja, Juho; Winsvold, Bendik S.; Dedoussis, George V.; Kaprio, Jaakko; Province, Michael A.; Zwart, John-Anker; Burnier, Michel; Campbell, Harry; Cusi, Daniele; Davey Smith, George; Frayling, Timothy M.; Gieger, Christian; Palmer, Lyle J.; Pramstaller, Peter P.; Rudan, Igor; Völzke, Henry; Wichmann, H. -Erich; Wright, Alan F.; Zeggini, Eleftheria

2012-01-01

Brachial circumference (BC), also known as upper arm or mid arm circumference, can be used as an indicator of muscle mass and fat tissue, which are distributed differently in men and women. Analysis of anthropometric measures of peripheral fat distribution such as BC could help in understanding the complex pathophysiology behind overweight and obesity. The purpose of this study is to identify genetic variants associated with BC through a large-scale genome-wide association scan (GWAS) meta-analysis. We used fixed-effects meta-analysis to synthesise summary results across 14 GWAS discovery and 4 replication cohorts comprising overall 22,376 individuals (12,031 women and 10,345 men) of European ancestry. Individual analyses were carried out for men, women, and combined across sexes using linear regression and an additive genetic model: adjusted for age and adjusted for age and BMI. We prioritised signals for follow-up in two-stages. We did not detect any signals reaching genome-wide significance. The FTO rs9939609 SNP showed nominal evidence for association (p<0.05) in the age-adjusted strata for men and across both sexes. In this first GWAS meta-analysis for BC to date, we have not identified any genome-wide significant signals and do not observe robust association of previously established obesity loci with BC. Large-scale collaborations will be necessary to achieve higher power to detect loci underlying BC. PMID:22479309

Anthropometric surrogates for screening of low birth weight newborns: a community-based study.

PubMed

Rustagi, Neeti; Prasuna, J G; Taneja, D K

2012-03-01

In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. This study compares various anthropometric surrogates for identification of low birth weight neonates. A longitudinal community based study was done in an urban resettlement colony and 283 singleton neonates within 7 days of birth were examined for the anthropometric measurements such as head, chest, mid upper arm circumference and foot length as a screening tool for low birth weight. Chest circumference measured within 7 days of birth appeared to be the most appropriate surrogate of low birth weight with highest sensitivity (75.4%), specificity (78.4%), and positive predictive value (48.9%) as compared with other anthropometric parameters. Low birth weight neonates in absence of weighing scales can be early identified by using simple anthropometric measurements for enhanced home-based care and timely referral.

Sex and genetic effects on upper and lower body fat and associations with diabetes in multigenerational families of African heritage.

PubMed

Miljkovic-Gacic, Iva; Wang, Xiaojing; Kammerer, Candace M; Bunker, Clareann H; Patrick, Alan L; Wheeler, Victor W; Kuller, Lewis H; Evans, Rhobert W; Zmuda, Joseph M

2008-06-01

Very few studies have comprehensively defined the genetic and environmental influences on body fat storage in the arms and legs and their association with diabetes, especially in families of African heritage. We analyzed body fat distribution by dual-energy x-ray absorptiometry (percentage total fat, percentage trunk fat, percentage arm fat, and percentage leg fat) and fasting serum glucose in 471 individuals (mean age, 43 years) from 8 multigenerational Afro-Caribbean families (mean family size = 51; 3535 relative pairs). Diabetes was inversely associated with percentage leg fat (P = .009) and, to some extent, positively associated with percentage arm fat independent of age, sex, and body size (P = .08), but not with anthropometric or dual-energy x-ray absorptiometric measures of total and central adiposity. Furthermore, percentage leg fat was inversely, whereas percentage arm fat was positively, associated with body mass index, waist circumference, and serum glucose (P < .01). Residual heritability (h2r) for arm and leg fat was significant (P < .01) and high: 62% (for percentage arm fat) and 40% (for percentage leg fat). Moreover, sex-specific h2r for leg fat was considerably higher (P = .02) in women than in men (h2r values, 58% vs 17%, respectively). Genetic correlation (rho(G)) between arm and leg fat was -0.61 (P < .01), suggesting that only 37% of the covariation between these 2 adipose tissue depots may be due to shared genetic influences. This study provides new evidence for a strong genetic and sex contribution to upper and lower body fat, with relatively little covariation between these traits due to shared genes. Our findings also suggest that, in this population, leg fat is associated with diabetes independent of overall adiposity.

Food consumption in patients referred for bariatric surgery with and without binge eating disorder.

PubMed

Horvath, Jaqueline Driemeyer Correia; Kops, Natália Luiza; de Castro, Mariana Laitano Dias; Friedman, Rogério

2015-12-01

The prevalence of Binge Eating Disorder (BED) is high in obese patients referred to bariatric surgery. Although the total energy intake is increased, the risk of nutritional deficiencies in these patients is unknown. This study proposes to evaluate and compare the intakes of candidate patients for bariatric surgery with and without BED, using for this purpose the Dietary Reference Intakes. 116 patients referred for bariatric surgery were submitted to nutritional, laboratory and psychological assessments. Among the patients, 46.6% had BED, of these, 25.9% had the severe form. The patients with current depression (31.9%) were more compulsive than those without depression (p < 0.001). The mean age was significantly higher in patients without BED (46.94 ± 12.05 vs 42.32 ± 10.60, p = 0.030). The only difference in anthropometric parameters individuals with and without BED was the mid-upper arm circumference (P = 0.047). The percentage of energy from carbohydrates was higher in patients with BED (53.78%) than without BED (48.88%) (U = 1222, P = 0.018, r = − 0.22). The percentage from total fat (13.63% versus 12.89%, U = 1201.0, P = 0.019, r = − 0.22) and from saturated fat (9.04% versus 8.15%, U = 1074.0, P = 0.023, r = − 0.21), was higher in patients without BED. When adjusted for the body weight of patients, these differences were not significant. Patients with BED eat more carbohydrates and have larger mid-upper arm circumference in the face of similar body weight, suggesting a higher percentage of fat mass.

Validation of the Pangao PG-800B5 for clinical use and self-measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Chen, Wan; Zeng, Zhaolin; Li, Lizhi; Wan, Xiaofen; Wan, Yi

2014-10-01

This study aimed to validate the Pangao PG-800B5 upper arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. A total of 33 participants, 16 men and 17 women, were included in the device evaluation. The protocol requirements were followed precisely. The mean age of the participants was 56.4±21.0 years (range 22-84 years). The mean systolic blood pressure was 143.6±25.5 mmHg (range 98-188 mmHg), the mean diastolic blood pressure was 85.7±17.2 mmHg (range 49-125 mmHg), and the mean arm circumference was 26.1±2.2 cm (range 23-32 cm). On average, the device overestimated the systolic blood pressure by 0.9±4.2 mmHg and diastolic blood pressure by 0.7±4.5 mmHg. The device passed all requirements, fulfilling the standards of the protocol. Therefore, the Pangao PG-800B5 upper arm blood pressure monitor can be recommended for clinical use and self-measurement in an adult population.

Coordinate measuring machine test standard apparatus and method

DOEpatents

Bieg, L.F.

1994-08-30

A coordinate measuring machine test standard apparatus and method are disclosed which includes a rotary spindle having an upper phase plate and an axis of rotation, a kinematic ball mount attached to the phase plate concentric with the axis of rotation of the phase plate, a groove mounted at the circumference of the phase plate, and an arm assembly which rests in the groove. The arm assembly has a small sphere at one end and a large sphere at the other end. The small sphere may be a coordinate measuring machine probe tip and may have variable diameters. The large sphere is secured in the kinematic ball mount and the arm is held in the groove. The kinematic ball mount includes at least three mounting spheres and the groove is an angular locating groove including at least two locking spheres. The arm may have a hollow inner core and an outer layer. The rotary spindle may be a ratio reducer. The device is used to evaluate the measuring performance of a coordinate measuring machine for periodic recertification, including 2 and 3 dimensional accuracy, squareness, straightness, and angular accuracy. 5 figs.

Coordinate measuring machine test standard apparatus and method

DOEpatents

Bieg, Lothar F.

1994-08-30

A coordinate measuring machine test standard apparatus and method which iudes a rotary spindle having an upper phase plate and an axis of rotation, a kinematic ball mount attached to the phase plate concentric with the axis of rotation of the phase plate, a groove mounted at the circumference of the phase plate, and an arm assembly which rests in the groove. The arm assembly has a small sphere at one end and a large sphere at the other end. The small sphere may be a coordinate measuring machine probe tip and may have variable diameters. The large sphere is secured in the kinematic ball mount and the arm is held in the groove. The kinematic ball mount includes at least three mounting spheres and the groove is an angular locating groove including at least two locking spheres. The arm may have a hollow inner core and an outer layer. The rotary spindle may be a ratio reducer. The device is used to evaluate the measuring performance of a coordinate measuring machine for periodic recertification, including 2 and 3 dimensional accuracy, squareness, straightness, and angular accuracy.

Upper-arm anthropometry: an alternative indicator of nutritional health to body mass index in unilateral lower-extremity amputees?

PubMed

Miller, Michelle; Wong, Wing Ki; Wu, Jing; Cavenett, Sally; Daniels, Lynne; Crotty, Maria

2008-10-01

To evaluate the utility of body mass index (BMI) and corrected-arm-muscle area (CAMA) as measures of nutritional health for lower-limb amputees attending prosthetics clinics. Cross-sectional study. Prosthetics clinic in Australia. Unilateral lower-extremity amputees (N=58; age range, 21-91y; 37 transtibial, 21 transfemoral) attending a regional prosthetics clinic between May and November 2003. Not applicable. Weight (without prosthesis), corrected and uncorrected for the amputated limb was used with height estimated from knee height to calculate corrected BMI (cBMI) and uncorrected BMI (uBMI). CAMA was calculated using the mean of triplicate mid-upper-arm circumference (MUAC) and triceps skinfold thickness (TST) measurements. The Mini Nutritional Assessment (MNA) and Assessment of Quality of Life were administered according to recommended protocols. The Pearson correlation was used to determine the strength and significance of associations between variables, and bivariate regression analyses were performed to determine whether an association existed between the nutritional variables (BMI, CAMA, MNA) and quality of life (QOL). There were no statistically significant differences in the measures of nutritional health according to site (transtibial, transfemoral) of amputation. MUAC, TST, and CAMA all showed moderate to high positive correlations (r range, .541-.782) with both cBMI and uBMI. The strength of the relationship between the MNA and cBMI/uBMI was weaker (r=.383, r=.380, respectively) but remained positive and statistically significant (P=.003). QOL was not associated with cBMI or uBMI but was related to CAMA (beta=-.132; P=.030) and MNA (beta=-.561; P=.017). For persons with unilateral lower-extremity amputation, measurement of upper-arm anthropometry may be a more useful indicator of nutritional health and its consequences than BMI.

Catch-up growth in children fed a macrobiotic diet in early childhood.

PubMed

Van Dusseldorp, M; Arts, I C; Bergsma, J S; De Jong, N; Dagnelie, P C; Van Staveren, W A

1996-12-01

To study the relationship between diet and growth, a longitudinal anthropometric study was conducted in a Dutch population consuming a macrobiotic diet. Measurements (anthropometry and food habit questionnaire) were taken in 1985 (0-7 y), 1987, and in 1993 (7-16 y, n = 209). Z-scores were calculated for anthropometric measures and changes expressed as the differences between 1993 and the mean of 1985 and 1987. Analysis indicated significant (P < 0.002) catch-up in height [(mean Z-score +/-sEM) +0.59 +/- 0.071 and arm circumference (+0.34 +/- 0.09) for age (boys and girls combined). In 1993, both girls and boys were still significantly (P < 0.05) below the reference for height and sum of four skinfolds for age, and girls were below reference for weight-for-height and arm circumference for age. In girls, multiple regression analyses showed a significant positive effect of the consumption frequency of dairy products on catch-up growth in height, weight and arm circumference, after adjustment for menarche, age, and baseline height, weight and arm circumference (P < 0.05). The addition of moderate amounts of dairy products to a vegan type of diet improved growth of children, especially girls.

[Anthropometry of elderly people living in geriatric institutions, Brazil].

PubMed

de Menezes, Tarciana Nobre; de Fátima Nunes Marucci, Maria

2005-04-01

To provide anthropometric and body composition information on elderly people living in geriatric institutions. Three-hundred and five elderly people, of both sexes, living in six geriatric institutions in Fortaleza were assessed. The following anthropometric variables were studied: weight, height, body mass index, mid-arm circumference, triceps skinfold thickness, arm muscle circumference, and corrected arm-muscle area. The body mass index was calculated as weight divided by the square of the height (m2). The arm muscle circumference and corrected arm-muscle area were calculated using specific equations. The results are presented as means, standard deviations and percentiles (5th, 10th, 25th, 50th, 75th, 90th and 95th). The analyses included Student t-test to detect differences in mean values of the variables between both sexes. Age impact was investigated by ANOVA. In all variables, mean values in men were higher than those in women, except for triceps skinfold thickness . The mean difference of the variables body mass index and mid-arm circumference for both sexes were not statistically significant (p>0.05). Age has significantly contributed to reducing the variables' values. This means that specific reference standards are needed for elderly people. Despite being institutionalized, there was seen a trend of decreasing anthropometric values in the study population similar to that found in other studies of elderly people but with different values. Thereby, such values could be useful in the nutritional assessment of institutionalized elderly people.

A study of mid-arm and chest circumferences as predictors of low birthweight.

PubMed

Rogo, K; Nyagudi, O; Ferguson, A

1991-02-01

Nine hundred ninety-nine newborns were examined in order to determine the relationship between birthweight and mid-arm and chest circumstances. An early neonatal mortality rate of 51/1000 was recorded, being much higher for preterm (301/1000) than term babies (2.5/1000). Both mid-arm and chest circumference showed highly significant correlations with birthweight (r = 0.872, P less than 0.0001 and r = 0.918, P less than 0.0001, respectively). The correlation between weight and chest circumstances was upheld even for very small babies.

Nutritional status improvement in neurologically impaired patients by percutaneous endoscopic gastrostomy feeding.

PubMed

Nakao, F S; Brant, C Q; Stanich, P; Ferrari Júnior, A P

1999-01-01

With increased use of percutaneous endoscopic gastrostomy, it became clear that neurologically impaired patients might benefit from its use. From August 1996 to July 1997, we performed 19 percutaneous endoscopic gastrostomies in patients with neurological sequelae, who were incapable to maintain their nutritional status by oral ingestion or had repeated episodes of aspiration. Sixteen patients were followed prospectively, from 30 days to 11 months (median: 6.4 months). Average weight (38.2 kg to 44.8 kg), BMI (14.8 kg/m2 to 17.8 kg/m2), weight/height ratio (23.5 kg/cm to 28 kg/cm), mid-upper arm circumference (19.4 cm to 21.6 cm) and triceps skinfold thickness (10.3 mm to 12.6 mm) were significantly increased (P < 0.01). Before percutaneous endoscopic gastrostomy, there were 10 (10/16, 62.5%) patients with grade III thinness. In this group, 3/10 patients (30%) showed improvement to grade I (two individuals) and II (one patient). All but five patients (68.75%) were below the fifth percentile of normal distribution for mid-upper arm circumference. One patient (6.2%) showed improvement of her status (between 25th and 50th percentiles). Four patients (25%) started the follow-up below the fifth percentile for normal distribution of triceps skinfold thickness, and showed no improvement. There were no early complications secondary the procedure. Late complications included granulation tissue on ostomy site (18.8%) and ostomy infection (6.2%). Statistical analysis showed significant improvement of anthropometric data. Percutaneous endoscopic gastrostomy is a simple, highly successful and safe procedure, when performed in neurologically impaired patients. It is efficient as a long-term enteral feeding method.

Undernutrition in the Kora Mudi tribal population, West Bengal, India: a comparison of body mass index and mid-upper-arm circumference.

PubMed

Bisai, Samiran; Bose, Kaushik

2009-03-01

Undernutrition among adult tribal women is a major health problem in India. To compare the utility of two different anthropometric indicators of chronic energy deficiency (CED) among tribal Kora Mudi women and to determine which of these two is a better indicator of undernutrition. A cross-sectional study of 123 individuals was conducted. The body mass index (BMI) and mid-upper-arm circumference (MUAC) were used to evaluate CED. The prevalence of CED based on BMI less than 18.5 was 55.3%, and the prevalence of CED based on MUAC less than 22.0 cm was 51.2%. Both of these prevalence rates are classified in the very high-prevalence category (> or = 40%) and indicate a critical situation according to World Health Organization recommendations. Mean BMI increased significantly with higher quartile of MUAC. There was a significant difference in the prevalence of CED between the MUAC quartiles. The risk ratio for CED for women in the lowest quartile of MUAC was 9.33 compared with those in the highest quartile. There was a significant positive association between MUAC and BMI. Regression analysis demonstrated that MUAC had a significant positive impact on BMI; the percentage of the variation in BMI explained by MUAC was 52%. Logistic regression analysis demonstrated that overall, 82.11% of cases of CED were correctly classified with the use of MUAC. The use of MUAC correctly diagnosed 82.35% of cases of CED and 81.82% of women with normal nutritional status. This population was facing severe nutritional stress. With limited resources and in the absence of skilled manpower, it may be more appropriate to use MUAC for human population surveys, particularly among tribal populations of developing countries.

Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children

PubMed Central

Dale, Nancy M.; Myatt, Mark; Prudhon, Claudine; Briend, André

2013-01-01

Objective The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper arm circumference (MUAC <115 mm) when weight gain is >15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect. Methods and Findings Data from 753 children cured from a Médecins Sans Frontières outpatient nutrition program in Gedaref, North Sudan were analyzed. MUAC >125 mm was used as discharge criteria. Length of stay and percent weight gain of children were compared in relation to nutritional status on admission. Children with low MUAC on admission had a longer duration of treatment (p = 0.000) and also a higher percent weight gain (p = 0.000) than children with higher MUAC. Similar results with weight-for-height z-scores categories were shown with both duration of treatment (p = 0.000) and percent weight gain (p = 0.000). Conclusion This study shows that using MUAC as the discharge criteria eliminates the effect of shorter treatment in most severely malnourished children compared to least severely malnourished, as is observed with percent weight gain. The findings directly address the main concern that has been identified with the current WHO recommendation of using percent weight gain. MUAC could be used as discharge criteria, instead of percent weight gain, as having a longer duration of treatment and a higher percent weight gain for the most malnourished is highly desirable. PMID:23418442

The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda.

PubMed

Rawat, Rahul; Faust, Elizabeth; Maluccio, John A; Kadiyala, Suneetha

2014-05-01

Although the last decade has seen increased access to antiretroviral therapy across the developing world, widespread food insecurity and undernutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV). We capitalized on an existing intervention to PLHIV in Uganda and conducted a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure antiretroviral therapy-naive PLHIVs for 12 months. The outcomes of interest measured at baseline and follow-up were nutritional status [body mass index; mid-upper arm circumference and hemoglobin (Hb) concentrations], disease severity (CD4 count), and 2 measures of food security: diet quality (Individual Dietary Diversity Score) and food access (Household Food Insecurity Access Scale). We used difference-in-difference propensity score matching to examine the impact of food assistance. Over 12 months, food assistance significantly increased body mass index by 0.6 kg/m (P < 0.01) and mid-upper arm circumference by 6.7 mm (P < 0.05). We found no impact on CD4 count, Hb concentrations, or Individual Dietary Diversity Score. Restricting the analysis to individuals with CD4 counts of greater than 350 cells per microliter, there were significant impacts on Hb concentrations (1.0 g/dL; P < 0.05). At the household level, food assistance increased the Household Food Insecurity Access Scale, by 2.1 points (P < 0.01). This study demonstrates the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.

Effects on Anthropometry and Appetite of Vitamins and Minerals Given in Lipid Nutritional Supplements for Malnourished HIV-Infected Adults Referred for Antiretroviral Therapy: Results From the NUSTART Randomized Controlled Trial

PubMed Central

Rehman, Andrea M.; Woodd, Susannah; PrayGod, George; Chisenga, Molly; Siame, Joshua; Koethe, John R.; Heimburger, Douglas C.; Kelly, Paul; Friis, Henrik

2015-01-01

Background: The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. Objective: We hypothesized that both vitamin and mineral deficiencies and poor appetite limit weight gain in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. Design: The randomized controlled Nutritional Support for Africans Starting Antiretroviral Therapy trial was conducted in Mwanza, Tanzania, and Lusaka, Zambia. ART-naive adults referred for ART and with body mass index <18.5 kg/m2 received lipid-based nutritional supplements either without (LNS) or with added vitamins and minerals (LNS-VM), beginning before ART initiation. Participants were given 30 g/d LNS from recruitment until 2 weeks after starting ART and 250 g/d from weeks 2 to 6 of ART. Results: Of 1815 patients recruited, 365 (20%) died during the study and 813 (45%) provided data at 12 weeks. Controlling for baseline values, anthropometric measures were consistently higher at 12-week ART in the LNS-VM than in the LNS group but statistically significant only for calf and mid-upper arm circumferences and triceps skinfold. Appetite did not differ between groups. Using piecewise mixed-effects quadratic models including all patients and time points, the main effects of LNS-VM were seen after starting ART and were significant for weight, body mass index, and mid-upper arm circumference. Conclusions: Provision of high levels of vitamins and minerals to patients referred for ART, delivered with substantial macronutrients, increased nutritional recovery but did not seem to act through treatment group differences in appetite. PMID:25501607

Assessment of under nutrition of Bangladeshi adults using anthropometry: can body mass index be replaced by mid-upper-arm-circumference?

PubMed

Sultana, Tania; Karim, Md Nazmul; Ahmed, Tahmeed; Hossain, Md Iqbal

2015-01-01

Body-mass-index (BMI) is widely accepted as an indicator of nutritional status in adults. Mid-upper-arm-circumference (MUAC) is another anthropometric-measure used primarily among children. The present study attempted to evaluate the use of MUAC as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition, and thus to suggest a suitable cut-off value. A cross-sectional study in 650 adult attendants of the patients of Dhaka-Hospital, of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) was conducted during 2012. Height, weight and MUAC of 260 male and 390 female aged 19-60 years were measured. Curve estimation was done to assess the linearity and correlation of BMI and MUAC. Sensitivity and specificity of MUAC against BMI<18.5 was determined. Separate Receiver-operating-characteristic (ROC) analyses were performed for male and female. Area under ROC curve and Youden's index were generated to aid selection of the most suitable cut-off value of MUAC for undernutrition. A value with highest Youden's index was chosen for cut-off. Our data shows strong significant positive correlation (linear) between MUAC and BMI, for males r = 0.81, (p<0.001) and for females r = 0.828, (p<0.001). MUAC cut-off <25.1 cm in males (AUC 0.930) and <23.9 cm in females (AUC 0.930) were chosen separately based on highest corresponding Youden's index. These values best correspond with BMI cut-off for under nutrition (BMI <18.5) in either gender. MUAC correlates closely with BMI. For the simplicity and easy to remember MUAC <25 cm for male and <24 cm for female may be considered as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition.

Effects on anthropometry and appetite of vitamins and minerals given in lipid nutritional supplements for malnourished HIV-infected adults referred for antiretroviral therapy: results from the NUSTART randomized controlled trial.

PubMed

Rehman, Andrea M; Woodd, Susannah; PrayGod, George; Chisenga, Molly; Siame, Joshua; Koethe, John R; Heimburger, Douglas C; Kelly, Paul; Friis, Henrik; Filteau, Suzanne

2015-04-01

The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. We hypothesized that both vitamin and mineral deficiencies and poor appetite limit weight gain in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. The randomized controlled Nutritional Support for Africans Starting Antiretroviral Therapy trial was conducted in Mwanza, Tanzania, and Lusaka, Zambia. ART-naive adults referred for ART and with body mass index <18.5 kg/m received lipid-based nutritional supplements either without (LNS) or with added vitamins and minerals (LNS-VM), beginning before ART initiation. Participants were given 30 g/d LNS from recruitment until 2 weeks after starting ART and 250 g/d from weeks 2 to 6 of ART. Of 1815 patients recruited, 365 (20%) died during the study and 813 (45%) provided data at 12 weeks. Controlling for baseline values, anthropometric measures were consistently higher at 12-week ART in the LNS-VM than in the LNS group but statistically significant only for calf and mid-upper arm circumferences and triceps skinfold. Appetite did not differ between groups. Using piecewise mixed-effects quadratic models including all patients and time points, the main effects of LNS-VM were seen after starting ART and were significant for weight, body mass index, and mid-upper arm circumference. Provision of high levels of vitamins and minerals to patients referred for ART, delivered with substantial macronutrients, increased nutritional recovery but did not seem to act through treatment group differences in appetite.

Using alternative or direct anthropometric measurements to assess risk for malnutrition in nursing homes.

PubMed

Lorini, Chiara; Collini, Francesca; Castagnoli, Mariangela; Di Bari, Mauro; Cavallini, Maria Chiara; Zaffarana, Nicoletta; Pepe, Pasquale; Lucenteforte, Ersilia; Vannacci, Alfredo; Bonaccorsi, Guglielmo

2014-10-01

The aim of this study was to use the Malnutrition Universal Screening Tool (MUST) to assess the applicability of alternative versus direct anthropometric measurements for evaluating the risk for malnutrition in older individuals living in nursing homes (NHs). We conducted a cross-sectional survey in 67 NHs in Tuscany, Italy. We measured the weight, standing height (SH), knee height (KH), ulna length (UL), and middle-upper-arm circumference of 641 NH residents. Correlations between the different methods for calculating body mass index (BMI; using direct or alternative measurements) were evaluated by the intraclass correlation coefficient and the Bland-Altman method; agreement in the allocation of participants to the same risk category was assessed by squared weighted kappa statistic and indicators of internal relative validity. The intraclass correlation coefficient for BMI calculated using KH was 0.839 (0.815-0.861), whereas those calculated by UL were 0.890 (0.872-0.905). The limits of agreement were ±6.13 kg/m(2) using KH and ±4.66 kg/m(2) using UL. For BMI calculated using SH, 79.9% of the patients were at low risk, 8.1% at medium risk, and 12.2% at high risk for malnutrition. The agreement between this classification and that obtained using BMI calculated by alternative measurements was "fair-good." When it is not possible to determine risk category by using SH, we suggest using the alternative measurements (primarily UL, due to its highest sensitivity) to predict the height and to compare these evaluations with those obtained by using middle-upper-arm-circumference to predict the BMI. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Mid-upper arm circumference: A surrogate for body mass index in pregnant women.

PubMed

Fakier, Ahminah; Petro, Gregory; Fawcus, S

2017-06-30

Nutrition in pregnancy has implications for both mother and fetus, hence the importance of an accurate assessment at the booking visit during antenatal care. The body mass index (BMI, kg/m2) is currently the gold standard for measuring body fatness. However, pregnancy-associated weight gain and oedema, as well as late booking in our population setting, cause concern about the reliability of using the BMI to assess body fat or nutritional status in pregnancy. The mid-upper arm circumference (MUAC) has been used for many decades to assess malnutrition in children aged <5 years. Several studies have also shown a strong correlation between MUAC and BMI in both pregnant and non-pregnant adult populations. To assess the correlation between the MUAC and BMI in pregnant women booking for antenatal care in the Metro West area of Cape Town, South Africa. We conducted a cross-sectional study of women booking at four midwife obstetric units. Anthropometric measurements (height, weight and MUAC) were carried out on pregnant women at their first antenatal booking visit. The results showed a strong correlation between MUAC and BMI in pregnant women up to 30 weeks' gestation. The correlation was calculated at 0.92 for the entire group. The MUAC cut-offs for obesity (BMI >30) and malnutrition (BMI <18.5) were calculated as 30.57 cm and 22.8 cm, respectively. MUAC correlates strongly with BMI in pregnancy up to a gestation of 30 weeks in women attending Metro West maternity services. In low-resource settings, the simpler MUAC measurement could reliably be substituted for BMI to assess nutritional status.

Influence of some socio-economic factors on growth and development of the boys in the Tuzla region (Bosnia and Herzegovina).

PubMed

Redzić, Amira; Hadzihalilović, Jasminka

2007-06-01

The impact of certain exogenous factor (socio-economic, ecological) has been investigated with special attention paid to the parents' living standard, and number of family members on some anthropometric parameters like: body height, body mass, chest circumference, upper leg circumference, upper arm circumference, sitting height, arm length, leg length, pelvis width, shoulders width, lenght of head and with of head on the sample of 698 boys aged 11 to 16 (17) years in the Tuzla region (the northeastern Bosnia, Western Balkan peninsula). Anthropometric measurements have been carried out using methodology proposed by the International Biological program (IBP). The results of these investigations have shown that there is a certain impact of the socio-economic conditions on the growth and development of boys. Children from families that have better living standard are, as a rule, taller, which is indicated by the statistical significant differences (P > 0.01). This trend indicates also value of Body Mass Index (BMI), which is in younger children from the families with lower living standard 16, while in the same category in the children from the families with better living standard it has value 18.5. The real impact of living conditions on the dynamics of development could be the best seen in the period of puberty. The number of children in the family has negative relationship with anthropometric features. Statistically significant differences (P > 0.001) have been detected in numerous analysed features in families with one or two children in comparison with families with three, four, or five children. Therefore, BMI has been significantly lower (16) in children from families with several children, while in the families with one child in the same growth class (11 years) it was significantly higher (17.4). Similar value of BMI (17.9) have children from the families with five children and which are 17 years old. Besides socio-economic conditions, high level of environmental pollution which is typical for Tuzla region for a long time, has also significant impact on the growth and development of children.

ANTHROPOMETRIC DIFFERENCES RELATED TO GENDERS AND AGE IN THE ELDERLY.

PubMed

Canaan Rezende, Fabiane Aparecida; Queiroz Ribeiro, Andréia; Priore, Sílvia Eloiza; Castro Franceschini, Sylvia do Carmo

2015-08-01

anthropometry facilitates the evaluation of the risks associated with reduced lean body mass, as well as of excess adiposity. However, very little is known regarding the anthropometric standards among the elderly and the differences observed between the genders and among the various age groups Objective: to compare indicators and indices anthropometrics of the elderly by gender and age group. a cross-sectional study was undertaken using a representative probability sample, involving 621 elderly. We evaluated the weight, height, circumferences (waist, hip, calf and arm); body mass index, body adiposity index, waist-hip ratio and waist-stature ratio. women were found to have a higher mean body mass index, waist-stature ratio, body adiposity index and arm circumference (p < 0.001), whereas men had higher values for weight, height and waist-hip ratio (p < 0.001). The average arm and calf circumference, however, did not differ between the genders (p > 0.05). Weight, and calf and arm circumferences were observed to be lower in the older age groups (p < 0.001) and the same was true for the body mass index and height only in men (p < 0.05). The waist circumference, waist-hip ratio, body adiposity index and waist-stature ratio did not differ among the age groups (p > 0.05). the total and peripheral body mass, for the men, in particular, was lower among the older subjects. Central adiposity did not differ among the age groups in both the genders. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Effects of Partner's Improvisational Resistance Training on dancers' muscular strength.

PubMed

Vetter, Rheba E; Dorgo, Sandor

2009-05-01

The purpose of this study was to observe the effects of Partner's Improvisational Resistance Training (PIRT) on muscular strength, body circumference, and body fat percentage in 10 female college-age dancers in comparison with 8 female dancers in a control group. The PIRT program, based on the concepts of manual resistance training, is the application of contact improvisation in a systematic strength development program, which proposes a way of contextualizing muscular strength development within the dance class. The program lasted 8 weeks, meeting 3 times weekly for 60-minute sessions. The muscular strength pre- and posttests included 1-repetition maximum (1RM) for leg extension, leg flexion, leg press, bench press, lat pulldown, back extension, and modified sit-up. Hydrostatic weighing for body composition and circumference measures on the waist, hip, shoulder, upper arm, and thigh were made pre- and posttest analyses. There were no significant pretest differences between the groups for age, height, body weight, body fat percentage, any of the circumference measures, or 5 of the 7 muscular strength measures. At posttest, neither group showed significant changes in total body weight, body fat percentage, or lean body weight. The experimental group showed significant decrements in the waist and hip circumference measures, and all other body circumference changes were nonsignificant. The experimental group showed significant changes from pretest to posttest for all seven 1RM strength measures and greater absolute and relative strength improvements in 5 measures compared with the control group. Thus, the 8-week PIRT program for female dancers was found effective in improving overall muscular strength and decreasing circumference in the waist-hip region, but it did not elicit significant changes in body composition.

Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed.

PubMed

Akın, S; Mucuk, S; Öztürk, A; Mazıcıoğlu, M; Göçer, Ş; Arguvanlı, S; Şafak, E D

2015-10-01

The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors. This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS. A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤ 0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia. An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

Determinants of linear growth in Malaysian children with cerebral palsy.

PubMed

Zainah, S H; Ong, L C; Sofiah, A; Poh, B K; Hussain, I H

2001-08-01

To compare the linear growth and nutritional parameters of a group of Malaysian children with cerebral palsy (CP) against a group of controls, and to determine the nutritional, medical and sociodemographic factors associated with poor growth in children with CP. The linear growth of 101 children with CP and of their healthy controls matched for age, sex and ethnicity was measured using upper-arm length (UAL). Nutritional parameters of weight, triceps skin-fold thickness and mid-arm circumference were also measured. Total caloric intake was assessed using a 24-h recall of a 3-day food intake and calculated as a percentage of the Recommended Daily Allowance. Multiple regression analysis was used to determine nutritional, medical and sociodemographic factors associated with poor growth (using z-scores of UAL) in children with CP. Compared with the controls, children with CP had significantly lower mean UAL measurements (difference between means -1.1, 95% confidence interval -1.65 to - 0.59), weight (difference between means -6.0, 95% CI -7.66 to -4.34), mid-arm circumference (difference between means -1.3, 95% CI -2.06 to -0.56) and triceps skin-fold thickness (difference between means -2.5, 95% CI -3.5 to -1.43). Factors associated with low z-scores of UAL were a lower percentage of median weight (P < 0.001), tube feeding (P < 0.001) and increasing age (P < 0.001). A large proportion of Malaysian children with CP have poor nutritional status and linear growth. Nutritional assessment and management at an early age might help this group of children achieve adequate growth.

Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables.

PubMed

Madden, A M; Smith, S

2016-02-01

Evaluation of body composition is an important part of assessing nutritional status and provides prognostically useful data and an opportunity to monitor the effects of nutrition-related disease progression and nutritional intervention. The aim of this narrative review is to critically evaluate body composition methodology in adults, focusing on anthropometric variables. The variables considered include height, weight, body mass index and alternative indices, trunk measurements (waist and hip circumferences and sagittal abdominal diameter) and limb measurements (mid-upper arm and calf circumferences) and skinfold thickness. The importance of adhering to a defined measurement protocol, checking measurement error and the need to interpret measurements using appropriate population-specific cut-off values to identify health risks were highlighted. Selecting the optimum method for assessing body composition using anthropometry depends on the purpose (i.e. evaluating obesity or undernutrition) and requires practitioners to have a good understanding of both practical and theoretical limitations and to be able to interpret the results wisely. © 2014 The British Dietetic Association Ltd.

Predictors of anemia among pregnant women in Westmoreland, Jamaica

PubMed Central

Charles, Alyson M.; Campbell-Stennett, Dianne; Yatich, Nelly; Jolly, Pauline E.

2010-01-01

Anemia in pregnancy is a worldwide problem, but it is most prevalent in the developing world. This research project was conducted to determine the predictors of anemia in pregnant women in Westmoreland, Jamaica. A cross-sectional study design was conducted and descriptive, bivariate, and multiple logistic regression analyses were used. Body mass index, Mid-upper arm circumference, and the number of antenatal care visits showed a statistically significant association with anemia. Based on the results, we believe that maintaining a healthy body weight, and frequently visiting an antenatal clinic, will help to lower the prevalence of anemia among pregnant women in Westmoreland. PMID:20526925

Effect of Integrated Approach of Yoga Therapy on Male Obesity and Psychological Parameters-A Randomised Controlled Trial

PubMed Central

Subramanya, Pailoor

2016-01-01

Introduction Obesity is a growing global epidemic and cause of non-communicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity. Aim To assess the effect of Integrated Approach of Yoga Therapy (IAYT) yoga module on adult male obesity in an urban setting. Materials and Methods RCT (Randomized Controlled Trial) was conducted for 14 weeks on obese male subjects with yoga and control groups. Total number of subjects were 72 and they were randomized into two groups (Yoga n=37, Control n=35). The subjects were from an urban setting of Mumbai and were doing yoga for the first time. Special yoga training of IAYT was given to yoga group for one and half hour for 5 days in a week for 14 weeks. The control group continued regular physical activities and no specific physical activity was given. The assessments were anthropometric parameters of weight, Body Mass Index (BMI), MAC (Mid Upper Arm Circumferences) of Left and Right Arm, Waist Circumference (WC), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF(Skin Fold Thickness of Biceps, Triceps, Sub scapular, suprailiac and cumulative), Percentage body fat based on SKF and Psychological Questionnaires of Perceived Stress Scale (PSS) and AAQW (Acceptance and Action Questionnaire for Weight Related Difficulty). These were taken before and after intervention for both yoga and control groups. Within and between group analysis & correlation of differences from post to pre readings among the variables, were carried out using SPSS 21. Results The anthropometric and psychological parameters were improved in both the groups but changes were significant in yoga group. Conclusion Incorporating the IAYT for obese male in urban setting will be effective for obesity treatment and for reducing the obesity related problems. PMID:27891357

[Nutritional status of school children from different socioeconomic levels].

PubMed

Amigo, H; Bustos, P; Radrigán, M E; Ureta, E

1995-09-01

The aim of this work was to compare the nutritional status of children from low and high socioeconomic levels. Weight, height, mid arm circumference and tricipital skinfold thickness were measured in 1,842 children of low and 2,770 of high socioeconomic status. Mean weight, height, and mid arm muscular circumference were higher in children of high socioeconomic status. Also, growth failure and overweight had a higher frequency among children of low socioeconomic status. Mean weight, height and mid arm circumference were higher in males of both groups. Among children of low socioeconomic status, height/age ratios were lower in men and weight/height ratios were higher in women. These differences were not observed in children of high socioeconomic level. We conclude that adverse environmental conditions, lower physical activity and indigenous ancestors may alter the nutritional status of children of low socioeconomic levels.

Accuracy of the WatchBP office ABI device for office blood pressure measurement over a wide range of arm sizes.

PubMed

Palatini, Paolo; Fania, Claudio; Gasparotti, Federica

2018-04-01

The aim of this study was to determine the accuracy of the WatchBP Office ABI monitor for office blood pressure measurement over a wide range of arm circumferences using the ANSI/AAMI/ISO 81060-2:2013 protocol. The device accuracy was tested in 88 participants whose mean±SD age was 54.5±17.6 years, whose arm circumference was 30.6±8.3 cm (range: 15-46 cm), and whose entry blood pressure (BP) was 138.3±23.4 mmHg for systolic and 83.7±14.6 mmHg for diastolic BP. Four cuffs (small, standard, large, and extra-large) suitable for arm circumferences ranging from 14.0 to 52.0 cm were used. The mean device-observer difference in the 264 separate BP data pairs was 0.7±3.8 mmHg for systolic BP and was 0.0±3.7 mmHg for diastolic BP. These data were in agreement with criterion 1 of the ANSI/AAMI/ISO 81060-2:2013 standard requirements (≤5±8 mmHg). Moreover, criterion 2 was satisfied, the mean±SD device-observer difference of the 88 participants being 0.7±3.1 and 0.0±3.2 mmHg, respectively, for systolic and diastolic BP. Good agreement between observer and device was present across the whole range of arm circumferences. These data show that the Microlife WatchBP Office ABI monitor satisfied the ANSI/AAMI/ISO 81060-2:2013 standard requirements across a wide range of arm sizes.

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis

PubMed Central

Campbell, Rosalind; Augustine, Titus; Hurst, Helen; Pararajasingam, Ravi; van Dellen, David; Armstrong, Sheilagh; Bartley, Carol; Birtles, Linda; Summers, Angela

2015-01-01

♦ Introduction: Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center. ♦ Methods: Of 51 patients admitted to this EPS specialist center hospital for their first peritonectomy in the study period, 50 had a preoperative dietetic assessment, and 49 underwent upper-arm anthropometry. ♦ Results: Mean body mass index (BMI) was 20.6 kg/m2. Mean weight loss was 14% of body weight in the preceding 6 months, with 35 of 50 patients losing more than 10%. On anthropometry, 25 of 49 patients were below the 5th percentile for mid-arm circumference (MAC), 17 of 49 were below for triceps skinfold thickness (TSF), and 21 of 49 were below for mid-arm muscle circumference (MAMC). Mean handgrip strength (HGS) was 60% of normal, with 43 of 49 patients being below 85% of normal. Appetite was poor in 21 of 50 patients, and 37 of 50 had upper and 40 of 50 had lower GI symptoms. By subjective global assessment, 27 of 51 patients were graded as severely malnourished, and 5 of 51, as well-nourished. Mean serum albumin was 28 g/L and did not correlate with BMI, MAC, TSF, MAMC, or HGS. In most patients, C-reactive protein was elevated (mean: 111 mg/L). Preoperative parenteral nutrition was given to 46 of 51 patients for a mean of 21 days. ♦ Discussion: Our findings demonstrate the poor nutrition status of patients admitted for EPS surgical intervention. Anthropometrics reveal depleted fat and lean body mass in EPS patients, which might be a result of anorexia and inflammation, and the reason that albumin was not an accurate marker of nutrition. Poor nutrition status is likely to negatively affect outcome in this patient group. ♦ Conclusions: Early recognition of GI symptoms may herald a diagnosis of EPS. Optimization of preoperative nutrition status with intensive nutrition support is needed. PMID:24584612

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis.

PubMed

Campbell, Rosalind; Augustine, Titus; Hurst, Helen; Pararajasingam, Ravi; van Dellen, David; Armstrong, Sheilagh; Bartley, Carol; Birtles, Linda; Summers, Angela

2015-01-01

♦ Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center. ♦ Of 51 patients admitted to this EPS specialist center hospital for their first peritonectomy in the study period, 50 had a preoperative dietetic assessment, and 49 underwent upper-arm anthropometry. ♦ Mean body mass index (BMI) was 20.6 kg/m(2). Mean weight loss was 14% of body weight in the preceding 6 months, with 35 of 50 patients losing more than 10%. On anthropometry, 25 of 49 patients were below the 5th percentile for mid-arm circumference (MAC), 17 of 49 were below for triceps skinfold thickness (TSF), and 21 of 49 were below for mid-arm muscle circumference (MAMC). Mean handgrip strength (HGS) was 60% of normal, with 43 of 49 patients being below 85% of normal. Appetite was poor in 21 of 50 patients, and 37 of 50 had upper and 40 of 50 had lower GI symptoms. By subjective global assessment, 27 of 51 patients were graded as severely malnourished, and 5 of 51, as well-nourished. Mean serum albumin was 28 g/L and did not correlate with BMI, MAC, TSF, MAMC, or HGS. In most patients, C-reactive protein was elevated (mean: 111 mg/L). Preoperative parenteral nutrition was given to 46 of 51 patients for a mean of 21 days. ♦ Our findings demonstrate the poor nutrition status of patients admitted for EPS surgical intervention. Anthropometrics reveal depleted fat and lean body mass in EPS patients, which might be a result of anorexia and inflammation, and the reason that albumin was not an accurate marker of nutrition. Poor nutrition status is likely to negatively affect outcome in this patient group. ♦ Early recognition of GI symptoms may herald a diagnosis of EPS. Optimization of preoperative nutrition status with intensive nutrition support is needed. Copyright © 2015 International Society for Peritoneal Dialysis.

Nutritional parameters predicting pressure ulcers and short-term mortality in patients with minimal conscious state as a result of traumatic and non-traumatic acquired brain injury.

PubMed

Montalcini, Tiziana; Moraca, Marta; Ferro, Yvelise; Romeo, Stefano; Serra, Sebastiano; Raso, Maria Girolama; Rossi, Francesco; Sannita, Walter G; Dolce, Giuliano; Pujia, Arturo

2015-09-17

The association between malnutrition and worse outcomes as pressure ulcers and mortality is well established in a variety of setting. Currently none investigation was conducted in patients with long-term consequences of the acquired brain injury in which recovery from brain injury could be influenced by secondary complications. The aim of this study was to investigate the association between various nutritional status parameters (in particular albumin) and pressure ulcers formation and short-term mortality in minimal conscious state patients. In this prospective, observational study of 5-months duration, a 30 patients sample admitted to a Neurological Institute was considered. All patients underwent a complete medical examination. Anthropometric parameters like mid-arm circumference and mid-arm muscle circumference and nutritional parameters as serum albumin and blood hemoglobin concentration were assessed. At univariate and logistic regression analysis, mid-arm circumference (p = 0.04; beta = -0.89), mid-arm muscle circumference (p = 0.050; beta = -1.29), hemoglobin (p = 0.04, beta -1.1) and albumin (p = 0.04, beta -7.91) were inversely associated with pressure ulcers. The area under the ROC curve for albumin to predict sores was 0.76 (p = 0.02) and mortality was 0.83 (p = 0.03). Patient with lower albumin had significantly higher short-term mortality than those with higher serum albumin (p = 0.03; χ(2) test = 6.47). Albumin, haemoglobin and mid-arm circumference are inversely associated with pressure ulcers. Albumin is a prognostic index in MCS patients. Since albumin and haemoglobin could be affected by a variety of factors, this association suggests to optimize nutrition and investigate on other mechanism leading to mortality and pressure ulcers.

Comparison of the effects of swimming and Tai Chi Chuan on body fat composition in elderly people.

PubMed

Yu, Tung-Yang; Pei, Yu-Cheng; Lau, Yiu-Chung; Chen, Chih-Kuang; Hsu, Hung-Chih; Wong, Alice M K

2007-01-01

Accumulation of fat and substantial loss of muscle mass are common phenomena in the elderly. In this study, we observed the effects of Tai Chi Chuan (TCC) and swimming, two exercises suitable for elderly people, on the percentage body fat and fat distribution by measuring subcutaneous adipose tissue thickness and body composition. Subjects were divided into three groups: regular swimmers (n = 20), regular TCC practitioners (n = 32), and age-matched control subjects (n = 31). Subcutaneous adipose tissue thickness was taken using a Lange skinfold caliper at the chests, abdomens, and thighs in the men, and the triceps, suprailium, and thighs in the women. Mid-arm circumference (MAC) was measured on the non-dominant upper arm using fiberglass tape. Body composition was analyzed using the Inbody 3.0 logo, a bioelectrical impedance analysis (BIA) system. No significant differences were found between the three test groups in relation to total body adiposity and arm muscle circumference in the men and women. There was significantly less subcutaneous adipose tissue at the abdomen (p = 0.011) and thigh (p < 0.001) of TCC-group men and at the thighs (p < 0.001) of the swimming group compared with the control group. In women, only the thigh skinfold (p = 0.002) showed a decrease in the TCC group compared with the control group. Swimming and TCC may not decrease total fat adiposity in elderly men and women, however, they may change body fat distribution due to certain muscle group usage. The differences observed in the effects of exercise on body fat distribution between elderly women and men may be gender-related.

PREVALENCE OF CHILDHOOD OBESITY AND UNDERNUTRITION AMONG URBAN SCHOOL CHILDREN IN BANGLADESH.

PubMed

Sultana, Niru; Afroz, Sadya; Tomalika, Nehlin; Momtaz, Hasina; Kabir, Md Humayun

2018-04-10

SummaryDespite the ongoing problems of undernutrition and infectious disease, obesity and overweight have become a major problem in developing countries, including Bangladesh. This cross-sectional study was undertaken to determine the prevalence of obesity, overweight and underweight among school children aged 6-12 years in Bangladesh. The study was conducted from June 2012 to May 2013 and the study sample comprised 1768 children (980 boys; 788 girls) from eight purposively selected schools in different areas of Dhaka city. Students were interviewed about their diet and physical activity, and anthropometric measurements were made, including height, weight, mid-upper-arm circumference (MUAC), waist circumference, hip circumference and body mass index (BMI). Undernutrition, overweight and obesity were defined using internationally accepted BMI cut-off points. Mean height, weight, BMI, MUAC, waist circumference and hip circumference values were found to be higher in boys than in girls, except at age 12 when these were found to be significantly higher in girls than in boys (p<0.05). The mean prevalence of overweight was 10.0% (boys 10.2%; girls 9.8%), and that of obesity 5.0% (boys 4.3%; girls 5.8%). The prevalence of underweight was 16.3% in boys and 12.7% in girls. The prevalence of underweight was significantly higher in poor than in rich children (22.1% vs 11.2%) and that of obesity was higher in rich than in poor children (9.9% vs 1.3%; p<0.001). A family history of obesity and hypertension emerged as a significant predictor of developing overweight and obesity (p<0.001). The data suggest that underweight and obesity co-exist in urban areas of Bangladesh, posing a challenge for the nutritional health of Bangladeshi children.

Validation of the iHealth BP3 upper-arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Chen, Can; Shang, Fujun; Wang, Jiepin; Chen, Jianghong; Ji, Na; Wan, Yi

2012-12-01

This study aimed to evaluate the performance of the iHealth BP3 upper-arm blood pressure monitor, which is designed for clinic use and self-measurement of blood pressure using Apple touch devices as an interface. The European Society of Hypertension International Protocol (ESH-IP) revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. Ninty-nine couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The 33 participants, age 47.1±12.3 years (age range 27-69 years) and arm circumference 30.0±4.4 cm, had a mean systolic blood pressure (SBP) of 143.9±27.4 mmHg and a mean diastolic blood pressure (DBP) of 90.1±18.3 mmHg. The device passed all of the requirements fulfilling the standards of the protocol, and the mean±SD device-observer difference was 2.8±4.2 mmHg for SBP and -0.4±3.5 mmHg for DBP. According to the results of the validation study on the basis of the ESH-IP revision 2010, the iHealth BP3 can be recommended for clinic use and self-measurement in an adult population. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

PubMed

Nosaka, K; Muthalib, M; Lavender, A; Laursen, P B

2007-01-01

This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

Anthropometric evaluation of pediatric patients with nonprogressive chronic encephalopathy according to different methods of classification☆

PubMed Central

Teixeira, Jéssica Socas; Gomes, Mirian Martins

2014-01-01

Objective: To perform anthropometric assessment of patients with quadriplegic, chronic non-progressive encephalopathy, comparing two distinct references of nutritional classification and to compare the estimated height to the length measured by stadiometer. Method: Cross-sectional study including 0-3-year children with quadriplegic chronic non-progressive encephalopathy in secondary public hospital. Length, weight, arm circumference, triceps skinfold and knee height were measured. The arm muscle circumference and estimated height were calculated. The following relations were evaluated: weight-for-age, length-for-age and weight-for-length, using as reference the charts of the World Health Organization (WHO) and those proposed by Krick et al. Results: Fourteen children with a mean age of 21 months were evaluated. Assessment of anthropometric indicators showed significant difference between the two classification methods to assess nutritional indicators length/age (p=0.014), weight/age (p=0.014) and weight/length (p=0.001). There was significant correlation between measured length and estimated height (r=0.796, p=0.001). Evaluation of arm circumference and triceps skinfold showed that most patients presented some degree of malnutrition. According to arm muscle circumference, most were eutrophic. Conclusions: Specific curves for children with chronic non-progressive encephalopathy appear to underestimate malnutrition when one takes into account indicators involving weight. Curves developed for healthy children can be a good option for clinical practice and weight-for-length indicator and body composition measurements should be considered as complementary tools. PMID:25479849

Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period.

PubMed

Çiçek, Betül; Öztürk, Ahmet; Mazıcıoğlu, Mustafa Mümtaz; Kurtoğlu, Selim

2014-12-01

Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period. The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method. In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls. The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

Nutritional status and body composition in patients early after renal transplantation.

PubMed

Netto, M C A S; Alves-Filho, G; Mazzali, M

2012-10-01

After renal transplantation recovery in nutritional status occurs during the first year. We assessed the changes in nutritional status after transplantation in 145 transplant recipients (94 males, 51 females). Patients were evaluated immediately after renal transplant (baseline data) and at 6 months' follow-up. Analysis included body mass index (BMI), body composition (skin fold and arm circumference), and estimated body composition (calculated percent of fat, arm circumference, arm muscle circumference, and arm muscle area). Other data obtained from medical records included renal function (MDRD) serum albumin and lipid profile. At baseline evaluation (21 ± 15 days posttransplant), mean BMI was 23.9 ± 3.9 kg/m(2), serum albumin was 3.7 ± 0.7 g/dL, and lipid profile showed (cholesterol 158.5 ± 52.7 mg% and triglycerides 135.9 ± 91.8 mg%. Body composition analysis showed better adaptation of muscle mass in females [AC (91 ± 10.2 × 98 ± 14.6; male × female, P < .05) arm muscle circumference (92.6 ± 1.4 × 102.3% ± 2.9%, male × female, P < .05) and arm muscle area (87.1 ± 22.3 × 105.5% ± 25.9%, male × female, P < .05)]. Body fat was above the recommended levels in 80% of patients, especially females. After 6 months we divided the groups according to BMI, observing better renal function in the normal weight group compared with obese subjects (60 ± 17.2 × 39.5 ± 19.8 mL/min MDRD, P < .05), despite comparable estimated glomerular filtration rate at baseline. The nutritional assessment of patients with end-stage renal disease early after renal transplantation, showed inadequate body composition, with increased fat and reduced lean body mass. The lower glomerular filtration rate after 6 months may be attributed to relatively inadequate renal mass or to obesity-induced hyperfiltration. Copyright © 2012 Elsevier Inc. All rights reserved.

Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia.

PubMed

Assefa, Nega; Berhane, Yemane; Worku, Alemayehu

2012-01-01

Low Birth Weight (LBW) is one of the major risk factor for death in early life. However, little is known about predictors of LBW in sub-Saharan Africa. Therefore, the aim of this study was to measure the incidence and determinants of LBW in a rural population of Ethiopia. An observational cohort study on pregnant women was conducted from December 2009 to November 2010. During the study period 1295 live birth were registered and the weights of 956 children were measured within 24 hours after birth. Socio-demographic, economic, maternal and organizational factors were considered as a predicators of LBW, defined as birth weight below 2500g. Logistic regression was used to analyze the data, odds ratio (OR) and confidence intervals (CI) are reported. The incidence of LBW was 28.3%. It is significantly associated with poverty [OR 2.1; 95% CI: 1.42, 3.05], maternal Mid Upper Arm Circumference (MUAC) less than 23 cm [OR 1.6; 95% CI: 1.19, 2.19], not attending ANC [OR 1.6; 95% CI: 1.12, 2.28], mother's experience of physical violence during pregnancy [OR 1.7; 95% CI: 1.12, 2.48], and longer time to walk to health facility [OR 1.6; 95% CI: 1.11, 2.40]. The incidence of LBW was high in Kersa. Babies born to women who were poor, undernourished, experienced physical violence during pregnancy and who had poor access to health services were more likely to be LBW in this part of the country. In this largely poor community where ANC coverage is low, to reduce the incidence of LBW, it is essential to improve access for maternal health care. The involvement of husbands and the community at large to seek collective action on LBW is essential.

Acceptability and Efficacy of Locally Produced Ready-to-Use Therapeutic Food Nutreal in the Management of Severe Acute Malnutrition in Comparison With Defined Food.

PubMed

Thapa, Babu Ram; Goyal, Pooja; Menon, Jagadeesh; Sharma, Ajay

2017-01-01

Severe acute malnutrition (SAM) is a salient health problem in India. Federation of Indian Chamber of Commerce and Industry (FICCI) Research and Analysis Centre, New Delhi, prepared nutreal equivalent to ready-to-use therapeutic food by World Health Organization (WHO) for the management of SAM and defined food like homemade diet. To compare acceptability and efficacy of nutreal over defined food for the management of SAM. One hundred twelve children aged less than 5 years with SAM were enrolled as per the standard of WHO. Children were randomized into 2 groups to receive nutreal (n = 56) and defined food (n = 56) in unlimited amounts for 42 consecutive days and extended by 2 weeks as per demand. Calorie and protein intake, weight, and mid-upper arm circumference (MUAC) were recorded daily. Age range was 8 to 45 months. Ninety-three percent of children eagerly accepted nutreal but 7% does not. Whereas in the defined food group, 68% accepted eagerly, 30% did not accept eagerly, and 1.8% accepted poorly ( P = .004). At enrollment, mean weight in the nutreal group was 6.44 ± 1.60 kg and in the defined food group was 8.69 ± 1.76 kg, with MUAC in the nutreal group being 11.12 ± 0.47 cm and in the defined food group being 11.54 ± 0.34 cm. Mean weight in the nutreal and defined food groups at eighth week of intervention was 7.97 ± 1.8 kg and 9.71 ± 1.8 kg ( P < .001), respectively. Mid-upper arm circumference at eighth week was 12.10 ± 0.29 cm in the nutreal group and 12.49 ± 0.50 cm in the defined group ( P < .001). Acceptability, mean weight gain, and MUAC in the nutreal group are greater than the defined food.

Assessment of Under Nutrition of Bangladeshi Adults Using Anthropometry: Can Body Mass Index Be Replaced by Mid-Upper-Arm-Circumference?

PubMed Central

Sultana, Tania; Karim, Md. Nazmul; Ahmed, Tahmeed; Hossain, Md. Iqbal

2015-01-01

Background and Objective Body-mass-index (BMI) is widely accepted as an indicator of nutritional status in adults. Mid-upper-arm-circumference (MUAC) is another anthropometric-measure used primarily among children. The present study attempted to evaluate the use of MUAC as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition, and thus to suggest a suitable cut-off value. Methods A cross-sectional study in 650 adult attendants of the patients of Dhaka-Hospital, of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) was conducted during 2012. Height, weight and MUAC of 260 male and 390 female aged 19–60 years were measured. Curve estimation was done to assess the linearity and correlation of BMI and MUAC. Sensitivity and specificity of MUAC against BMI<18.5 was determined. Separate Receiver-operating-characteristic (ROC) analyses were performed for male and female. Area under ROC curve and Youden's index were generated to aid selection of the most suitable cut-off value of MUAC for undernutrition. A value with highest Youden's index was chosen for cut-off. Results Our data shows strong significant positive correlation (linear) between MUAC and BMI, for males r = 0.81, (p<0.001) and for females r = 0.828, (p<0.001). MUAC cut-off <25.1 cm in males (AUC 0.930) and <23.9 cm in females (AUC 0.930) were chosen separately based on highest corresponding Youden's index. These values best correspond with BMI cut-off for under nutrition (BMI <18.5) in either gender. Conclusion MUAC correlates closely with BMI. For the simplicity and easy to remember MUAC <25 cm for male and <24 cm for female may be considered as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition. PMID:25875397

The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children.

PubMed

Myatt, Mark; Duffield, Arabella; Seal, Andrew; Pasteur, Frances

2009-01-01

Nutritional anthropometry surveys from Somalia and Ethiopia have reported that standard weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) case definitions return different estimates of the prevalence of acute malnutrition in pastoralist livelihood zones but similar estimates of the prevalence of acute malnutrition in the agrarian livelihood zones. A study undertaken in Somalia to investigate this finding reported that children from pastoralist livelihood zones tended to have longer limbs and lower SSRs than children from agrarian livelihood zones. The present study investigated the relationship between weight-for-height and body shape and the relationship between MUAC and body shape in different populations of Ethiopian children. Six cross-sectional nutritional anthropometry surveys were undertaken. The combined survey datasets form the study sample. Data sources were grouped according to the livelihood zone from which data originated (either settled agrarian or semi-nomadic pastoralist). Case definitions of acute malnutrition using WHZ calculated using the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The SSR was used as an index of body shape. The association between body shape and the different case definitions of acute malnutrition were investigated using standard statistical techniques. Weight-for-height and MUAC case definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibit different SSRs. The SSR is an important predictor of weight-for-height. The SSR is a poor predictor of MUAC. WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition.

Impact of demographic, genetic, and bioimpedance factors on gestational weight gain and birth weight in a Romanian population

PubMed Central

Mărginean, Claudiu; Mărginean, Cristina Oana; Bănescu, Claudia; Meliţ, Lorena; Tripon, Florin; Iancu, Mihaela

2016-01-01

Abstract The present study had 2 objectives, first, to investigate possible relationships between increased gestational weight gain and demographic, clinical, paraclinical, genetic, and bioimpedance (BIA) characteristics of Romanian mothers, and second, to identify the influence of predictors (maternal and newborns characteristics) on our outcome birth weight (BW). We performed a cross-sectional study on 309 mothers and 309 newborns from Romania, divided into 2 groups: Group I—141 mothers with high gestational weight gain (GWG) and Group II—168 mothers with normal GWG, that is, control group. The groups were evaluated regarding demographic, anthropometric (body mass index [BMI], middle upper arm circumference, tricipital skinfold thickness, weight, height [H]), clinical, paraclinical, genetic (interleukin 6 [IL-6]: IL-6 -174G>C and IL-6 -572C>G gene polymorphisms), and BIA parameters. We noticed that fat mass (FM), muscle mass (MM), bone mass (BM), total body water (TBW), basal metabolism rate (BMR) and metabolic age (P < 0.001), anthropometric parameters (middle upper arm circumference, tricipital skinfold thickness; P < 0.001/P = 0.001) and hypertension (odds ratio = 4.65, 95% confidence interval: 1.27–17.03) were higher in mothers with high GWG. BW was positively correlated with mothers’ FM (P < 0.001), TBW (P = 0.001), BMR (P = 0.02), while smoking was negatively correlated with BW (P = 0.04). Variant genotype (GG+GC) of the IL-6 -572C>G polymorphism was higher in the control group (P = 0.042). We observed that high GWG may be an important predictor factor for the afterward BW, being positively correlated with FM, TBW, BMR, metabolic age of the mothers, and negatively with the mother's smoking status. Variant genotype (GG+GC) of the IL-6 -572C>G gene polymorphism is a protector factor against obesity in mothers. All the variables considered explained 14.50% of the outcome variance. PMID:27399105

Impact of demographic, genetic, and bioimpedance factors on gestational weight gain and birth weight in a Romanian population: A cross-sectional study in mothers and their newborns: the Monebo study (STROBE-compliant article).

PubMed

Mărginean, Claudiu; Mărginean, Cristina Oana; Bănescu, Claudia; Meliţ, Lorena; Tripon, Florin; Iancu, Mihaela

2016-07-01

The present study had 2 objectives, first, to investigate possible relationships between increased gestational weight gain and demographic, clinical, paraclinical, genetic, and bioimpedance (BIA) characteristics of Romanian mothers, and second, to identify the influence of predictors (maternal and newborns characteristics) on our outcome birth weight (BW).We performed a cross-sectional study on 309 mothers and 309 newborns from Romania, divided into 2 groups: Group I-141 mothers with high gestational weight gain (GWG) and Group II-168 mothers with normal GWG, that is, control group.The groups were evaluated regarding demographic, anthropometric (body mass index [BMI], middle upper arm circumference, tricipital skinfold thickness, weight, height [H]), clinical, paraclinical, genetic (interleukin 6 [IL-6]: IL-6 -174G>C and IL-6 -572C>G gene polymorphisms), and BIA parameters.We noticed that fat mass (FM), muscle mass (MM), bone mass (BM), total body water (TBW), basal metabolism rate (BMR) and metabolic age (P < 0.001), anthropometric parameters (middle upper arm circumference, tricipital skinfold thickness; P < 0.001/P = 0.001) and hypertension (odds ratio = 4.65, 95% confidence interval: 1.27-17.03) were higher in mothers with high GWG. BW was positively correlated with mothers' FM (P < 0.001), TBW (P = 0.001), BMR (P = 0.02), while smoking was negatively correlated with BW (P = 0.04). Variant genotype (GG+GC) of the IL-6 -572C>G polymorphism was higher in the control group (P = 0.042).We observed that high GWG may be an important predictor factor for the afterward BW, being positively correlated with FM, TBW, BMR, metabolic age of the mothers, and negatively with the mother's smoking status. Variant genotype (GG+GC) of the IL-6 -572C>G gene polymorphism is a protector factor against obesity in mothers. All the variables considered explained 14.50% of the outcome variance.

Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study.

PubMed

Manuskiatti, W; Wachirakaphan, C; Lektrakul, N; Varothai, S

2009-07-01

A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Objective To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction. Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded. Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen (P = 0.002) and thigh (P = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated (P = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted. Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

The prediction of lean body mass and fat mass from arm anthropometry at diagnosis in children with cancer.

PubMed

Webber, Colin; Halton, Jacqueline; Walker, Scott; Young, Andrea; Barr, Ronald D

2013-10-01

Maintenance of adequate nutrition is important in the care of children with cancer. In clinical practice, determination of nutritional status can be accomplished with measurement of body composition by dual-energy x-ray absorptiometry (DXA). However, DXA is seldom available in low-income countries where most children with cancer live. This study sought to provide predictive equations for lean body mass and fat mass, measured by DXA, on the basis of simple arm anthropometry providing measures of mid-upper arm circumference and triceps skin-fold thickness in a population (N=99) of children diagnosed with cancer. Such equations were derived successfully with the inclusion of absolute body weight, the body weight Z-score, and the predicted whole-body bone mineral content on the basis of age and sex. Attempted validation in a small sample (N=7) of children who completed therapy for acute lymphoblastic leukemia revealed disparities reflective of the prevalence of obesity in such survivors. Further validation must be undertaken in large samples of children with a variety of malignant diseases to assess the robustness of the equations predictive of body composition.

Determination of sex by armbone dimensions.

PubMed

Aye, Victor Omakoji

2010-06-15

Sex determination is a vital part of the medico-legal system but can be difficult in cases where the body is damaged. The purpose of this study was to develop a technique for sex determination from three arm-bone dimensions (wrist circumference, arm length and arm span). This knowledge can be applied in cases of mass disaster, homicide and events such as sports. Data were collected for 95 Nigerian male students and 90 Nigerian female students using physical anthropometry. Discriminant function presented the wrist dimension as the dominant contributor in this study. Combination equations for both the wrist and arm-span dimensions correctly classified sex (male/female) with an accuracy rate of 84.9%. On cross-validation, sex was also established with the same 84.9% accuracy rate. Sex determination was higher in males. Sexual dimorphism was established in this study, although the wrist circumference was more distinct than arm span; a combination of both generated sex with an accuracy prediction rate of 84.9%. (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Impact of nutrition education and medical supervision on pregnancy outcome.

PubMed

Sachdeva, R; Mann, S K

1993-11-01

Sixty Punjabi women from low and lower middle income groups were selected from eight villages of Ludhiana district. The supplements of iron, folic acid and calcium in the form of Folifer and Calcium Sandoz tablets were regularly supplied to experimental (E) group from second trimester onwards. A pamphlet about the diet during pregnancy was distributed to the E group along with four individual and three group contacts during the second half of pregnancy. The control (C) group was provided iron and folate supplements as per Government practice. Body height, weight, mid-upper arm circumference (MUA) and skinfold thickness of the subjects were recorded. Weight gained during pregnancy and post partum weight were also recorded and body mass index was calculated. In addition, crown heel length (CHL), birth weight (BW), skinfold thickness, MUA, head circumference (HC), Chest circumference (CC) and ponderal index (PI) of the neonates were recorded within eight hours of their birth. The gain in weight during pregnancy was 6.30 and 5.7 kg in E and C groups respectively. The study revealed that BW, CHL, skinfold thickness and PI of the newborns were significantly (p < 0.01) higher in E group. The mean BW of newborns in E and C groups was 2700 g and 2300 g, respectively. Weight gained during pregnancy had significant (p < 0.05) correlation to MUA, BW and skinfold thickness of the newborn.

Predictor variables of performance in recreational male long-distance inline skaters.

PubMed

Knechtle, Beat; Knechtle, Patrizia; Rüst, Christoph Alexander; Senn, Oliver; Rosemann, Thomas; Lepers, Romuald

2011-06-01

We investigated the associations between selected anthropometric and training characteristics with race time in 84 recreational male long-distance inline skaters at the longest inline marathon in Europe, the 'Inline One-eleven' over 111 km in Switzerland, using bi- and multivariate analysis. The mean (s) race time was 264 (41) min. The bivariate analysis showed that age (r = 0.30), body mass (r = 0.42), body mass index (r = 0.35), circumference of upper arm (r = 0.32), circumference of thigh (r = 0.29), circumference of calf (r = 0.38), skin-fold of thigh (r = 0.22), skin-fold of calf (r = 0.27), the sum of skin-folds (r = 0.43), percent body fat (r = 0.45), duration per training unit in inline skating (r = 0.33), and speed during training (r = -0.46) were significantly and positively correlated to race time. Stepwise multiple regression showed that duration per training unit (P = 0.003), age (P = 0.029) and percent body fat (P = 0.016) were the best correlated with race time. Race time in a long-distance inline race such as the 'Inline One-eleven' over 111 km with a mean race time of ∼260 min might be predicted by the following equation (r(2) = 0.41): Race time (min) = 114.91 + 0:51* (duration per training unit, min) + 0:85* (age, years) +3:78* (body fat, %) for recreational long-distance inline skaters.

Association of cocaine- and amphetamine-related transcript, leptin and leptin receptor gene polymorphisms with anthropometric obesity phenotype indicators in South African learners.

PubMed

Yako, Y Y; Fanampe, B L; Hassan, M S; Erasmus, R T; van der Merwe, L; van Rensburg, S J; Matsha, T E

2011-01-01

Obesity has increased rapidly in South African children and adolescents. Genes involved in appetite regulation have been extensively studied worldwide, but their role in the obesity phenotype in South African Black and mixed-ancestry school adolescents is unknown. Seven common polymorphisms in LEP, GHRL, CART and LEPR were analysed for genotype and haplotype association with anthropometric obesity phenotype indicators in South African Black and mixed-ancestry adolescent school learners. The CART c.517A→G polymorphism was significantly associated with obesity susceptibility. The LEPR Lys(109)Arg G allele was associated with an average reduction of 2.36 kg/m(2) in body mass index (BMI), 5.66 cm in waist circumference (WC) and 1.61 cm in mid-upper-arm circumference (MUAC). This was confirmed by haplotype analysis. Additionally, a haplotype of the LEP polymorphisms significantly increased BMI, MUAC and hip circumference, while LEPR haplotypes were associated with differences in MUAC. Our findings suggest that c.517A→G and Lys(109)Arg contribute to the variation in anthropometric obesity phenotype indicators observed among Black African and mixed-ancestry South African learners. Furthermore, haplotypes of LEP, LEPR and GHRL polymorphisms were associated with varying measurements of weight, BMI and WC. Further studies are required to confirm our results in a larger and homogeneous study population group. Copyright © 2011 S. Karger AG, Basel.

Patient-generated subjective global assessment and classic anthropometry: comparison between the methods in detection of malnutrition among elderly with cancer.

PubMed

Araújo dos Santos, Carolina; de Oliveira Barbosa Rosa, Carla; Queiroz Ribeiro, Andréia; Lanes Ribeiro, Rita de Cássia

2015-01-01

A comparative study of the various methods of nutritional assessment currently available in oncology are necessary to identify the most appropriate one, as well as the relationships that exist among the different instruments. To compare the nutritional diagnosis obtained by the Patient-Generated Subjective Global Assessment (PG-SGA) with the objective anthropometric measurements in the elderly undergoing oncology treatment and to assess the concordance between the methods used in detecting malnutrition. A cross-sectional study of the elderly, older than or equal to 60 years in age undergoing oncology treatment. The PG-SGA was performed and the anthropometric parameters including weight, height, Body Mass Index (BMI), arm circumference, arm muscle circumference, corrected arm muscle area, arm fat area, calf circumference, waist circumference, hip circumference, waist-hip ratio and triceps skinfold were evaluated. From a 24-hour recall the energy and macronutrient intakes were estimated. A total of 96 elderly patients were evaluated. The PG-SGA identified 29.2% with moderate malnutrition or suspected malnutrition and 14.6% with severe malnutrition. From among the elderly evaluated, 47.9% required critical nutritional intervention. The anthropometric parameters and the consumption of energy and macronutrients revealed significant differences based on the subjective PG-SGA classification. The prevalence of malnutrition ranged from 43.8% to 61.4%, depending upon the instrument used. The method most consistent with the diagnosis of malnutrition provided by the PGSGA was the BMI (kappa = 0.54; CI: 0.347-0.648). The PG-SGA showed a significant correlation with the anthropometric measurements and with food consumption for both the categorical classification, as well as for the scoring system. Diagnosis of malnutrition showed variable prevalence depending upon the method used, and none were found equivalent to the PG-SGA. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The influence of participant characteristics on the relationship between cuff pressure and level of blood flow restriction.

PubMed

Hunt, Julie E A; Stodart, Clare; Ferguson, Richard A

2016-07-01

Previous investigations to establish factors influencing the blood flow restriction (BFR) stimulus have determined cuff pressures required for complete arterial occlusion, which does not reflect the partial restriction prescribed for this training technique. This study aimed to establish characteristics that should be accounted for when prescribing cuff pressures required for partial BFR. Fifty participants were subjected to incremental blood flow restriction of the upper and lower limbs by proximal pneumatic cuff inflation. Popliteal and brachial artery diameter, blood velocity and blood flow was assessed with Doppler ultrasound. Height, body mass, limb circumference, muscle-bone cross-sectional area, adipose thickness (AT) and arterial blood pressure were measured and used in different models of hierarchical linear regression to predict the pressure at which 60 % BFR (partial occlusion) occurred. Combined analysis revealed a difference in cuff pressures required to elicit 60 % BFR in the popliteal (111 ± 12 mmHg) and brachial arteries (101 ± 12 mmHg). MAP (r = 0.58) and AT (r = -0.45) were the largest independent determinants of lower and upper body partial occlusion pressures. However, greater variance was explained by upper and lower limb regression models composed of DBP and BMI (48 %), and arm AT and DBP (30 %), respectively. Limb circumference has limited impact on the cuff pressure required for partial blood flow restriction which is in contrast to its recognised relationship with complete arterial occlusion. The majority of the variance in partial occlusion pressure remains unexplained by the predictor variables assessed in the present study.

[Weight/head circumference ratio at birth for assessing fetal growth].

PubMed

Gonçalves, Fabiana Cristina Lima da Silva Pastich; Lira, Pedro Israel Cabral de; Eickmann, Sophie Helena; Lima, Marilia de Carvalho

2015-09-01

The objective of this study was to use weight/head circumference ratio at birth to assess fetal growth. A retrospective cohort study was conducted in Zona da Mata, Pernambuco State, Brazil, with 915 term infants. Infants' anthropometric measurements and data on prenatal care, smoking during pregnancy, family income, and maternal schooling and nutritional status were collected in the first 24 hours after birth. Infants were classified as proportionate (weight/head circumference ratio ≥ 0.90) versus disproportionate (< 0.90). Lower mean weight/head circumference ratio was associated with maternal smoking, younger age, inadequate prenatal care, and low BMI, height, and triceps skinfold thickness. Mean weight, length, head and chest circumference, arm circumference, and triceps skinfold thickness were lower among infants with disproportionate weight/head circumference ratio, independently of sex. In conclusion, weight/head circumference ratio and birth weight are important indicators of fetal growth.

Upper body fat predicts metabolic syndrome similarly in men and women.

PubMed

Grundy, Scott M; Williams, Corbin; Vega, Gloria L

2018-04-23

The metabolic syndrome is a constellation of risk factors including dyslipidemia, dysglycemia, hypertension, a pro-inflammatory state, and a prothrombotic state. All of these factors are accentuated by obesity. However, obesity can be defined by body mass index (BMI), percent body fat, or by body fat distribution. The latter consists of upper body fat (subcutaneous and visceral fat) and lower body fat (gluteofemoral fat). Waist circumference is a common surrogate marker for upper body fat. Data from the National Health and Nutrition Examination Survey (NHANES) for the years 1999-2006 was examined for associations of metabolic risk factors with percent body fat, waist circumference, and BMI. Associations between absolute measures of waist circumference and risk factors were similiar for men and women. The similarities of associations between waist circumference and risk factors suggests that greater visceral fat in men does not accentuate the influence of upper body fat on risk factors. Different waist concumference values should not be used to define abdominal obesity in men and women. © 2018 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

Changes in prevalence of obesity and high waist circumference over four years across European regions: the European male ageing study (EMAS).

PubMed

Han, Thang S; Correa, Elon; Lean, Michael E J; Lee, David M; O'Neill, Terrence W; Bartfai, György; Forti, Gianni; Giwercman, Aleksander; Kula, Krzysztof; Pendleton, Neil; Punab, Margus; Rutter, Martin K; Vanderschueren, Dirk; Huhtaniemi, Ilpo T; Wu, Frederick C W; Casanueva, Felipe F

2017-02-01

Diversity in lifestyles and socioeconomic status among European populations, and recent socio-political and economic changes in transitional countries, may affect changes in adiposity. We aimed to determine whether change in the prevalence of obesity varies between the socio-politically transitional North-East European (Łódź, Poland; Szeged, Hungary; Tartu, Estonia), and the non-transitional Mediterranean (Santiago de Compostela, Spain; Florence, Italy) and North-West European (Leuven, Belgium; Malmö, Sweden; Manchester, UK) cities. This prospective observational cohort survey was performed between 2003 and 2005 at baseline and followed up between 2008 and 2010 of 3369 community-dwelling men aged 40-79 years. Main outcome measures in the present paper included waist circumference, body mass index and mid-upper arm muscle area. Baseline prevalence of waist circumference ≥ 102 cm and body mass index ≥ 30 kg/m 2 , respectively, were 39.0, 29.5 % in North-East European cities, 32.4, 21.9 % in Mediterranean cities, and 30.0, 20.1 % in North-West European cities. After median 4.3 years, men living in cities from transitional countries had mean gains in waist circumference (1.1 cm) and body mass index (0.2 kg/m 2 ), which were greater than men in cities from non-transitional countries (P = 0.005). North-East European cities had greater gains in waist circumference (1.5 cm) than in Mediterranean cities (P < 0.001). Over 4.3 years, the prevalence of waist circumference ≥ 102 cm had increased by 13.1 % in North-East European cities, 5.8 % in the Mediterranean cities, 10.0 % in North-West European cities. Odds ratios (95 % confidence intervals), adjusted for lifestyle factors, for developing waist circumference ≥ 102 cm, compared with men from Mediterranean cities, were 2.3 (1.5-3.5) in North-East European cities and 1.6 (1.1-2.4) in North-West European cities, and 1.6 (1.2-2.1) in men living in cities from transitional, compared with cities from non-transitional countries. These regional differences in increased prevalence of waist circumference ≥ 102 cm were more pronounced in men aged 60-79 years than in those aged 40-59 years. Overall there was an increase in the prevalence of obesity (body mass index  ≥ 30 kg/m 2 ) over 4.3 years (between 5.3 and 6.1 %) with no significant regional differences at any age. Mid-upper arm muscle area declined during follow-up with the greatest decline among men from North-East European cities. In conclusion, increasing waist circumference is dissociated from change in body mass index and most rapid among men living in cities from transitional North-East European countries, presumably driven by economic and socio-political changes. Information on women would also be of value and it would be of interest to relate the changes in adiposity to dietary and other behavioural habits.

A low arm and leg muscle mass to total body weight ratio is associated with an increased prevalence of metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2010-2011.

PubMed

Kim, Yong Hwan; So, Wi-Young

2016-09-14

The aim of this study was to investigate the association between metabolic syndrome (MetS) and arm and leg muscle mass to total weight ratios in Korean adults. This was a randomized, controlled, cross-sectional study. Data from 2,383 adults (1,030 men and 1,353 women) were collected from the Korea National Health and Nutrition Examination Survey 2010-2011. Blood lipid profiles, blood pressure, and anthropometric characteristics, including weight, height, waist circumference, and muscle mass on dual energy X-ray absorptiometry (DXA), were evaluated in the participants. MetS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III. The average mass of both arms and legs was determined using regional muscle analysis by DXA. Afterwards, the arm and leg muscle mass to total body weight ratio was determined and classified into 4 quartiles (i.e., quartile 1 [highest muscle ratio] to quartile 4 [lowest muscle ratio]). According to the arm muscle and leg muscle ratios, there was a higher prevalence of MetS in quartile 4 than in quartile 1 in both men and women. A low arm and leg muscle mass to body weight ratio was associated with a higher prevalence of MetS after adjusting for age, physical activity, frequency of smoking, and frequency of alcohol consumption. In conclusion, MetS patients demonstrated a lower arm and leg muscle mass to body weight ratio. Strength training for the lower and upper extremities is recommended because it can have a positive effect on MetS prevention.

Wide range of body composition measures are associated with cognitive function in community-dwelling older adults.

PubMed

Won, Huiloo; Abdul Manaf, Zahara; Mat Ludin, Arimi Fitri; Shahar, Suzana

2017-04-01

Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults. A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass. The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P < 0.05), except for the Rey Auditory Verbal Learning Test. Waist-to-hip ratio was detected as a significant predictor for all cognitive tests among women (P < 0.05), but was only a significant predictor for the Bahasa Malaysia version of Montreal Cognitive Assessment among men (P < 0.05). These results suggest that there is a need to maintain muscle mass and lower adipose tissue among older adults for optimal cognitive function. Geriatr Gerontol Int 2017; 17: 554-560. © 2016 Japan Geriatrics Society.

Association between LEPR, FTO, MC4R, and PPARG-2 polymorphisms with obesity traits and metabolic phenotypes in school-aged children.

PubMed

Almeida, Sílvia M; Furtado, José M; Mascarenhas, Paulo; Ferraz, Maria E; Ferreira, José C; Monteiro, Mariana P; Vilanova, Manuel; Ferraz, Fernando P

2018-06-01

Evaluate the relationship of leptin receptor (LEPR) rs1137101, fat mass obesity-associated (FTO) receptors 9939609, melanocortin-4 receptors (MC4R) rs2229616 and rs17782313, and proliferator-activated receptor-gamma (PPARG) rs1801282 with clinical and metabolic phenotypes in prepubertal children. What is the effect of polymorphisms on clinical and metabolic phenotypes in prepubertal children? A cross-sectional descriptive study was performed to evaluate anthropometric features, percentage body fat (%BF), biochemical parameters, and genotype in 773 prepubertal children. FTO rs9939609 was associated with an increase in body mass index (BMI) and BMI z-score (zBMI). MC4R rs17782313 was associated with a decrease in BMI and +0.06 units in zBMI. LEPR, and PPARG-2 polymorphisms were associated with decreases in BMI and an increase and decrease units in zBMI, respectively. The homozygous SNPs demonstrated increases (FTO rs993609 and MC4R rs17782313) and decreases (LEPR rs1137101, PPARG rs1801282) in zBMI than the homozygous form of the major allele. In the overweight/obese group, the MC4R rs17782313 CC genotype showed higher average weight, zBMI, waist circumference, waist-circumference-to-height ratio, and waist-hip ratio, and lower BMI, mid-upper arm circumference, calf circumference, and %BF (P< 0.05). FTO rs9939609 AT and AA genotypes were associated with lower triglycerides (P < 0.05). We showed that MC4R rs17782313 and FTO rs9939609 were positively associated with zBMI, with weak and very weak effects, respectively, suggesting a very scarce contribution to childhood obesity. LEPR rs1137101 and PPARG-2 rs1801282 had weak and medium negative effects on zBMI, respectively, and may slightly protect against childhood obesity.

Differences in physical growth of Aymara and Quechua children living at high altitude in Peru.

PubMed

de Meer, K; Bergman, R; Kusner, J S; Voorhoeve, H W

1993-01-01

Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810-3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system.

Health-related morphological characteristics and physiological fitness in connection with nutritional, socio-economic status, occupational workload of tea garden workers.

PubMed

Sengupta, Pallav; Sahoo, Sobhana

2014-09-01

Reports on the cardiorespiratory fitness and body composition of male workers engaged in processing of tea leaves in factories within the tea-estates of West Bengal, under the influence of physiological workload, are quite scanty. This cross-sectional study was conducted to evaluate morphometric characteristics based on physiological status and physical fitness of tea factory laborers who are continuously exposed to tea dust in their work environment for more than two years. Subjects were divided into control and tea garden workers groups. Height and weight were measured and the body mass index (BMI) was computed. Physiological parameters such as resting heart rate, blood pressure, fitness variables like physical fitness index (PFI), energy expenditure (EE), handgrip strength and anthropometric parameters like mid-upper arm (MUAC), thigh circumference (TC), head circumference (HC) and waist-to-hip ratio (WHR) were measured. Body surface area (BSA), BMI, body fat percentage and fitness variables (PFI, EE) showed significant difference (p < 0.05) between the two groups. Anthropometric measures (MUAC, TC, HC, WHR) reflected poor status among laborers. The present study shows that the majority of workers had ectomorph stature, good physical fitness, but had poor nutritional status (BMI and WHR).

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study.

PubMed

Baya Botti, A; Pérez-Cueto, F J A; Vasquez Monllor, P A; Kolsteren, P W

2009-01-01

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time.

Influence of anthropometry on race performance in extreme endurance triathletes: World Challenge Deca Iron Triathlon 2006

PubMed Central

Knechtle, Beat; Knechtle, Patrizia; Andonie, Jorge Luis; Kohler, Götz

2007-01-01

Objective To investigate the influence of anthropometric variables on race performance in ultra‐endurance triathletes in an ultra‐triathlon. Design Descriptive field study. Setting The “World Challenge Deca Iron Triathlon 2006” in Monterrey, Mexico, in which everyday for 10 consecutive days athletes had to perform the distance of one Ironman triathlon of 3.8 km swimming, 180 km cycling and 42.195 km running. Subjects Eight male ultra‐endurance athletes (mean (SD) age 40.6 (10.7) years, weight 76.4 (8.4) kg, height 175 (4) cm and body mass index (BMI) 24.7 (2.2) kg/m2). Interventions None. Main outcome measures Direct measurement of body mass, height, leg length, skinfold thicknesses, limb circumference and calculation of BMI, skeletal muscle mass (SM), percentage SM (%SM) and percentage body fat (%BF) in order to correlate measured and calculated anthropometric variables with race performance. Results Race time was not significantly (p>0.05) influenced by the directly measured variables, height, leg length, body mass, average skinfold thicknesses, or circumference of thigh, calf or upper arm. Furthermore, no significant (p>0.05) correlation was observed between race time and the calculated variables, BMI, %SM and %BF. Conclusions In a multistage ultra‐triathlon over 10 Ironman triathlon distances in 10 consecutive days, there was no effect of body mass, height, leg length, skinfold thicknesses, limb circumference, BMI, %SM or %BF on race performance in the only eight finishers. PMID:17556527

Forearm and upper-arm oscillometric blood pressure comparison in acutely ill adults.

PubMed

Schell, Kathleen; Morse, Kate; Waterhouse, Julie K

2010-04-01

When patients' upper arms are not accessible and/or when cuffs do not fit large upper arms, the forearm site is often used for blood pressure (BP) measurement. The purpose of this study is to compare forearm and upper-arm BPs in 70 acutely ill adults, admitted to a community hospital's 14-bed ICU. Using Philips oscillometric monitors, three repeated measures of forearm and upper-arm BPs are obtained with head of bed flat and with head of bed elevated at 30 degrees. Arms are resting on the bed. Paired t tests show statistically significant differences in systolic BPs, diastolic BPs, and mean arterial pressures in the supine and head-elevated positions. Bland-Altman analyses indicate that forearm and upper-arm oscillometric BPs are not interchangeable in acutely ill adults.

Comparison of forearm and upper arm blood pressures.

PubMed

Singer, A J; Kahn, S R; Thode, H C; Hollander, J E

1999-01-01

In the prehospital setting it is not always feasible to obtain blood pressure (BP) readings from the upper arm. This study was performed to compare BPs obtained from subjects' forearms and upper arms in order to assess the utility of forearm BP as a surrogate for standard BP. The authors performed a prospective, cross-sectional, convenience study in a sample of ambulatory university ED patients, where each subject had sequential determinations of left upper arm and forearm BPs with an automated monitor at ED triage. The order of measurement was determined by the day of the week. Demographic and clinical data were also recorded. The main outcome measure was the correlation between upper arm and forearm systolic and diastolic BPs. Pearson's correlation coefficient and Student's t-test were used to analyze the data. 151 patients were enrolled. The mean age was 35.3+/-15.7 years; 40% were female and 78% were white. The mean forearm and upper arm systolic BPs were 129.8+/-20.7 mm Hg and 126.2+/-17.6 mm Hg (p = 0.002). The mean forearm and upper arm diastolic BPs were 80.7+/-14.5 mm Hg and 76.8+/-13.4 mm Hg (p<0.001). The correlations between forearm and upper arm systolic and diastolic BPs were 0.75 (p<0.001) and 0.72 (p<0.001). The differences between forearm and upper arm systolic and diastolic BPs were within 20 mm Hg in 86% and 94% of patients, respectively. Forearm BP is a fairly good predictor of standard upper arm BP in most patients. Forearm BP may be used when measurement of upper arm BP is not feasible.

Assessment of volume measurement of breast cancer-related lymphedema by three methods: circumference measurement, water displacement, and dual energy X-ray absorptiometry.

PubMed

Gjorup, Caroline; Zerahn, Bo; Hendel, Helle W

2010-06-01

Following treatment for breast cancer 12%-60% develop breast cancer-related lymphedema (BCRL). There are several ways of assessing BCRL. Circumference measurement (CM) and water displacement (WD) for volume measurements (VM) are frequently used methods in practice and research, respectively. The aim of this study was to evaluate CM and WD for VM of the BCRL arm and the contralateral arm, comparing the results with regional dual energy X-ray absorptiometry (DXA). Twenty-four women with unilateral BCRL were included in the study. Blinded duplicate VM were obtained from both arms using the three methods mentioned above. CM and DXA were performed by two observers. WD was performed by a group of observers. Mean differences (d) in duplicated volumes, limits of agreement (LOA), and 95% confidence intervals (CI) were calculated for each method. The repeatability expressed as d (95% CI) between the duplicated VM of the BCRL arm and the contralateral arm was for DXA 3 ml (-6-11) and 3 ml (1-7), respectively. For CM and WD, the d (95% CI) of the BCRL arm were 107 ml (86-127) and 26 ml (-26-79), respectively and in the contralateral arm 100 ml (78-122) and -6 ml (-29-17), respectively. DXA is superior in repeatability when compared to CM and WD for VM, especially for the BCRL arm but also the contralateral arm.

Is Middle-Upper Arm Circumference "normally" distributed? Secondary data analysis of 852 nutrition surveys.

PubMed

Frison, Severine; Checchi, Francesco; Kerac, Marko; Nicholas, Jennifer

2016-01-01

Wasting is a major public health issue throughout the developing world. Out of the 6.9 million estimated deaths among children under five annually, over 800,000 deaths (11.6 %) are attributed to wasting. Wasting is quantified as low Weight-For-Height (WFH) and/or low Mid-Upper Arm Circumference (MUAC) (since 2005). Many statistical procedures are based on the assumption that the data used are normally distributed. Analyses have been conducted on the distribution of WFH but there are no equivalent studies on the distribution of MUAC. This secondary data analysis assesses the normality of the MUAC distributions of 852 nutrition cross-sectional survey datasets of children from 6 to 59 months old and examines different approaches to normalise "non-normal" distributions. The distribution of MUAC showed no departure from a normal distribution in 319 (37.7 %) distributions using the Shapiro-Wilk test. Out of the 533 surveys showing departure from a normal distribution, 183 (34.3 %) were skewed (D'Agostino test) and 196 (36.8 %) had a kurtosis different to the one observed in the normal distribution (Anscombe-Glynn test). Testing for normality can be sensitive to data quality, design effect and sample size. Out of the 533 surveys showing departure from a normal distribution, 294 (55.2 %) showed high digit preference, 164 (30.8 %) had a large design effect, and 204 (38.3 %) a large sample size. Spline and LOESS smoothing techniques were explored and both techniques work well. After Spline smoothing, 56.7 % of the MUAC distributions showing departure from normality were "normalised" and 59.7 % after LOESS. Box-Cox power transformation had similar results on distributions showing departure from normality with 57 % of distributions approximating "normal" after transformation. Applying Box-Cox transformation after Spline or Loess smoothing techniques increased that proportion to 82.4 and 82.7 % respectively. This suggests that statistical approaches relying on the normal distribution assumption can be successfully applied to MUAC. In light of this promising finding, further research is ongoing to evaluate the performance of a normal distribution based approach to estimating the prevalence of wasting using MUAC.

Differences and effects of medium and large adult cuffs on blood pressure readings in individuals with muscular arms.

PubMed

Fonseca-Reyes, Salvador; Fajardo-Flores, Ismael; Montes-Casillas, Mayra; Forsyth-Macquarrie, Avril

2009-08-01

This study analyzed systolic and diastolic blood pressure (SBP and DBP) reading differences in individuals with muscular arms, using medium and large adult cuffs. Resting blood pressures (BPs) were measured in bodybuilders competing at the Mexican National Bodybuilding and Fitness Championship. The means of two bilateral simultaneous arm BP measurements were obtained using two different cuff sizes, 12 cm (medium adult) and 16 cm (large adult). A total of 193 bodybuilders completed the measurements. With an arm circumference greater than 33 cm, the SBP and DBP average taken with the medium adult cuff was higher than that obtained with the large adult cuff, 8.2+/-10.6 and 1.6+/-7.4 mmHg, respectively; however, a significant difference was observed only with the SBP. With the medium adult cuff, 48 of 144 individuals showed SBP at least 140 mmHg, whereas with the large adult cuff there were only 17 of 144 individuals. In those participants with an arm circumference less than 33 cm, the BP was nonsignificantly lower with the large cuff, -4.24+/-9.2 and -2.24+/-5.4 mmHg for the SBP and DBP, respectively. Incorrect cuffing of a muscular arm leads to significant errors in the measurement of SBP and DBP, similar to that observed in miscuffing of nonmuscular arms.

Anthropometric measurements of a sixty-year and older Mexican urban group.

PubMed

Velasquez-Alva, M C; Irigoyen, M E; Zepeda, M; Sanchez, V M; Garcia Cisneros, M P; Castillo, L M

2004-01-01

In the Third World Countries, little attention has been paid to health and nutrition aspects of the elderly population. In Mexico, there are no data that provides anthropometric parameters of this group. The purpose of this study was to obtain anthropometric measurements of 60-year-old-and older Mexican men and women in Mexico City. A cross sectional study was carried out. The sample was selected from men and women registered as retired or pensioned by the Mexican Social Security Institute (IMSS) and from those requesting identification cards from the Elderly National Institute (INSEN). Standardized protocols were used to register anthropometric measurements. The group examined included 1091 people, 484 males and 607 females. The mean age of the population was 66.1 (s.d. 6.1). The values in the male group were higher than in the female group in height, weight and waist circumference; women showed higher values in body mass index (BMI), arm circumference, triceps skinfold and hip circumference (p < 0.01). The data gathered up were divided in five age groups; each one in a five-year interval. Percentiles of the anthropometric measurements according to the age group and gender are presented. Regression analysis indicated that the measurements of weight, body mass index, arm circumference and arm muscle area, showed lower values in the older groups. An important segment of the population studied had a BMI higher to the normal values. Additional studies covering other communities in Mexico with a different socioeconomic and ethnic composition, would be necessary to obtain a better characterization of the Mexican elderly.

The Effects of Market Integration on Childhood Growth and Nutritional Status: the Dual Burden of Under- and Over-Nutrition in the Northern Ecuadorian Amazon

PubMed Central

Houck, K; Sorensen, MV; Lu, F; Alban, D; Alvarez, K; Hidobro, D; Doljanin, C; Ona, A

2015-01-01

Objectives Market integration is an important source of cultural change exposing indigenous populations to epidemiologic and nutrition transitions. As children and adolescents are biologically sensitive to the health effects of market integration, we examine community variation of anthropometric indicators of nutritional status and growth among a cross-cultural sample of Kichwa, Shuar, Huaorani and Cofán indigenous groups in the northern Ecuadorian Amazon. Methods We measured height, weight, body mass index (BMI), upper arm circumference and triceps skinfolds of 186 children and adolescents aged two to 18 years from seven communities. Anthropometric z-scores were calculated based on the National Health and Nutritional Examination Survey. Comparisons were made to this US reference group, along with between community differences to contextually explore the impacts of varying degrees of market integration. Results We found a high prevalence of stunting in both boys (40%) and girls (34%). Adiposity increased with age and 40% of girls between 15 and 18 years old were overweight. There were large sex differences in body composition with higher BMI, arm circumference and triceps skinfolds in adolescent girls. The Kichwa demonstrated the poorest growth outcomes and nutritional stress followed by the Huaorani and Shuar; yet distinctions in under- and over-nutrition were evident within groups. Conclusion Market integration is a major factor influencing the developmental and lifestyle mismatch associated with the epidemiologic and nutrition transition in general, and the dual burden pattern of high rates of stunting yet adequate to above average short-term nutritional status indicators found among indigenous Amazonian populations. PMID:23657874

The effects of market integration on childhood growth and nutritional status: the dual burden of under- and over-nutrition in the Northern Ecuadorian Amazon.

PubMed

Houck, Kelly; Sorensen, Mark V; Lu, Flora; Alban, Dayuma; Alvarez, Kati; Hidobro, David; Doljanin, Citlali; Ona, Ana Isabel

2013-01-01

Market integration is an important source of cultural change exposing indigenous populations to epidemiologic and nutrition transitions. As children and adolescents are biologically sensitive to the health effects of market integration, we examine community variation of anthropometric indicators of nutritional status and growth among a cross-cultural sample of Kichwa, Shuar, Huaorani, and Cofán indigenous groups in the northern Ecuadorian Amazon. We measured height, weight, body mass index (BMI), upper arm circumference, and triceps skinfolds of 186 children and adolescents aged 2 to 18 years from seven communities. Anthropometric z-scores were calculated based on the National Health and Nutritional Examination Survey. Comparisons were made with this US reference group, along with between community differences to contextually explore the impacts of varying degrees of market integration. We found a high prevalence of stunting in both boys (40%) and girls (34%). Adiposity increased with age and 40% of girls between 15 and 18 years old were overweight. There were large sex differences in body composition with higher BMI, arm circumference, and triceps skinfolds in adolescent girls. The Kichwa demonstrated the poorest growth outcomes and nutritional stress followed by the Huaorani and Shuar; yet distinctions in under- and over-nutrition were evident within groups. Market integration is a major factor influencing the developmental and lifestyle mismatch associated with the epidemiologic and nutrition transition in general, and the dual burden pattern of high rates of stunting yet adequate to above average short-term nutritional status indicators found among indigenous Amazonian populations. Copyright © 2013 Wiley Periodicals, Inc.

A prospective study of arm circumference and risk of death in Bangladesh.

PubMed

Chen, Yu; Ge, Wenzhen; Parvez, Faruque; Bangalore, Sripal; Eunus, Mahbub; Ahmed, Alauddin; Islam, Tariqul; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Argos, Maria; Levy, Diane; Sarwar, Golam; Ahsan, Habibul

2014-08-01

Epidemiological studies have observed protective effects of mid-upper arm circumference (MUAC) against all-cause mortality mostly in Western populations. However, evidence on cause-specific mortality is limited. The sample included 19 575 adults from a population-based cohort study in rural Bangladesh, who were followed up for an average of 7.9 years for mortality. Cox proportional hazards regression was used to evaluate the effect of MUAC, as well as the joint effect of body mass index (BMI) and MUAC, on the risk of death from any cause, cancer and cardiovascular disease (CVD). During 154 664 person-years of follow-up, 744 deaths including 312 deaths due to CVD and 125 deaths due to cancer were observed. There was a linear inverse relationship of MUAC with total and CVD mortality. Each 1-cm increase in MUAC was associated a reduced risk of death from any cause [hazard ratio (HR) = 0.85; 95% confidence interval (C), 0.81-0.89) and CVD (HR = 0.87; 95% CI, 0.80-0.94), after controlling for potential confounders. No apparent relationship between MUAC and the risk of death from cancer was observed. Among individuals with a low BMI (<18.5 kg/m(2)), a MUAC less than 24 cm was associated with increased risk for all-cause (HR = 1.81; 95% CI, 1.52-2.17) and CVD mortality (HR = 1.45; 95% CI, 1.11-1.91). MUAC may play a critical role on all-cause and CVD mortality in lean Asians. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Risk factors for early infant mortality in Sarlahi district, Nepal.

PubMed Central

Katz, Joanne; West, Keith P.; Khatry, Subarna K.; Christian, Parul; LeClerq, Steven C.; Pradhan, Elizabeth Kimbrough; Shrestha, Sharada Ram

2003-01-01

OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy. PMID:14758431

Nutritional aspects of Noonan syndrome and Noonan-related disorders.

PubMed

da Silva, Fernanda Marchetto; Jorge, Alexander Augusto; Malaquias, Alexandra; da Costa Pereira, Alexandre; Yamamoto, Guilherme Lopes; Kim, Chong Ae; Bertola, Debora

2016-06-01

Rasopathies are a group of rare disorders characterized by neurocardiofaciocutaneous involvement, and caused by mutations in several genes of the RAS/MAPK pathway. In the present study, we characterized growth parameters, body composition, and nutritional aspects of children and adults (n = 62) affected by these disorders, mainly Noonan syndrome, using an indirect method-anthropometry-and a 24-hr recall questionnaire. The growth parameters in our cohort showed short stature, especially in individuals with RAF1 and SHOC2 mutations, lower obesity rates compared to the control population, and BMI scores highest in individuals with BRAF mutations and lowest in individuals with SHOC2. Body composition showed a compromise in the upper arm muscle circumference, with a statistically significant difference in the z-score of triceps skinfold (P = 0.0204) and upper arm fat area (P = 0.0388) between BRAF and SHOC2 groups and in the z-score of triceps skinfold between RAF1 and SHOC2 (P = 0.0218). The pattern of macronutrient consumption was similar to the control population. Our study is the first to address body composition in RASopathy individuals and the data indicate a compromise not only in adipose tissue, but also in muscle mass. Studies using different techniques, such as dual-energy X-ray absorptiometry or imaging studies, which give a more precise delineation of fat and non-fat mass, are required to confirm our results, ultimately causing an impact on management strategies. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Hypertension in children and adolescents attending a lipid clinic.

PubMed

Martino, Francesco; Puddu, Paolo Emilio; Pannarale, Giuseppe; Colantoni, Chiara; Martino, Eliana; Zanoni, Cristina; Barillà, Francesco

2013-12-01

This study aims to investigate prevalence of hypertension and cardiovascular risk factor clustering in children and adolescents attending a lipid clinic as well as the relationship of their hypertensive status with indicators of fat distribution and parental fat distribution and blood pressure (BP). In this cross-sectional primary prevention study, data on indicators of fat distribution (waist, hip, and middle-upper arm circumferences), body mass index (BMI), BP, high-sensitivity C-reactive protein (hsCRP), lipid and glucose profile of 370 children and adolescents (180 M, 190 F, mean age 9.5 years, (range 6-14 years)) were collected. Parents (502, 251 M, 251 F, age range 28-36 years), who gave their informed consent, underwent BMI, fat distribution, and BP measurements. There were 131 (35.4 %) hypercholesterolemic subjects and 72 (19.5 %) hypertensives. Using tests on medians, in comparison with 298 normotensives, the 72 hypertensives had higher levels of insulin (p<0.005) and no differences in cholesterol levels, age, and height. BMI and all the indicators of fat distribution were significantly higher (all p<0.01) in hypertensives than normotensives. BMI and waist circumferences were higher (both p<0.05) in the mothers of hypertensives, but not in the fathers. Hypertensive subjects' BMI was related to mothers' hip and waist circumferences (r=0.28 and 0.21, respectively). In this study, children's hypertension was a component of the metabolic syndrome, but uric acid and hsCRP levels were not contributive. This hemodynamic and metabolic disorder was related to maternal fat distribution and BMI suggesting an epigenetic etiology.

Anthropometric changes during pregnancy of urban Indian women related to birthweight.

PubMed

Lakhani, S A; Sequeira, E; Thiuri, B; Mannetje, W; Jansen, A A

1982-06-01

Vegetarian and nonvegetarian women of Asian Indian origin living in Nairobi, Kenya, and attending the antenatal clinic at the Aga Khan Hospital were followed up from 26 weeks of pregnancy to term. The objective was to observe these pregnant women in relation to pregnancy performance and outcome. The mean gestational age for both groups was 39.0 weeks. There is a progressive increase in weight from the 26th week of pregnancy up to the time of delivery among both groups. 65.4% of the women gained between 90 and 150% of the expected value. Women who gained less than 90% of the expected value (34.6%) did not produce smaller babies. The mean birth weight of the newborns was 2,869 gms in the vegetarian group and 3,026 gms in the nonvegetarian group. There was no significant difference in the outcome of pregnancy between the 2 groups. Mean birth weight, mean length and mean head circumference of the babies in both the groups fell within the 10th and 25th percentiles of the Harvard standards. The mean chest circumference of the babies in the vegetarian group fell within the 25th and 50th percentiles, while that of the babies in the nonvegetarian group fell between 50th and 75th percentiles. The pattern of weight gain in the study population corresponds favorably with that observed among British women . Other anthropometric parameters studied were height, mid-upper arm circumference and 4 skinfold thickness. Changes in muscle mass and fat area were also calculated. Tables show quantitative data.

Hand volume estimates based on a geometric algorithm in comparison to water displacement.

PubMed

Mayrovitz, H N; Sims, N; Hill, C J; Hernandez, T; Greenshner, A; Diep, H

2006-06-01

Assessing changes in upper extremity limb volume during lymphedema therapy is important for determining treatment efficacy and documenting outcomes. Although arm volumes may be determined by tape measure, the suitability of circumference measurements to estimate hand volumes is questionable because of the deviation in circularity of hand shape. Our aim was to develop an alternative measurement procedure and algorithm for routine use to estimate hand volumes. A caliper was used to measure hand width and depth in 33 subjects (66 hands) and volumes (VE) were calculated using an elliptical frustum model. Using regression analysis and limits of agreement (LOA), VE was compared to volumes determined by water displacement (VW), to volumes calculated from tape-measure determined circumferences (VC), and to a trapezoidal model (VT). VW and VE (mean +/- SD) were similar (363 +/- 98 vs. 362 +/-100 ml) and highly correlated; VE = 1.01VW -3.1 ml, r=0.986, p<0.001, with LOA of +/- 33.5 ml and +/- 9.9 %. In contrast, VC (480 +/- 138 ml) and VT (432 +/- 122 ml) significantly overestimated volume (p<0.0001). These results indicate that the elliptical algorithm can be a useful alternative to water displacement when hand volumes are needed and the water displacement method is contra-indicated, impractical to implement, too time consuming or not available.

Parametric model of human body shape and ligaments for patient-specific epidural simulation.

PubMed

Vaughan, Neil; Dubey, Venketesh N; Wee, Michael Y K; Isaacs, Richard

2014-10-01

This work is to build upon the concept of matching a person's weight, height and age to their overall body shape to create an adjustable three-dimensional model. A versatile and accurate predictor of body size and shape and ligament thickness is required to improve simulation for medical procedures. A model which is adjustable for any size, shape, body mass, age or height would provide ability to simulate procedures on patients of various body compositions. Three methods are provided for estimating body circumferences and ligament thicknesses for each patient. The first method is using empirical relations from body shape and size. The second method is to load a dataset from a magnetic resonance imaging (MRI) scan or ultrasound scan containing accurate ligament measurements. The third method is a developed artificial neural network (ANN) which uses MRI dataset as a training set and improves accuracy using error back-propagation, which learns to increase accuracy as more patient data is added. The ANN is trained and tested with clinical data from 23,088 patients. The ANN can predict subscapular skinfold thickness within 3.54 mm, waist circumference 3.92 cm, thigh circumference 2.00 cm, arm circumference 1.21 cm, calf circumference 1.40 cm, triceps skinfold thickness 3.43 mm. Alternative regression analysis method gave overall slightly less accurate predictions for subscapular skinfold thickness within 3.75 mm, waist circumference 3.84 cm, thigh circumference 2.16 cm, arm circumference 1.34 cm, calf circumference 1.46 cm, triceps skinfold thickness 3.89 mm. These calculations are used to display a 3D graphics model of the patient's body shape using OpenGL and adjusted by 3D mesh deformations. A patient-specific epidural simulator is presented using the developed body shape model, able to simulate needle insertion procedures on a 3D model of any patient size and shape. The developed ANN gave the most accurate results for body shape, size and ligament thickness. The resulting simulator offers the experience of simulating needle insertions accurately whilst allowing for variation in patient body mass, height or age. Copyright © 2014 Elsevier B.V. All rights reserved.

Weight-for-height values and limb anthropometric composition of tube-fed children with quadriplegic cerebral palsy.

PubMed

Kong, Chi-Keung; Wong, Heung-Sang Stephen

2005-12-01

Research has shown that growth retardation among children with quadriplegic cerebral palsy (CP) is often attributed to feeding dysfunction and malnutrition. The study compared weight-for-height values and limb anthropometric composition of nasogastric and gastrostomy tube-fed children with quadriplegic CP with those of orally fed children with quadriplegic CP and normal children, to examine the plausible effects of tube feeding on weight-for-height, fat, and muscle values for children with quadriplegic CP. Triceps, anterior mid-thigh, and medial calf skinfold thicknesses and the corresponding circumferences of the right or less affected side were measured. The subjects consisted of 119 normal children and 62 orally fed and 48 tube-fed children with quadriplegic CP. Body weight and height were recorded. For children with CP whose height could not be measured, height was estimated from the ulna length. Weight-for-height z scores, limb skinfold thicknesses, fat areas, skinfold-corrected muscle girths, and muscle areas of the children were compared. Tube-fed children with CP had normal mean weight-for-height z scores. Weight-for-height z scores of the orally fed children with CP were significantly below those of normal children and tube-fed children with CP. For children with CP, whereas triceps skinfold thickness seemed to predict the mid-upper arm fat area correctly, leg skinfold thicknesses seemed to overestimate the corresponding fat areas. Stepwise multiple regression analysis showed that triceps skinfold thicknesses had good correlation (r = 0.86) and the presence of CP had nonsignificant correlation with mid-upper arm fat areas. Multiple regression analysis of fat areas with skinfold thicknesses and the presence of CP, however, showed that CP was correlated negatively (partial correlation of CP: thigh, -0.45; calf, -0.53) with thigh and calf fat areas. Although skinfold-corrected mid-upper arm muscle girths of children with CP were quite similar to those of normal children, leg muscle girths were much reduced for both orally fed and tube-fed children with CP. The apparent thickening of leg skinfold thicknesses among children with CP probably was attributable to disproportional leg muscle wasting, with resulting reduced internal circumference of the subcutaneous fat layer. For tube-fed children with CP, skinfold thicknesses and fat areas were increased significantly, although their leg skinfold-corrected muscle girths and areas remained reduced. Skinfold thickness may overestimate the fat area in the affected limb with significant muscle wasting for children with CP. The condition was particularly obvious in the leg, where muscle wasting was prominent. Because leg muscles represent approximately one quarter of the normal body weight, low weight-for-height values among children with CP can be caused by leg muscle wasting attributable to disuse atrophy, which is unlikely to be correctable with tube feeding. Tube feeding may improve body weight mainly through fat deposition.

Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm.

PubMed

Schell, Kathleen; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Lyons, Denise; Wakai, Sandra; Bartell, Deborah; Carson, Elizabeth; Chichester, Melanie; Foraker, Teresa; Simpson, Kathleen

2005-05-01

When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure. To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm. A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level. Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P < .001 for both). Mean systolic pressures, but not mean diastolic pressures, in the upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure). Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.

Nutritional status of children with cerebral palsy in Turkey.

PubMed

Tüzün, Emine Handan; Güven, Duygu Korkem; Eker, Levent; Elbasan, Bülent; Bülbül, Selda Fatma

2013-03-01

The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required.

Acupuncture for breast cancer-related lymphedema: a randomized controlled trial.

PubMed

Bao, Ting; Iris Zhi, Wanqing; Vertosick, Emily A; Li, Qing Susan; DeRito, Janice; Vickers, Andrew; Cassileth, Barrie R; Mao, Jun J; Van Zee, Kimberly J

2018-03-08

Approximately 20% of breast cancer survivors develop breast cancer-related lymphedema (BCRL), and current therapies are limited. We compared acupuncture (AC) to usual care wait-list control (WL) for treatment of persistent BCRL. Women with moderate BCRL lasting greater than six months were randomized to AC or WL. AC included twice weekly manual acupuncture over six weeks. We evaluated the difference in circumference and bioimpedance between affected and unaffected arms. Responders were defined as having a decrease in arm circumference difference greater than 30% from baseline. We used analysis of covariance for circumference and bioimpedance measurements and Fisher's exact to determine the proportion of responders. Among 82 patients, 73 (89%) were evaluable for the primary endpoint (36 in AC, 37 in WL). 79 (96%) patients received lymphedema treatment before enrolling in our study; 67 (82%) underwent ongoing treatment during the trial. We found no significant difference between groups for arm circumference difference (0.38 cm greater reduction in AC vs. WL, 95% CI - 0.12 to 0.89, p = 0.14) or bioimpedance difference (1.06 greater reduction in AC vs. WL, 95% CI - 5.72 to 7.85, p = 0.8). There was also no difference in the proportion of responders: 17% AC versus 11% WL (6% difference, 95% CI - 10 to 22%, p = 0.5). No severe adverse events were reported. Our acupuncture protocol appeared to be safe and well tolerated. However, it did not significantly reduce BCRL in pretreated patients receiving concurrent lymphedema treatment. This regimen does not improve upon conventional lymphedema treatment for breast cancer survivors with persistent BCRL.

Reference Values for Body Composition and Anthropometric Measurements in Athletes

PubMed Central

Santos, Diana A.; Dawson, John A.; Matias, Catarina N.; Rocha, Paulo M.; Minderico, Cláudia S.; Allison, David B.; Sardinha, Luís B.; Silva, Analiza M.

2014-01-01

Background Despite the importance of body composition in athletes, reference sex- and sport-specific body composition data are lacking. We aim to develop reference values for body composition and anthropometric measurements in athletes. Methods Body weight and height were measured in 898 athletes (264 female, 634 male), anthropometric variables were assessed in 798 athletes (240 female and 558 male), and in 481 athletes (142 female and 339 male) with dual-energy X-ray absorptiometry (DXA). A total of 21 different sports were represented. Reference percentiles (5th, 25th, 50th, 75th, and 95th) were calculated for each measured value, stratified by sex and sport. Because sample sizes within a sport were often very low for some outcomes, the percentiles were estimated using a parametric, empirical Bayesian framework that allowed sharing information across sports. Results We derived sex- and sport-specific reference percentiles for the following DXA outcomes: total (whole body scan) and regional (subtotal, trunk, and appendicular) bone mineral content, bone mineral density, absolute and percentage fat mass, fat-free mass, and lean soft tissue. Additionally, we derived reference percentiles for height-normalized indexes by dividing fat mass, fat-free mass, and appendicular lean soft tissue by height squared. We also derived sex- and sport-specific reference percentiles for the following anthropometry outcomes: weight, height, body mass index, sum of skinfold thicknesses (7 skinfolds, appendicular skinfolds, trunk skinfolds, arm skinfolds, and leg skinfolds), circumferences (hip, arm, midthigh, calf, and abdominal circumferences), and muscle circumferences (arm, thigh, and calf muscle circumferences). Conclusions These reference percentiles will be a helpful tool for sports professionals, in both clinical and field settings, for body composition assessment in athletes. PMID:24830292

Morbidity after conventional dissection of axillary lymph nodes in breast cancer patients

PubMed Central

2014-01-01

Background Conventional axillary lymph node dissection (ALND) has recently become less radical. The treatment morbidity effects of reduced ALND aggressiveness are unknown. This article investigates the prevalence of the main complications of ALND: lymphedema, range-of-motion restriction, and arm paresthesia and pain. Methods This cross-sectional study included 200 women with invasive breast cancer who underwent breast-conserving surgery (82.5%, n = 165) or mastectomy (17.5%, n = 35) with ALND from 2007 to 2011. Arm perimetry was used to assess lymphedema, defined as a difference >2 cm in the upper arm circumference between the nonsurgical and surgical arms. Range-of-motion restriction was assessed by evaluating the degree of arm abduction. Paresthesia was measured in the inner and proximal arm regions. Arm pain was assessed by directly questioning the patients and defined as either present or absent. Results The average (±SD) time between ALND and morbidity evaluation was 35 ± 18 months (range, 7-60 months). The average dissected lymph node number per patient was 14 ± 4 (range, 6-30 lymph nodes). Only 3.5% (n = 7) of the patients presented with lymphedema. Single-incision approaches to breast tumor and ALND (P = 0.04) and the presence of a postoperative seroma (P = 0.02) were associated with lymphedema in univariate analysis. Paresthesia was the most frequent side effect observed (53% of patients, n = 106). This complication was associated with increased age (P < 0.0001) and a larger dissected lymph node number (P = 0.01) in univariate and multivariate analysis. Additionally, 24% (n = 48) of patients had noticeable limited arm abduction. Among the patients, 27.5% (n = 55) experienced sporadic arm pain corresponding to the surgically treated armpit. In multivariate analysis, the pain risk was 1.9-fold higher in patients who underwent ALND corresponding to their dominant arm (95% CI, 1.0-3.7, P = 0.04). Conclusion Conventional ALND in breast cancer patients can result in unwanted complications. However, the current lymphedema prevalence is lower than that of the other analyzed side effects. PMID:24670000

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

PubMed Central

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

2015-01-01

Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice. PMID:26495971

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.

Dyspeptic symptoms in patients with type 1 diabetes: endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors.

PubMed

Faria, Mariza; Pavin, Elizabeth João; Parisi, Maria Cândida Ribeiro; Nagasako, Cristiane Kibune; Mesquita, Maria Aparecida

2015-04-01

To evaluate, in a group of patients with long-standing type 1 diabetes (DM1), an association of dyspepsia symptoms with: changes in the gastroduodenal mucosa, infection by Helicobacter pylori, glycemic control, and psychological and nutritional factors. A total of 32 patient with DM1 were studied (age: 38 ± 9 years; females: 25; diabetes duration: 22 ± 5 years). All patients answered a standardized questionnaire for the evaluation of gastrointestinal symptoms and underwent upper gastrointestinal endoscopy, with gastric biopsies for the evaluation of Helicobacter pylori infection. The presence of anxiety and depression was evaluated by the HAD scale. Nutritional parameters were BMI, arm and waist circumference, skinfold measurement, and body fat percentage. Upper endoscopy detected lesions in the gastric mucosa in 34.4% of the patients, with similar frequency in those with (n = 21) and without dyspepsia (n = 11). The patients with dyspepsia complaints showed greater frequency of depression (60% vs. 0%; p = 0.001), higher values for HbA1c (9.6 ± 1.7 vs. 8.2 ± 1.3%; p = 0.01) and lower values for BMI (24.3 ± 4.1 vs. 27.2 ± 2.6 kg/m2; p = 0.02), body fat percentage (26.6 ± 6.2 vs. 30.8 ± 7.7%; p = 0.04), and waist circumference (78.7 ± 8 vs. 85.8 ± 8.1 cm; p = 0.02). No association was found between the symptoms and the presence of Helicobacter pylori. Dyspepsia symptoms in patients with long-standing DM1 were associated with glycemic control and depression, and they seem to negatively influence the nutritional status of these patients.

Characterization of symptoms and edema distribution in premenstrual syndrome

PubMed Central

Tacani, Pascale Mutti; Ribeiro, Danielle de Oliveira; Barros Guimarães, Barbara Evelyn; Machado, Aline Fernanda Perez; Tacani, Rogério Eduardo

2015-01-01

Background Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized. Objective To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period. Subjects and methods Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student’s t-test and the test for equality of two proportions (P≤0.05). Results Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume. Conclusion In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb. PMID:25792857

Comparison of Marginal Circumference of Two Different Pre-Crimped Stainless Steel Crowns for Primary Molars After Re-Crimping.

PubMed

Afshar, Hossein; Ghandehari, Mehdi; Soleimani, Banafsheh

2015-12-01

It is not clear what type of pre-crimped crown is more successful in achieving greater marginal adaptation following re-crimping. This study aimed to assess the changes in the circumference of 3M ESPE and MIB pre-crimped stainless steel crowns (SSCs) for the primary maxillary and mandibular first and second molars following re-crimping. This was an in-vitro, experimental study. Initial photographs were obtained from the margins of 3M and MIB SSCs for the upper and lower primary molars using a digital camera. Crown margins were crimped by applying 0.2N force using 114 and 137 pliers. Post-crimping photographs were also obtained and the changes in crown circumference after crimping were calculated using AutoCad software. The percentage of reduction in the circumference of crowns for each tooth was statistically analyzed based on the type of crown using student t-test. The effect of crown design and the associated teeth on the decreased circumference percentage was statistically analyzed by two-sided ANOVA. The percentage of reduction in lower E SSC circumference was 3.71±0.39% in MIB and 6.29±0.62% in 3M crowns. These values were 3.55±0.55% and 7.15±1.13% for the lower Ds, and 3.95±0.43 and 6.24±0.85% for the upper Ds, respectively. For the upper Es, these values were found to be 3.12±0.65% and 5.14±0.94%, respectively. For each tooth, a significant difference was found between MIB and 3M SSCs in terms of the percentage of reduction in crown circumference following crimping. The magnitude of this reduction was smaller in MIB compared to 3M SSCs (P<0.001). Considering the significant reduction in the marginal circumference of precrimped SSCs following re-crimping, it appears that this manipulation must be necessarily performed for MIB and 3M pre-crimped SSCs. By using 3M SSCs, higher marginal adaptation can be achieved following crimping.

Comparison of Marginal Circumference of Two Different Pre-Crimped Stainless Steel Crowns for Primary Molars After Re-Crimping

PubMed Central

Afshar, Hossein; Ghandehari, Mehdi; Soleimani, Banafsheh

2015-01-01

Objectives: It is not clear what type of pre-crimped crown is more successful in achieving greater marginal adaptation following re-crimping. This study aimed to assess the changes in the circumference of 3M ESPE and MIB pre-crimped stainless steel crowns (SSCs) for the primary maxillary and mandibular first and second molars following re-crimping. Materials and Methods: This was an in-vitro, experimental study. Initial photographs were obtained from the margins of 3M and MIB SSCs for the upper and lower primary molars using a digital camera. Crown margins were crimped by applying 0.2N force using 114 and 137 pliers. Post-crimping photographs were also obtained and the changes in crown circumference after crimping were calculated using AutoCad software. The percentage of reduction in the circumference of crowns for each tooth was statistically analyzed based on the type of crown using student t-test. The effect of crown design and the associated teeth on the decreased circumference percentage was statistically analyzed by two-sided ANOVA. Results: The percentage of reduction in lower E SSC circumference was 3.71±0.39% in MIB and 6.29±0.62% in 3M crowns. These values were 3.55±0.55% and 7.15±1.13% for the lower Ds, and 3.95±0.43 and 6.24±0.85% for the upper Ds, respectively. For the upper Es, these values were found to be 3.12±0.65% and 5.14±0.94%, respectively. For each tooth, a significant difference was found between MIB and 3M SSCs in terms of the percentage of reduction in crown circumference following crimping. The magnitude of this reduction was smaller in MIB compared to 3M SSCs (P<0.001). Conclusion: Considering the significant reduction in the marginal circumference of precrimped SSCs following re-crimping, it appears that this manipulation must be necessarily performed for MIB and 3M pre-crimped SSCs. By using 3M SSCs, higher marginal adaptation can be achieved following crimping. PMID:27559353

Nutritional and cognitive status of entry-level primary school children in Zomba, rural Malawi.

PubMed

Nkhoma, Owen W W; Duffy, Maresa E; Davidson, Philip W; Cory-Slechta, Deborah A; McSorley, Emeir M; Strain, J J; O'Brien, Gerard M

2013-05-01

Entry-level Malawian children (n = 226) aged 6-8 years from two public primary schools, one a participant in a national school feeding programme (FP), the other not, were investigated for differences in nutritional and cognitive status. Stunted growth (42%) and underweight (25%) were prevalent, with no significant differences between the schools, although the school attended was a significant predictor of mid-upper arm circumference. Previous attendance at a community-based childcare centre was significantly associated with lower body weight and height. There were no significant differences in memory, reversal learning and attention outcomes between the schools. These findings report no major significant difference in nutrition or cognitive statuses between the schools, and on this basis suggest that both schools were equally in need of FP participation. More inclusive interventions and broadening/review of FP participation criteria are recommended.

Sex differences in the malnourished status of Chinese children due to schistosomiasis infections and inadequate dietary intake.

PubMed

Zhou, Huan; He, Yongkang; Ohtsuka, Ryutaro

2005-01-01

Based on nutritional and parasitological examinations of 389 children aged 10-13 years in five primary schools in the schistosomiasis endemic Dongting Lake region of China, the causal factors of their retarded growth, represented by height, weight, mid-upper arm circumference and body mass index, were investigated. Among the four parasites, schistosomiasis infection due to Schistosoma japonicum played a significant role, with higher rates in girls than in boys. Praziquantel treatment of schistosomiasis decreased the infection rate and improved the children's growth. For dietary intake factors, the contribution of protein to total energy intake, which was lower in girls than in boys, had the greatest effect on the growth patterns. The sex difference in growth retardation is judged to be attributable to the traditional norms, such as girls spending more time in infested environments and gender discrimination in food distribution.

Nutritional status and dietary intake of institutionalized elderly in Turkey: a cross-sectional, multi-center, country representative study.

PubMed

Ongan, Dilek; Rakıcıoğlu, Neslişah

2015-01-01

To evaluate the nutritional status and dietary intake of institutionalized elderly in Turkey. Cross-sectional study. 25 institutions in 19 cities throughout Turkey. Elderly residents aged 65 years and older (n=554). Nutritional status using Mini Nutritional Assessment (MNA), food consumption with 24-h dietary recall and anthropometric measurements (body weight, height, body mass index (BMI), waist circumference (WC), hip circumference, waist/hip ratio, mid-upper arm circumference (MUAC)). The mean age of the elderly was 76.1±7.3 years. BMI of elderly men and women were found to be 26.59±4.58kg/m(2) and 30.07±6.32kg/m(2), respectively. WC of elderly men and women were found to be 98.90±1.33cm and 100.62±1.34cm, respectively. Most of the elderly were overweight based on BMI and at risk of metabolic diseases based on WC. According to MNA, 44.2% had normal nutritional status, 49.1% were at risk of malnutrition, 6.7% had malnutrition. All nutrients intake was favorable according to requirements, except for calcium and magnesium. Energy, protein, carbohydrate, fat, vitamins A, E, B1, B2, B6, C folat, iron, zinc intake of elderly who had normal nutritional status, who were at risk of malnutrition and malnourished were significantly different. Energy and nutrients intake of elderly who had normal nutritional status was found to be better than the others. Nutritional status should be periodically screened in the institutionalized elderly to prevent malnutrition. Also, it was noted that adequate energy and nutrients intake of the elderly played a crucial role in maintaining nutritional status and preventing malnutrition within residential homes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementation of whole body scanner for determining somatotype index at Chang Gung Memorial Hospital.

PubMed

Liu, T H; Chiou, W K; Lin, J D; Yu, C Y

2001-11-01

Body mass index (BMI) and waist-hip ratio (WHR) using 1-dimensional circumference data have been proven to be highly related to blood pressure and total cholesterol; these 2 indices have been widely used as health indicators in preventive diagnosis and health examination. Sophisticated software, which allows calculation of the triangular mesh related to the body surface in 3D space, is capable of computing the circumference, width, sectional surface, volume, and surface area of the body. Chang Gung Whole Body Scanner (CGWBS) was used to capture 3D whole body surface images. In this study, the human body was divided into 10 segments consisting of the head, breast, wrist, hip, upper arm, forearm, hand, thigh, calf, and foot. Five independent assessments were made on a total of 32 anthropometric sites, including 12 circumferences, 3 widths, 3 profile areas, 7 surface areas, and 7 volumes. In this study, the somatotype index (SI) was computed through anthropometric data after 1,323 subjects were investigated. Correlation analysis was used to describe the relationship between BMI, WHR, SI, and anthropometric data. One-way analysis of variance (ANOVA) and Duncan's multiple range tests were used to examine differences between examination variables across sex and SI groups. This study found 4 somatotypes from anthropometric data. SI determined by CGWBS has better correlation with anthropometry than WHR or BMI. Of the 644 male subjects, 155 were in the ectomorph group, 232 in the semi-mesomorph group, 136 in the full-mesomorph group, and 121 in the endomorph group. Of the 679 female subjects, 160 were in the ectomorph group, 235 in the semi-mesomorph group, 168 in the full-mesomorph group, and 116 in the endomorph group. The results show that SI has great potential to perform precise somatotype classification.

Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors.

PubMed

Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Zhang, Yunjue; Seow, Esmond; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

2017-08-04

Hand-grip strength (HGS) serves as a proxy measure for muscle function and physical health. Studies have shown that low HGS is associated with common age-related disorders including frailty and sarcopenia. The aim of the present study was to establish the normative values of HGS among older adults in Singapore and to compare it with data from Western and other Asian countries. The study also aimed to explore the sociodemographic and anthropometric correlates of HGS. Data were collected from 2043 men and women aged 60 years and above who took part in the Well-being of the Singapore Elderly study in 2013. HGS was obtained using a Jamar Plus + digital hand dynamometer. Normative data were stratified by; 5-year age groups, sex and ethnicity. Relationships between the HGS with various sociodemographic and anthropometric correlates were examined using multiple linear regression analysis. The mean HGS demonstrate a decreasing trend with increased age across all ethnic groups and sexes. HGS among Singapore older adults were relatively low compared to Western and other Asian countries. Males in the youngest age group (60-64) and of Chinese ethnicity attained greater HGS values than their counterparts. When the regression analysis was stratified for sex, significant associations were found between height, upper arm circumference with HGS in the males sample, and between height, weight, waist circumference and HGS in the females sample. Older adults in Singapore have a relatively weak HGS compared to other countries. Greater height and weight, and smaller waist circumference are independently associated with greater HGS in females but not males. These results facilitate the interpretation of HGS conducting using Jamar digital-type dynamometers among the older adults in Singapore.

Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam

PubMed Central

Young, Melissa F.; Hong Nguyen, Phuong; Addo, O. Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

2017-01-01

Objective To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21–29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Methods Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Results Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21–29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46–0.70). Conclusion There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. Trial Registration ClinicalTrials.gov, NCT01665378 PMID:28114316

Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.

PubMed

Young, Melissa F; Hong Nguyen, Phuong; Addo, O Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

2017-01-01

To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. ClinicalTrials.gov, NCT01665378.

Assessing the growth of preterm infants using detailed anthropometry.

PubMed

Ashton, James J; Johnson, Mark J; Pond, Jenny; Crowley, Philippa; Dimitrov, Borislav D; Pearson, Freya; Beattie, R Mark

2017-06-01

Preterm infants display altered body composition compared to term infants, and weight gain is a crude indicator body composition. Childhood mid-upper arm circumference (MUAC) is a measure of nutritional status. This study investigates MUAC and mid-thigh circumference (MTC) to monitor growth in preterm infants. Preterm infants (<30-week gestation) were recruited. MUAC, MTC, weight, length and head circumference (HC) were measured at recruitment and weekly intervals until discharge. Descriptive, correlation and regression analyses were used. Ninety-three infants were recruited. Median measurement duration was eight weeks (1-19). Median gestational age was 27 weeks (23-29). Analysis by curve estimation displayed a mean increase of 2.58 mm/week (left MUAC) (p ≤ 0.0001), 2.56 mm/week (right MUAC) (p ≤ 0.0001), 4.16 mm/week (left MTC) (p ≤ 0.0001), 4.20 mm/week (right MTC) (p ≤ 0.0001). Coefficients of determination (R 2 ) were calculated using a growth regression model for MUAC and MTC (0.866-0.917); measures were comparable to growth modelling of weight (0.913), length (0.945) and HC (0.928). High concordance between left and right MUAC and MTC generated a Pearson's correlation coefficient of 0.999 (MUAC) (p ≤ 0.001) and 0.994 (MTC) (p ≤ 0.001). Data demonstrate the potential utility of MUAC and MTC as additional measures of growth in preterm infants that are reproducible over time. There is potential to gain insights to improve lean-mass accretion in preterm infants. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Nutritional status of mentally retarded children in north-west Spain. I. Anthropometric indicators.

PubMed

Sánchez-Lastres, J; Eirís-Puñal, J; Otero-Cepeda, J L; Pavón-Belinchón, P; Castro-Gago, M

2003-06-01

To evaluate the nutritional status of mentally retarded children in the region of Galicia in north-west Spain, on the basis of anthropometric variables. The following variables were determined in a sample of 128 mentally retarded children (81 M, 47 F): birthweight, bodyweight, height/length, head circumference, mid-arm circumference, mid-arm muscle circumference, triceps skinfold thickness, subscapular skinfold thickness, arm area, arm muscle area, arm fat area, arm lean-to-fat ratio, Shukla's nutrition index and Quetelet's body mass index (BMI). A preliminary statistical analysis indicated that most information content could be maintained considering only eight of these variables. A factor analysis of the resulting 8 x 128 (variables by subjects) data matrix was performed, identifying two factors (FA1 and FA2) that together explained 82% of total variance. Taking these factors as indicators of nutritional status, the data were analysed for possible effects of age, gender, socioeconomic and family environment, intelligence quotient (IQ), presence/absence of cerebral palsy, quality of diet, appetite and antiepileptic use. The analysis suggested that most subjects were in the normal nutrition range, but about 33% showed either borderline or definite malnutrition. Mean score on FA2 showed a significant negative correlation with age. Children with cerebral palsy had lower mean scores on both factors, and scores on both factors varied with IQ. Children with definite malnutrition had a significantly lower IQ than those in the normal nutrition range. Mean score on both factors varied with appetite and quality of diet. The mean FAI score of children from inland-rural areas was significantly lower than that of children from coastal or urban areas. Mean FA1 score increased with increasing age of the parents. The prevalence of obesity was 13% when obesity was defined on the basis of Shukla's nutrition index, and 19% when defined on the basis of FA1 score. Malnutrition as revealed by anthropometric variables occurs with a high prevalence among mentally retarded children. The prevalence increases with age, increasing IQ deficit and cerebral palsy.

The efficacy of cryolipolysis treatment on arms and inner thighs.

PubMed

Wanitphakdeedecha, Rungsima; Sathaworawong, Angkana; Manuskiatti, Woraphong

2015-11-01

Cryolipolysis has emerged as a new non-invasive body contouring method using controlled cooling to selectively destroy fat cells. Previous studies demonstrated the safety and efficacy of cryolipolysis for the reduction of localized subcutaneous fat on abdomen and flanks. Recently, the new flat cup vacuum applicator has been developed to treat localized subcutaneous fat on arms and inner thighs. The objective of this study was to determine the efficacy of non-invasive cryolipolysis for body contouring with a flat cup vacuum applicator on arms and inner thighs. Twenty females with excess localized subcutaneous fat on arms or inner thighs received a single cryolipolysis treatment. Forty treatment areas have been treated including 10 arms and 30 inner thighs. Subjects were evaluated using standardized photographs and measurements of body weight and circumference of arms or inner thighs at baseline, 3-month, and 6-month follow-up visits. Physicians' evaluation and patient's satisfaction of clinical improvement were also measured. Of all 20 subjects, 17 (10 arms and 24 inner thighs) completed the treatment protocol and attended all follow-up visits. Three subjects were withdrawn from the study, 1 subject could not complete the treatment session due to pain and numbness during treatment, 1 subject became pregnant after treatment, and the other subject could not attend all required follow-up visits. There was significant circumference reduction of 0.41 and 0.72 cm at 3-month and 6-month follow-up visits (p = 0.017), respectively. Most of the patients were rated to have 1-25% improvement at 6 months after treatment and were satisfied with the treatment outcome. The new cryolipolysis flat cup vacuum applicator provided beneficial effects for circumferential reduction of arms and inner thighs.

Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin.

PubMed

Jensterle Sever, Mojca; Kocjan, Tomaz; Pfeifer, Marija; Kravos, Nika Aleksandra; Janez, Andrej

2014-03-01

The effect of metformin on weight reduction in polycystic ovary syndrome (PCOS) is often unsatisfactory. In this study, we investigated the potential add-on effect of treatment with the glucagon-like peptide-1 receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost <5% body weight during pretreatment with metformin. A total of 40 obese women with PCOS, who had been pretreated with metformin for at least 6 months, participated in a 12-week open-label, prospective study. They were randomized to one of three treatment arms: metformin (MET) arm 1000 mg BID, liraglutide (LIRA) arm 1.2 mg QD s.c., or combined MET 1000 mg BID and LIRA (COMBI) 1.2 mg QD s.c. Lifestyle intervention was not actively promoted. The primary outcome was change in body weight. Thirty six patients (aged 31.3 ± 7.1 years, BMI 37.1 ± 4.6 kg/m²) completed the study: 14 on MET, 11 on LIRA, and 11 on combined treatment. COMBI therapy was superior to LIRA and MET monotherapy in reducing weight, BMI, and waist circumference. Subjects treated with COMBI lost on average 6.5 ± 2.8 kg compared with a 3.8 ± 3.7 kg loss in the LIRA group and a 1.2 ± 1.4 kg loss in the MET group (P<0.001). The extent of weight loss was stratified: a total of 38% of subjects were high responders who lost ≥5% body weight, 22% of them in the COMBI arm compared with 16 and 0% in the LIRA and MET arm respectively. BMI decreased by 2.4 ± 1.0 in the COMBI arm compared with 1.3 ± 1.3 in LIRA and 0.5 ± 0.5 in the MET arm (P<0.001). Waist circumference also decreased by 5.5 ± 3.8 cm in the COMBI arm compared with 3.2 ± 2.9 cm in LIRA and 1.6 ± 2.9 cm in the MET arm (P=0.029). Subjects treated with liraglutide experienced more nausea than those treated with metformin, but severity of nausea decreased over time and did not correlate with weight loss. Short-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy.

Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

PubMed Central

Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

2011-01-01

Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

The Contribution of Upper Body Movements to Dynamic Balance Regulation during Challenged Locomotion

PubMed Central

Boström, Kim J.; Dirksen, Tim; Zentgraf, Karen; Wagner, Heiko

2018-01-01

Recent studies suggest that in addition to movements between ankle and hip joints, movements of the upper body, in particular of the arms, also significantly contribute to postural control. In line with these suggestions, we analyzed regulatory movements of upper and lower body joints supporting dynamic balance regulation during challenged locomotion. The participants walked over three beams of varying width and under three different verbally conveyed restrictions of arm posture, to control the potential influence of arm movements on the performance: The participants walked (1) with their arms stretched out perpendicularly in the frontal plane, (2) spontaneously, i.e., without restrictions to the arm movements, and (3) with their hands on their thighs. After applying an inverse-dynamics analysis to the measured joint kinematics, we investigated the contribution of upper and lower body joints to balance regulation in terms of torque amplitude and variation. On the condition with the hands on the thighs, the contribution of the upper body remains significantly lower than the contribution of the lower body irrespective of beam widths. For spontaneous arm movements and for outstretched arms we find that the upper body (including the arms) contributes to the balancing to a similar extent as the lower body. Moreover, when the task becomes more difficult, i.e., for narrower beam widths, the contribution of the upper body increases, while the contribution of the lower body remains nearly constant. These findings lend further support to the hypothetical existence of an “upper body strategy” complementing the ankle and hip strategies especially during challenging dynamic balance tasks. PMID:29434544

[Effects of glutamine-enriched enteral nutrition on nutritional status and prognosis of patients with severe head injury].

PubMed

Zeng, Jing; Zhao, Xiao-yu; Huang, Qiong; Wang, En-ren

2009-10-01

To investigate the effects of glutamine-enriched enteral nutrition on the nutritional status and prognosis of patients with severe head injury. Thirty-three patients with severe head injury were randomly divided into control group (C, 15 cases) and glutamine-enriched group (Gln, 18 cases). Patients in both groups were given routine treatment and enteral nutrition with the same amount of nitrogen and calorie. Patients in Gln group were given glutamine 0.5 g x kg(-1) x d(-1) additionally added into the nutrient fluid. Vital signs and the occurrence of side effects of all patients were observed before and after nutrition support. Venous blood and urine sample of all patients were collected before and 7, 14 days after treatment to determine the parameters of blood, urine routine and hepatorenal function. At the same time points, body mass, skin fold thickness at the region of triceps brachii (TSF), upper arm circumference (AC), upper arm muscle circumference (AMC) and fasting blood glucose of all patients were detected and determined, Glasgow coma scale (GCS) scoring was performed. The length of hospital stay of all patients was recorded. Vital signs and parameters of blood, urine routine and hepatorenal function of patients in 2 groups after nutrition treatment were close to those before treatment. Side effects, such as nausea and diarrhea occurred with spontaneous remission in a few patients. There was no statistical significant difference between 2 groups, and within each group before and after treatment, in respect of body mass and TSF (P > 0.05). Values of AC and AMC of patients in Gln group were obviously higher than those of C group (P < 0.01) on post-treatment day 14. Fasting blood glucose and GCS score of all patients before treatment were close to those on post-treatment day 14 (P > 0.05). Fasting blood glucose and GCS score of patients was respectively lower and higher in Gln group than that in C group on post-treatment day 7 (P < 0.05). Length of hospital stay of patients in Gln group (25 +/- 9) d was obviously shorter than that of C group (33 +/- 12) d (P < 0.05). Glutamine-enriched enteral nutrition can control the blood glucose level, prevent the loss of lean tissue, improve nutrition status of patients,shorten hospital stay, and accelerate the recovery of patients to some extent.

Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya.

PubMed

Grant, Angeline; Njiru, James; Okoth, Edgar; Awino, Imelda; Briend, André; Murage, Samuel; Abdirahman, Saida; Myatt, Mark

2018-01-01

A novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification devices to determine whether they improved the sensitivity of mothers/caregivers at detecting acute malnutrition. Prospective, non-randomised, partially-blinded, clinical diagnostic trial describing and comparing the performance of three "Click-MUAC" devices and a MUAC insertion tape. The study took place in twenty-one health facilities providing integrated management of acute malnutrition (IMAM) services in Isiolo County, Kenya. Mothers/caregivers classified their child ( n =1040), aged 6-59 months, using the "Click-MUAC" devices and a MUAC insertion tape. These classifications were compared to a "gold standard" classification (the mean of three measurements taken by a research assistant using the MUAC insertion tape). The sensitivity of mother/caregiver classifications was high for all devices (>93% for severe acute malnutrition (SAM), defined by MUAC < 115 mm, and > 90% for global acute malnutrition (GAM), defined by MUAC < 125 mm). Mother/caregiver sensitivity for SAM and GAM classification was higher using the MUAC insertion tape (100% sensitivity for SAM and 99% sensitivity for GAM) than using "Click-MUAC" devices. Younden's J for SAM classification, and sensitivity for GAM classification, were significantly higher for the MUAC insertion tape (99% and 99% respectively). Specificity was high for all devices (>96%) with no significant difference between the "Click-MUAC" devices and the MUAC insertion tape. The results of this study indicate that, although the "Click-MUAC" devices performed well, the MUAC insertion tape performed best. The results for sensitivity are higher than found in previous studies. The high sensitivity for both SAM and GAM classification by mothers/caregivers with the MUAC insertion tape could be due to the use of an improved MUAC tape design which has a number of new design features. The one-on-one demonstration provided to mothers/caregivers on the use of the devices may also have helped improve sensitivity. The results of this study provide evidence that mothers/caregivers can perform sensitive and specific classifications of their child's nutritional status using MUAC. Clinical trials registration number: NCT02833740.

The effect of arm weight support on upper limb muscle synergies during reaching movements

PubMed Central

2014-01-01

Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke survivors and other patients who could benefit from upper limb rehabilitation with arm WS. PMID:24594139

[Evaluation of nutritional Status in lung cancer using bio electrical impedance analysis and mini nutritional assessment].

PubMed

Daghfous, Hafaoua; El Ayeb, Wejdène; Alouane, Leila; Tritar, Fatma

2014-12-01

Malnutrition and cachexia were a frequent problem in lung cancer and increases the risks of morbidity and mortality in these patients. Bioelectrical impedance analysis (BIA) is easy, non-invasive and reproducible method that can be performed. Evaluate nutritional status in patients with primary lung cancer by Mini Nutritional Assessment (MNA), BIA and anthropometric values (weight, arm and calf circumferences) and correlate the nutritional parameters to severity of cancer and histopathology. The nutritional status of 73 cases of primary lung cancer was evaluated by anthropometric parameters, MNA test and impedencemetrie Results: According to body mass index (BMI), malnutrition, overweight and obesity were noted in 34,2%, 13,7% and 5,5%. According to BMI, free-fat mass index (FFMI) and fat mass index (FMI), the investigations occurred malnutrition and depletion of muscle in respectively 19,2% and 23,3% of cases. Fat depletion was noted in 21,9%. Overweight and obesity were detected in 6,8% and 5,5% of cases. Assessment by MNA, revealed that 28,7% of patients were already malnourished and 49,3% of patients were at risk of malnutrition. A significant correlation existed between the score of MNA and arm and calf circumferences, FFMI and FMI. FMI was significantly lower in group of patients with small lung carcinoma. Only FFMI allows early detection of malnutrition in cancer patients overestimated by measuring BMI and arm circumference was the better indicator of depletion of muscle.

Nutritional status at diagnosis is related to clinical outcomes in children and adolescents with cancer: a perspective from Central America.

PubMed

Sala, Alessandra; Rossi, Emanuela; Antillon, Federico; Molina, Ana Lucia; de Maselli, Tania; Bonilla, Miguel; Hernandez, Angelica; Ortiz, Roberta; Pacheco, Carlos; Nieves, Rosa; Navarrete, Marta; Barrantes, Max; Pencharz, Paul; Valsecchi, Maria Grazia; Barr, Ronald

2012-01-01

The prevalence of malnutrition in children may exceed 50% in countries with limited resources. The aims of this study were to assess nutritional status at diagnosis in children and adolescents with cancer, and to correlate it with clinical outcomes in the Spanish speaking countries of Central America that formed the AHOPCA (Asociacion de Hemato-Oncologia Pediatrica de Centro America) consortium. Patients aged 1-18 years, diagnosed with cancer between 1st October 2004 and 30th September 2007, were eligible for study. Weight (kg) and height or length (m), mid upper arm circumference--MUAC and triceps skin fold thickness--TSFT were measured and their Z-scores or percentiles were calculated. Three categories of nutritional status were defined according to these parameters. A total of 2954 new patients were enrolled; 1787 had all anthropometric measurements performed and 1513 also had measurements of serum albumin. By arm anthropometry 322/1787 patients (18%) had moderate nutritional depletion and 813/1787 patients (45%) were severely depleted. Adding serum albumin, the proportion classified as severely depleted rose to 59%. Malnourished children more often abandoned therapy and their event free survival was inferior to that of other children. Arm anthropometry in children with cancer is a sensitive measure of nutritional status. Since malnutrition at diagnosis was related to important clinical outcomes, an opportunity exists to devise simple, cost-effective nutritional interventions in such children that may enhance their prospects for survival. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dislocated Shoulder: Symptoms and Causes

MedlinePlus

... arm bone pops out of the cup-shaped socket that's part of your shoulder blade. The shoulder ... your upper arm bone out of your shoulder socket. Partial dislocation — in which your upper arm bone ...

Intervention study shows suboptimal growth among children receiving a food supplement for five months in a slum in Bangladesh

PubMed Central

Choudhury, Nuzhat; Bromage, Sabri; Alam, M. Ashraful; Ahmed, A.M. Shamsir; Islam, M. Munirul; Hossain, M. Iqbal; Mahfuz, Mustafa; Mondal, Dinesh; Haque, M. Rashidul; Ahmed, Tahmeed

2017-01-01

Aim This study assessed weight and height changes among underweight children who received a locally produced, cereal-based, ready-to-use supplementary food. Methods We recruited 500 underweight Bangladeshi children aged 6–23 months from a Dhaka slum and individually matched them by sex and neighbourhood with 480 well-nourished controls. The intervention group received the daily food supplement for five months and both groups received daily micronutrient supplements. Their weight, height, mid-upper-arm circumference and head circumference were measured monthly. Results The children’s mean daily weight gain decreased from 1.27 to 0.66 grams per kilogram per day (g/kg/day) in the intervention group and 0.77 to 0.49 g/kg/day in the controls after adjusting for age differences between the two groups from baseline to five months of follow up. The mean monthly height gain decreased from 1.13 to 1.03 millimeters per metre per month in the intervention children and 1.26 to 1.01 in the controls. The weight gain was highest in the intervention children who were most wasted at baseline and the controls who were least stunted. Conclusion The children showed suboptimal growth despite food supplements, highlighting the need for ongoing research to develop inexpensive, locally-sourced food supplements to improve the nutrition of underweight children in Bangladesh. PMID:27415153

Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

PubMed Central

Pullen, Sara D; Chigbo, Nnenna Nina; Nwigwe, Emmanuel Chukwudi; Chukwuka, Chinwe J; Amah, Christopher Chim; Idu, Stanley C

2014-01-01

Background The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV. Methods This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV. Results The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being. Conclusion Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management. PMID:24936132

A multilateral modelling of Youth Soccer Performance Index (YSPI)

NASA Astrophysics Data System (ADS)

Bisyri Husin Musawi Maliki, Ahmad; Razali Abdullah, Mohamad; Juahir, Hafizan; Abdullah, Farhana; Ain Shahirah Abdullah, Nurul; Muazu Musa, Rabiu; Musliha Mat-Rasid, Siti; Adnan, Aleesha; Azura Kosni, Norlaila; Muhamad, Wan Siti Amalina Wan; Afiqah Mohamad Nasir, Nur

2018-04-01

This study aims to identify the most dominant factors that influencing performance of soccer player and to predict group performance for soccer players. A total of 184 of youth soccer players from Malaysia sport school and six soccer academy encompasses as respondence of the study. Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were computed to identify the most dominant factors whereas reducing the initial 26 parameters with recommended >0.5 of factor loading. Meanwhile, prediction of the soccer performance was predicted by regression model. CFA revealed that sit and reach, vertical jump, VO2max, age, weight, height, sitting height, calf circumference (cc), medial upper arm circumference (muac), maturation, bicep, triceps, subscapular, suprailiac, 5M, 10M, and 20M speed were the most dominant factors. Further index analysis forming Youth Soccer Performance Index (YSPI) resulting by categorizing three groups namely, high, moderate, and low. The regression model for this study was significant set as p < 0.001 and R2 is 0.8222 which explained that the model contributed a total of 82% prediction ability to predict the whole set of the variables. The significant parameters in contributing prediction of YSPI are discussed. As a conclusion, the precision of the prediction models by integrating a multilateral factor reflecting for predicting potential soccer player and hopefully can create a competitive soccer games.

Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

PubMed

Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

2018-06-01

Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

Yoga Practice for Reducing the Male Obesity and Weight Related Psychological Difficulties-A Randomized Controlled Trial

PubMed Central

Subramanya, Pailoor; Nidhi, Ram

2016-01-01

Introduction Obesity is a health disorder and increasing all over the world. It is also a cause for many non-communicable diseases. Yoga practice reduces the stress level which may improve the eating habits and help in weight reduction. Aim To assess the final outcome of the effects after 3 months of the 14 weeks yoga training on obesity of adult male in an urban setting. Materials and Methods This was a randomized controlled trial with parallel groups (Yoga and Control groups) on male obese. Total 80 subjects with Body Mass Index (BMI) between 25 to 35 kg/cm2 were enrolled and randomized into two equal groups in which 72 subjects (yoga n = 37 and control n=35) completed the trial. Yoga group mean age ± SD was 40.03±8.74 and Control group mean age±SD was 42.20±12.06. A 14 weeks special IAYT (Integrated Approach of Yoga Therapy) yoga training was given to the Yoga group and no specific activity was given to Control group. The interim results of this study at 14 weeks were covered in another article which is under process. After the 14 weeks of yoga training the Yoga group was asked to continue the yoga practice for the next 3 months and the Control group was not given any physical activity. The final outcome is covered in this paper. The assessments were anthropometric parameters of body weight (Wt), BMI (Body Mass Index), MAC (Mid-upper Arm Circumferences of left and right arm), WC (Waist Circumference), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF (Skin Fold Thickness) of biceps, triceps, sub scapular, suprailiac and cumulative skin fold thickness value), Percentage body fat based on SKF and Psychological questionnaires of PSS (Perceived Stress Scale) and AAQW (Acceptance and Action Questionnaire for Weight related difficulty). Assessments were taken after 3 months of yoga training, for both Yoga and Control groups. Within group, between group and correlation analyses were carried out using SPSS 21. Results Improvement in anthropometric and psychological parameters such as Wt, Percentage body fat, PSS were observed in the final outcome. Also, some of the improvements such as AAQW score were lost in the final outcome, compared to interim results. Conclusion The yoga practice is effective for obesity control for adult male in an urban setting. PMID:28050422

Upper Arm Central Venous Port Implantation: A 6-Year Single Institutional Retrospective Analysis and Pictorial Essay of Procedures for Insertion

PubMed Central

Shiono, Masatoshi; Takahashi, Shin; Kakudo, Yuichi; Takahashi, Masanobu; Shimodaira, Hideki; Kato, Shunsuke; Ishioka, Chikashi

2014-01-01

Background The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe and comfortable method in our unit. Here we report our experience and discuss the procedure and its potential advantages. Methods All CV port implantations (n = 599) performed in our unit from January 2006 to December 2011 were analyzed. Procedural success and complication rates between subclavian and upper arm groups were compared. Results Both groups had similar patient characteristics. Upper arm CV port and subclavian implantations were equivalently successful and safe. Although we only retrospectively analyzed data from a single center, the upper arm group had a significantly lower overall postprocedural complication rate than the subclavian group. No pneumothorax risk, less risk of arterial puncture by ultrasound, feasibility of stopping potential arterial bleeding, and prevention of accidental arterial cannulation by targeting the characteristic solitary basilic vein were the identified advantages of upper arm CV port implantation. In addition to the aforementioned advantages, there is no risk of “pinch-off syndrome,” possibly less patient fear of manipulation, no scars on the neck and chest, easier accessibility, and compatibility with the “peripherally inserted central catheter” technique. Conclusions Upper arm implantation may benefit clinicians and patients with respect to safety and comfort. We also introduce our methods for upper arm CV port implantation with the videos. PMID:24614412

Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.

PubMed

Batistão, Mariana Vieira; Sentanin, Anna Cláudia; Moriguchi, Cristiane Shinohara; Hansson, Gert-Åke; Coury, Helenice Jane Cote Gil; de Oliveira Sato, Tatiana

2012-01-01

The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (β=0.410) and 90th percentile of right upper arm elevation (β=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (β=-0.282) and 90th percentile of right upper arm elevation (β=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation.

Prosthesis Prescription Protocol of the Arm (PPP-Arm): The implementation of a national prosthesis prescription protocol.

PubMed

Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

2018-02-01

In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers. All stakeholders (rehabilitation teams, orthopedic workshops, patients, and insurance companies) were involved in development and implementation. A national project coordinator and knowledge brokers in each team were essential for the project. PPP-Arm was successfully developed and implemented in nine Dutch rehabilitation teams. The protocol improved team collaboration, structure, and completeness of prosthesis prescriptions and treatment uniformity and might be interesting for other countries as well. Clinical relevance A national protocol to prescribe upper limb prostheses can be helpful to create uniformity in treatment of patients with upper limb defects. Such a protocol improves quality of care for all patients in the country.

Prevalence and associated factors of protein- energy wasting among patients with chronic kidney disease at Mulago hospital, Kampala-Uganda: a cross-sectional study.

PubMed

Namuyimbwa, Lydia; Atuheire, Collins; Okullo, Joel; Kalyesubula, Robert

2018-06-14

Chronic kidney disease (CKD) is global health concern and priority. It is the 12th leading cause of death worldwide. Protein Energy Wasting occurs in 20-25% of patients with chronic kidney disease and can lead to a high morbidity and mortality rate. We determined the prevalence of protein energy wasting and factors associated among patients with chronic kidney disease at Mulago National Referral Hospital, Kampala, Uganda. We conducted a cross-sectional study recruiting 182 (89 non-CKD patients and 93 CKD patients) consecutively from the outpatient clinic and wards on New Mulago Hospital complex. We took anthropometric measurements including heights, weights, Triceps skin fold (TSF), Mid- Upper Arm circumference (MUAC), Body Mass Index (BMI) and Mid-arm muscle circumference (MAMC). Serum albumin levels and lipid profile levels were also obtained. Following consent of study participants, Data was collected using questionnaires and analyzed using STATA 14.1. Percentages, frequencies, means, medians, standard deviation and interquartile range were used to summarise data. Crude and adjusted binary logistic regression was performed to assess unadjusted and adjusted effect measures of protein energy wasting due to several factors. Stratification by CKD status was performed during the analysis to minimize confounding. The median age for CKD patients was 39 years compared to 27 years for non-CKD participants (p < 0.001). The prevalence of protein energy wasting (PEW) was 68.6% in this study with 47.3 and 21.3% among CKD and non-CKD participants respectively. Factors which were associated with PEW included CKD age between 18 and 24, being single, catholic religion, CKD stage 4, Hb < 11.5 g/dl and LDL > 160 mg/dl. Protein energy Wasting is prevalent among patients with chronic kidney disease and clinicians should routinely screen for it during patient care.

Comparison of 2 weekly-equalized volume resistance-training routines using different frequencies on body composition and performance in trained males.

PubMed

Yue, Fu Leon; Karsten, Bettina; Larumbe-Zabala, Eneko; Seijo, Marcos; Naclerio, Fernando

2018-05-01

The present study compared the effects of 2 weekly-equalized volume and relative load interventions on body composition, strength, and power. Based on individual baseline maximal strength values, 18 recreationally trained men were pair-matched and consequently randomly assigned to one of the following experimental groups: a low volume per session with a high frequency (LV-HF, n = 9) group who trained for 4 days (Mondays, Tuesdays, Thursdays, and Fridays) or a high volume per session and low frequency (HV-LF, n = 9) group who trained for 2 days (Mondays and Thursdays). Both groups performed 2 different routines over 6 weeks. Participants were tested pre- and post- intervention for maximal strength, upper body power, fat-free mass, limb circumferences, and muscle thickness. Compared with baseline values, both groups increased their fat-free mass (HV-LF: +1.19 ± 1.94; LV-HF: +1.36 ± 1.06 kg, p < 0.05) and vastus medialis thickness (HV-LF: +2.18 ± 1.88, p < 0.01; LV-HF: +1.82 ± 2.43 mm, p < 0.05), but only the HV-LF group enhanced arm circumference (1.08 ± 1.47 cm, p < 0.05) and elbow flexors thickness (2.21 ± 2.81 mm, P < 0.01) values and decreased their fat mass (-2.41 ± 1.10, P < 0.01). Both groups improved (p < 0.01) the maximal loads lifted in the bench press (LV-HF: +0.14 ± 0.01; HV-LF: +0.14 ± 0.01 kg·body mass -1 ) and the squat (LV-HF: +0.14 ± 0.06; HV-LF: 0.17 ± 0.01 kg·body mass -1 ) exercises as well as in upper body power (LV-HF: +0.22 ± 0.25; HV-LF: +0.27 ± 0.22 W·body mass -1 ) Although both training strategies improved performance and lower body muscle mass, only the HV-LF protocol increased upper body hypertrophy and improved body composition.

Correlations between human somatotype components and some anthropometric parameters in male patients with type 2 diabetes mellitus.

PubMed

Baltadjiev, Atanas G; Vladeva, Stefka V

2014-01-01

The aim of the present study was to find and compare the correlations between somatotype and some anthropological parameters in Bulgarian male patients with type 2 diabetes mellitus. Anthropometric measurements were taken from 165 male patients with type 2 diabetes mellitus. All patients were ethnic Bulgarians. They were divided into two age groups: a 40-60-year group (58 patients, mean age 52.05 ± 0.73 yrs), and a 61-80-year group (111 patients, mean age 68.02 ± 0.53 yrs). The controls were allocated into similar age-matched groups. Direct anthropometric measurements were body height and weight, biepicondylar breadth of the humerus and biepicondylar breadth of the femur. Circumferential measurements were taken from the relaxed and contracted upper arm, the forearm, the waist, the hip, the thigh and the medial calf. Skin folds were measured below the inferior angle of the scapula, above the X rib, above the crista iliaca, at the abdomen, triceps brachii, forearm, thigh and the medial calf. The components of human somatotype according to the criteria of Heath-Carter, body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. We found very strong positive correlations (PC > 0.70) between BMI and the endomorphic and mesomorphic components of somatotype in 40-60-year-old male diabetic patients. The correlation between the endomorphic and mesomorphic components of somatotype and the anthropometric measurements characterizing the central accumulation of adipose tissue (waist circumference, hip circumference, WHR) was very strong positive (PC = 0.5-0.7). Male diabetic patients aged 61-80 years: we found a very strong positive correlation between endomorphic and mesomorphic components and BMI, a strong correlation between these components and the waist circumference, and a good correlation between the components and the circumferences of the waist and hip and WHR. In male patients with type 2 diabetes aged 40-60 years, the endomorphic and mesomorphic components of somatotype are strongly positively correlated with the parameters which characterize the total adipose tissue accumulation in the human body (BMI). There is a good positive correlation between the two components of somatotype and the parameters showing visceral adipose tissue accumulation (circumferences of waist, hip, thigh and WHR). In male patients with type 2 diabetes aged 61-80 years we found a strong positive correlation of the endomorphic and mesomorphic components of somatotype with BMI and a good positive correlation with the circumferences of the waist, hip, thigh and WHR.

Subcutaneous Crotaline Fab antivenom for the treatment of rattlesnake envenomation in a porcine model.

PubMed

Offerman, Steven R; Barry, J David; Richardson, William H; Tong, Tri; Tanen, Dave; Bush, Sean P; Clark, Richard F

2009-01-01

This study was designed to investigate whether the local, subcutaneous injection of Crotaline Fab antivenom (CroFab) at the rattlesnake envenomation site would result in less extremity edema when compared to intravenous (i.v.) antivenom infusion alone. This is a randomized, three-arm laboratory experiment using a porcine model. Each animal was anesthetized, intubated, and maintained on mechanical ventilation. About 6 mg/kg of Crotalus atrox venom was injected subcutaneously at the hock of the right hind leg. Animals were then randomized to immediately receive subcutaneous and i.v. antivenom (SC/IV), i.v. antivenom only, or saline control. SC/IV animals received two vials of CroFab subcutaneously at the envenomation site and two vials intravenously. IV animals received four vials of CroFab intravenously. Limb edema was tracked by serial circumference and volumetric measurements over an 8-h period. Limb circumference was measured at four pre-determined locations hourly. Limb volume was measured by a water displacement method at baseline, 4, and 8 h. Twenty-six animals were randomized to the three treatment groups. The SC/IV and IV arms included nine animals each. Two animals in the SC/IV group died suddenly during the study, leaving seven animals for data analysis. There were eight controls. Increasing limb edema was observed in all groups. No differences were detected in limb circumferences or limb volumes between control and either treatment arms. In this porcine model of crotaline envenomation, no differences in limb edema were found between animals treated with SC/IV or IV CroFab when compared to saline controls.

Nutrition Status Parameters and Hydration Status by Bioelectrical Impedance Vector Analysis Were Associated With Lung Function Impairment in Children and Adolescents With Cystic Fibrosis.

PubMed

Hauschild, Daniela Barbieri; Barbosa, Eliana; Moreira, Emilia Addison Machado; Ludwig Neto, Norberto; Platt, Vanessa Borges; Piacentini Filho, Eduardo; Wazlawik, Elisabeth; Moreno, Yara Maria Franco

2016-06-01

(1) To compare nutrition and hydration status between a group of children/adolescents with cystic fibrosis (CFG; n = 46; median age, 8.5 years) and a control group without cystic fibrosis (CG). (2) To examine the association of nutrition and hydration status with lung function in the CFG. A cross-sectional study. Nutrition screening, anthropometric parameters, and bioelectrical impedance analysis (BIA) were assessed. The z scores for body mass index for age, height for age, mid upper arm circumference, triceps and subscapular skinfold thickness, mid upper arm muscle area, resistance/height, and reactance/height were calculated. Bioelectrical impedance vector analysis was conducted. Forced expiratory volume in 1 second <80% was considered lung function impairment. An adjusted logistic regression was applied (P < .05). In the CFG, lung function impairment was observed in 51.1%. All anthropometric parameters were lower, and the mean z-resistance/height and z-reactance/height were higher in the CFG (P < .05) compared with the CG. In the CFG, 43% were severely/mildly dehydrated, while none were in the CG (P = .007). In the CFG, there was an association between high nutrition risk-via nutrition screening (odds ratio [OR], 22.28; P < .05), lower values of anthropometric parameters, higher z-resistance/height (OR, 2.23; P < .05) and z-reactance/height (OR, 1.81; P < .05), and dehydration (OR, 4.94; P < .05)-and lung function impairment. The CFG exhibited a compromised nutrition status assessed by anthropometric and BIA parameters. Nutrition screening, anthropometric and BIA parameters, and hydration status were associated with lung function. © 2016 American Society for Parenteral and Enteral Nutrition.

Nutritional status and morbidity on an irrigation project in Turkana District, Kenya.

PubMed

Brainard, Jean

1990-01-01

The research reported on here was undertaken to identify the most important contributors to continuing high mortality on a small-scale irrigation project at Nakwamoru in Turkana District, Kenya. The health status of project settlers had not been assessed prior to the present study, which was undertaken in 1978-79, a decade after the project was started. The purpose of the study was to estimate the nutritional status of project children and the major causes of morbidity in the Nakwamoru area. Nutritional status was derived from cross-sectional anthropometric measurements, including weights, heights, triceps skinfolds, and upper arm circumferences, taken on approximately 60% of project children (n = 236) aged 1-10 years. The major causes of morbidity in project settlers of all ages for the period 1973-78 were estimated from outpatient records from the local primary care facility. Age/sex patterns of clinic use were obtained through interviews. Stunting was found to be prevalent, especially in children aged 1-4, while wasting was only observed in a small proportion of the sample, indicating a seasonal pattern of malnutrition. Derived cross-sectional areas of upper arm muscle and fat were found to be low by comparison with U.S. standards, suggesting both energy and protein deficits in project children. Malaria and acute respiratory infections were found to be the major causes of illness in the local population, and both are likely to have contributed to the generally poor nutritional status of project children. Despite free biomedical care, 15% of the local population in general and 23% of adult females had never used clinic services. Copyright © 1990 Wiley-Liss, Inc., A Wiley Company.

Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin

PubMed Central

Jensterle Sever, Mojca; Kocjan, Tomaz; Pfeifer, Marija; Kravos, Nika Aleksandra; Janez, Andrej

2014-01-01

Objective The effect of metformin on weight reduction in polycystic ovary syndrome (PCOS) is often unsatisfactory. In this study, we investigated the potential add-on effect of treatment with the glucagon-like peptide-1 receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost <5% body weight during pretreatment with metformin. Methods A total of 40 obese women with PCOS, who had been pretreated with metformin for at least 6 months, participated in a 12-week open-label, prospective study. They were randomized to one of three treatment arms: metformin (MET) arm 1000 mg BID, liraglutide (LIRA) arm 1.2 mg QD s.c., or combined MET 1000 mg BID and LIRA (COMBI) 1.2 mg QD s.c. Lifestyle intervention was not actively promoted. The primary outcome was change in body weight. Results Thirty six patients (aged 31.3±7.1 years, BMI 37.1±4.6 kg/m2) completed the study: 14 on MET, 11 on LIRA, and 11 on combined treatment. COMBI therapy was superior to LIRA and MET monotherapy in reducing weight, BMI, and waist circumference. Subjects treated with COMBI lost on average 6.5±2.8 kg compared with a 3.8±3.7 kg loss in the LIRA group and a 1.2±1.4 kg loss in the MET group (P<0.001). The extent of weight loss was stratified: a total of 38% of subjects were high responders who lost ≥5% body weight, 22% of them in the COMBI arm compared with 16 and 0% in the LIRA and MET arm respectively. BMI decreased by 2.4±1.0 in the COMBI arm compared with 1.3±1.3 in LIRA and 0.5±0.5 in the MET arm (P<0.001). Waist circumference also decreased by 5.5±3.8 cm in the COMBI arm compared with 3.2±2.9 cm in LIRA and 1.6±2.9 cm in the MET arm (P=0.029). Subjects treated with liraglutide experienced more nausea than those treated with metformin, but severity of nausea decreased over time and did not correlate with weight loss. Conclusions Short-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy. PMID:24362411

Comparison of upper arm and forearm blood pressure.

PubMed

Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

2008-11-01

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

The Influence of Dopaminergic Striatal Innervation on Upper Limb Locomotor Synergies

PubMed Central

Isaias, Ioannis U.; Volkmann, Jens; Marzegan, Alberto; Marotta, Giorgio; Cavallari, Paolo; Pezzoli, Gianni

2012-01-01

To determine the role of striatal dopaminergic innervation on upper limb synergies during walking, we measured arm kinematics in 13 subjects with Parkinson disease. Patients were recruited according to several inclusion criteria to represent the best possible in vivo model of dopaminergic denervation. Of relevance, we included only subjects with normal spatio-temporal parameters of the stride and gait speed to avoid an impairment of upper limbs locomotor synergies as a consequence of gait impairment per se. Dopaminergic innervation of the striatum was measured by FP-CIT and SPECT. All patients showed a reduction of gait-associated arms movement. No linear correlation was found between arm ROM reduction and contralateral dopaminergic putaminal innervation loss. Still, a partition analysis revealed a 80% chance of reduced arm ROM when putaminal dopamine content loss was >47%. A significant correlation was described between the asymmetry indices of the swinging of the two arms and dopaminergic striatal innervation. When arm ROM was reduced, we found a positive correlation between upper-lower limb phase shift modulation (at different gait velocities) and striatal dopaminergic innervation. These findings are preliminary evidence that dopaminergic striatal tone plays a modulatory role in upper-limb locomotor synergies and upper-lower limb coupling while walking at different velocities. PMID:23236504

Vascular Accesses for Haemodialysis in the Upper Arm Cause Greater Reduction in the Carotid-Brachial Stiffness than Those in the Forearm: Study of Gender Differences

PubMed Central

Bia, Daniel; Cabrera-Fischer, Edmundo I.; Zócalo, Yanina; Galli, Cintia; Graf, Sebastián; Valtuille, Rodolfo; Pérez-Cámpos, Héctor; Saldías, María; Álvarez, Inés; Armentano, Ricardo L.

2012-01-01

Purpose. To evaluate in chronically haemodialysed patients (CHPs), if: (1) the vascular access (VA) position (upper arm or forearm) is associated with differential changes in upper limb arterial stiffness; (2) differences in arterial stiffness exist between genders associated with the VA; (3) the vascular substitute (VS) of choice, in biomechanical terms, depends on the previous VA location and CHP gender. Methods. 38 CHPs (18 males; VA in upper arm: 18) were studied. Left and right carotid-brachial pulse wave velocity (PWVc-b) was measured. In in vitro studies, PWV was obtained in ePTFE prostheses and in several arterial and venous homografts obtained from donors. The biomechanical mismatch (BM) between CHP native vessel (NV) and VS was calculated. Results/Conclusions. PWVc-b in upper limbs with VA was lower than in the intact contralateral limbs (P < 0.05), and differences were higher (P < 0.05) when the VA was performed in the upper arm. Differences between PWVc-b in upper limbs with VA (in the upper arm) with respect to intact upper limbs were higher (P < 0.05) in males. Independently of the region in which the VA was performed, the homograft that ensured the minimal BM was the brachial artery. The BM was highly dependent on gender and the location in the upper limb in which the VA was performed. PMID:22567282

[Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

PubMed

Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

1995-09-01

Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly measuring arterial blood pressure remains the measurement at the upper arm site, which nevertheless showed a systolic pseudohypertension (deviation of more than 10 mm Hg) in comparison to the invasively measured values in 15% of our selected patients and a diastolic pseudohypertension (deviation of more than 15 mm Hg) in 23% of the patients.

Breastfeeding and Growth of Children in the Peri/postnatal Epigenetic Twins Study (PETS): Theoretical Epigenetic Mechanisms.

PubMed

Temples, Heide S; Willoughby, Deborah; Holaday, Bonnie; Rogers, Curtis R; Wueste, Daniel; Bridges, William; Saffery, Richard; Craig, Jeffrey M

2016-08-01

The prevalence of overweight infants and toddlers has increased by 60% in the past 30 years and is a significant contributor to diabetes, cardiovascular disease, and early morbidity and mortality. The World Health Organization's updated meta-analysis in 2013 observed an association between breastfeeding and a lower prevalence of obesity later in life. The purpose of this study was to assess the growth of children in a cohort of Australian twins to examine associations between duration of breastfeeding and growth at 18 months of age. Our hypothesis is that the anthropometric measurements of the participants will be greater with shorter duration of breastfeeding. Methods include using cross-sectional data from a cohort at the 18-month visit (n = 179) in the Peri/postnatal Epigenetics Twins Study (PETS) to assess the relationship between duration of breastfeeding and infant size at 18 months of age. Inclusion criteria were birth weight of more than 2000 grams and breastfed for less than 1 month, 1 to 3 months, or 4 to 6 months. The analysis suggested that infants breastfed for 1 to 3 months were significantly larger than infants breastfed for 4 to 6 months in terms of mean body mass index (BMI) (0.61 kg/m(2); P = .02; 95% confidence interval [CI], 0.17-1.05), arm circumference (0.66 cm; P = .006; 95% CI, 0.26-1.06), and abdominal circumference (1.16 cm; P = .03; 95% CI, 0.26-2.06). The analysis also suggested that infants breastfed for less than 1 month were significantly larger than infants breastfed for 4 to 6 months in terms of mean arm circumference (0.72 cm; P = .009; 95% CI, 0.26-1.17). Results suggest that supplementing with non-breast milk before 4 months of age was associated with an increased BMI, arm circumference, and abdominal circumference at 18 months of age. The mean BMI decreased from 85% to 65% when infants were breastfeeding for 4 to 6 months as compared to breastfeeding for 1 to 3 months. Breastfeeding for 4 to 6 months appeared to protect against the risk of obesity for the children in the PETS. © The Author(s) 2016.

How maternal malnutrition affects linear growth and development in the offspring.

PubMed

Papathakis, Peggy C; Singh, Lauren N; Manary, Mark J

2016-11-05

Maternal malnutrition is common in the developing world and has detrimental effects on both the mother and infant. Pre-pregnancy nutritional status and weight gain during pregnancy are positively related to fetal growth and development. Internationally, there is no agreement on the method of diagnosis or treatment of moderate or severe malnutrition during pregnancy. Establishing clear guidelines for diagnosis and treatment will be essential in elevating the problem. Possible anthropometric measurements used to detect and monitor maternal malnutrition include pre-pregnancy BMI, weight gain, and mid upper arm circumference. Food supplements have the potential to increase gestational weight gain and energy intake which are positively associated with fetal growth and development. Overall more studies are needed to conclude the impact of food/nutrient supplements on infant growth in undernourished pregnant women in developing countries. Currently, a study underway may provide much needed documentation of the benefits of treating malnutrition in pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Establishing the need for nutrition education: I. Methodology.

PubMed

Vaden, A G; Newell, G K; Dayton, A D; Foley, C S

1983-10-01

Developmental and data collection phases for a comprehensive needs assessment project designed to provide baseline data for planning a statewide nutrition education and training project are summarized. To meet project objectives, 97 Kansas elementary schools were selected randomly as sampling units. A mail questionnaire was used to assess nutrition knowledge and attitudes and dietary and nutrition education practices of elementary teachers and food service personnel. Data from fifth grade students were collected on-site at each school. A written test was used to measure students' nutrition knowledge, attitudes, and practices. Students' nutritional status was partially assessed by measuring their height, weight, skinfold thickness, and upper arm circumference. As an additional assessment, 24-hour dietary recall interviews were conducted with a random sample of the students. In this article, each aspect of the data collection methodology is described in detail. As emphasized by authorities in the field, more complete information is needed in many nutrition survey reports to assist in useful interpretations and for comparisons among studies.

Meat and milk intakes and toddler growth: a comparison feeding intervention of animal-source foods in rural Kenya.

PubMed

Long, Jennifer K; Murphy, Suzanne P; Weiss, Robert E; Nyerere, Susan; Bwibo, Nimrod O; Neumann, Charlotte G

2012-06-01

To examine the effects of animal-source foods on toddler growth. A 5-month comparison feeding intervention study with one of three millet-based porridges randomized to eighteen feeding stations serving 303 children aged 11-40 months. Feeding stations served plain millet porridge (Plain group), porridge with milk (Milk group) or porridge with beef (Meat group). Anthropometry, morbidity and food intake were measured at baseline and regular intervals. Longitudinal mixed models were used to analyse growth. Embu, Kenya. Two hundred and seventy-four children were included in final analyses. Linear growth was significantly greater for the Milk group than the Meat group (P = 0·0025). Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group (P = 0·0046), while the Milk group's mid-upper arm circumference growth rate was significantly greater than the Meat group's (P = 0·0418). The Milk and Plain groups' measures did not differ. Milk and meat porridges did not have a significantly greater effect on growth than plain porridge in this undernourished population. Linear growth was influenced by more than energy intakes, as the Plain group's total body weight-adjusted energy intakes were significantly greater than the Meat group's, although linear growth did not differ. Energy intakes may be more important for growth in arm muscle. The diverse age distribution in the study makes interpretation difficult. A longer study period, larger sample size and more focused age group would improve clarity of the results.

Attenuation of indirect markers of eccentric exercise-induced muscle damage by curcumin.

PubMed

Tanabe, Yoko; Maeda, Seiji; Akazawa, Nobuhiko; Zempo-Miyaki, Asako; Choi, Youngju; Ra, Song-Gyu; Imaizumi, Atsushi; Otsuka, Yoshihiko; Nosaka, Kazunori

2015-09-01

Polyphenolic curcumin is known to have potent anti-inflammatory effects; thus the present study investigated the hypothesis that curcumin ingestion would attenuate muscle damage after eccentric exercise. Fourteen untrained young men (24 ± 1 years) performed 50 maximal isokinetic (120°/s) eccentric contractions of the elbow flexors of one arm on an isokinetic dynamometer and the same exercise with the other arm 4 weeks later. They took 150 mg of curcumin (theracurmin) or placebo (starch) orally before and 12 h after each eccentric exercise bout in a randomised, crossover design. Maximal voluntary contraction (MVC) torque of the elbow flexors, range of motion of the elbow joint, upper-arm circumference, muscle soreness, serum creatine kinase (CK) activity, and plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentration were measured before, immediately after, and 24, 48, 72 and 96 h after each eccentric exercise. Changes in these variables over time were compared between curcumin and placebo conditions by two-way repeated measures ANOVA. MVC torque decreased smaller and recovered faster (e.g., 4 days post-exercise: -31 ± 13 % vs. -15 ± 15 %), and peak serum CK activity was smaller (peak: 7684 ± 8959 IU/L vs. 3398 ± 3562 IU/L) for curcumin than placebo condition (P < 0.05). However, no significant differences between conditions were evident for other variables, and no significant changes in IL-6 and TNF-α were evident after exercise. It is concluded that theracurmin ingestion attenuates some aspects of muscle damage such as MVC loss and CK activity increase.

The effect of hypocaloric diet enriched in legumes with or without L-arginine and selenium on anthropometric measures in central obese women

PubMed Central

Alizadeh, Mohammad; Daneghian, Sevana; Ghaffari, Aida; Ostadrahimi, Alireza; Safaeiyan, Abdolrasoul; Estakhri, Rassul; Gargari, Bahram Pourghasem

2010-01-01

BACKGROUND: Identifying new ways to decrease adiposity will be very valuable for health. The aim of this study was to find out whether L-Arginine (Arg) and selenium alone or together can increase the effect of hypocaloric diet enriched in legumes (HDEL) on anthropometric measures in healthy obese women. METHODS: This randomized, double-blind, placebo-controlled trial was undertaken in 84 healthy premenopausal women with central obesity. After 2 weeks of run-in on an isocaloric diet, participants were randomly considered to eat HDEL, Arg (5 g/d) and HDEL, selenium (200 µg/d) and HDEL or Arg, selenium and HDEL for 6 weeks. The following variables were assessed before intervention and 3 and 6 weeks after it: weight, waist circumference, hip circumference, waist to hip ratio (WHR), body mass index (BMI), and fasting nitrite/nitrate (NOx) concentrations. Other variables (arm, thigh, calf and breast circumferences, subscapular, triceps, biceps and suprailiac skinfold thicknesses, sum of skinfold thicknesses (SSF), body density (D) and estimated percent of body fat (EPF)) were assessed before and after intervention. RESULTS: HDEL showed a significant effect in reduction of waist, hip, arm, thigh, calf and breast circumferences, triceps, biceps, subscapular and suprailiac skinfold thicknesses, WHR, SSF, D and EPF. HDEL + Arg + selenium significantly reduced suprailiac skinfold thicknesses; and there was no significant effect of HDEL, Arg, selenium and Arg plus selenium on weight, BMI and fasting NOx. CONCLUSIONS: The study indicates that HDEL + Arg + selenium reduce suprailiac skinfold thicknesses which represents the abdominal obesity reduction. PMID:21526106

Early manifestation of arm-leg coordination during stepping on a surface in human neonates.

PubMed

La Scaleia, Valentina; Ivanenko, Y; Fabiano, A; Sylos-Labini, F; Cappellini, G; Picone, S; Paolillo, P; Di Paolo, A; Lacquaniti, F

2018-04-01

The accomplishment of mature locomotor movements relies upon the integrated coordination of the lower and upper limbs and the trunk. Human adults normally swing their arms and a quadrupedal limb coordination persists during bipedal walking despite a strong corticospinal control of the upper extremities that allows to uncouple this connection during voluntary activities. Here we investigated arm-leg coordination during stepping responses on a surface in human neonates. In eight neonates, we found the overt presence of alternating arm-leg oscillations, the arms moving up and down in alternation with ipsilateral lower limb movements. These neonates moved the diagonal limbs together, and the peak of the arm-to-trunk angle (i.e., maximum vertical excursion of the arm) occurred around the end of the ipsilateral stance phase, as it occurs during typical adult walking. Although episodes of arm-leg coordination were sporadic in our sample of neonates, their presence provides significant evidence for a neural coupling between the upper and lower limbs during early ontogenesis of locomotion in humans.

Growth trends in boys and girls (10-17 years-old) from autonomous region of Madeira, Portugal between 1996-1998 and 2007-2009.

PubMed

Sousa, B; Oliveira, B M P M; de Almeida, M D V

2012-01-01

Growth trends have never been studied in adolescents of the Autonomous Region of Madeira, Portugal. To analyse growth trends in weight, height, body mass index (BMI), waist circumference (WC), mid-upper arm circumference (MUAC) and triceps skin-fold thickness (TST) of adolescents (10-17 years old) of the Autonomous Region of Madeira between 1996-1998 and 2007-2009. A cross-sectional study was carried out between 2007-2009, including 4314 adolescents, 2237 girls and 2077 boys (10-17 years old). To study secular growth trends, data were compared with a sample from 1996-1998, comparing the means for each anthropometric variable by age and sex using the independent-sample t-test. An average increase was found in weight of 5.8 kg in boys and 6.3 kg in girls; in height of 3.0 cm in boys and 3.7 cm in girls; in BMI of 1.5 kg/m(2) in boys and 1.7 kg/m(2) in girls; in WC a difference of 5.6 cm and 4.9 cm for boys and girls, respectively, and for MUAC a difference of 2.7 cm in boys and 2.0 cm in girls. No differences were found in TST in boys, but in girls an increase of 1.2 mm was observed. A general increase in anthropometric measurements, more marked in weight, BMI, WC and MUAC and at younger ages, was observed.

Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh.

PubMed

Islam, Md Zahirul; Shamim, Abu Ahmed; Kemi, Virpi; Nevanlinna, Antti; Akhtaruzzaman, Mohammad; Laaksonen, Marika; Jehan, Atia H; Jahan, Khurshid; Khan, Habib Ullah; Lamberg-Allardt, Christel

2008-06-01

The manufacture of garments is the main industry in Bangladesh and employs 1.6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18-36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36.7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16% of the subjects were found to be vitamin D-deficient (S-25OHD 21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < -2.5 had a trend of lower values of BMI, waist-hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.

Comparison of Nutritional Status in the Elderly According to Living Situations.

PubMed

Kucukerdonmez, O; Navruz Varli, S; Koksal, E

2017-01-01

This study aimed to evaluate the nutritional status of elderly individuals living alone and with their families. The sample of the study included 872 elderly individuals who agreed to participate in the study, were aged 65 or over, and lived in Ankara. The data were gathered from a survey, using face-to-face interviews. The Mini Nutritional Assessment (MNA) was used in evaluating each individual's nutrition. The rate of malnutrition in the study population was 5% while the malnutrition risk was 67%. The rate of malnutrition in the individuals living alone was found to be higher than that of those living with their families. The rates of malnutrition in individuals living alone and with their families were, respectively, 7% and 4%, and the rates of malnutrition risk in individuals living alone and with their families were, respectively, 73% and 66% (p<0.05). In both groups, there were significant relationships between individuals' ages, BMI values, mid-upper arm circumference (MUAC), and calf circumference measurements and their MNA scores. While there was a negative and significant relationship between age and MNA scores, the relationships between other parameters and MNA scores were positive and significant (p<0.01). In this study, it was revealed that the nutrition of elderly individuals living alone differs from the nutrition of elderly individuals living with their families. Malnutrition rates were higher in individuals living alone. Raising the awareness of elderly people and their families regarding the need to improve and maintain nutrition would be beneficial.

Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

PubMed

Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

2016-01-01

Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

Arm posture-dependent changes in corticospinal excitability are largely spinal in origin.

PubMed

Nuzzo, James L; Trajano, Gabriel S; Barry, Benjamin K; Gandevia, Simon C; Taylor, Janet L

2016-04-01

Biceps brachii motor evoked potentials (MEPs) from cortical stimulation are influenced by arm posture. We used subcortical stimulation of corticospinal axons to determine whether this postural effect is spinal in origin. While seated at rest, 12 subjects assumed several static arm postures, which varied in upper-arm (shoulder flexed, shoulder abducted, arm hanging to side) and forearm orientation (pronated, neutral, supinated). Transcranial magnetic stimulation over the contralateral motor cortex elicited MEPs in resting biceps and triceps brachii, and electrical stimulation of corticospinal tract axons at the cervicomedullary junction elicited cervicomedullary motor evoked potentials (CMEPs). MEPs and CMEPs were normalized to the maximal compound muscle action potential (Mmax). Responses in biceps were influenced by upper-arm and forearm orientation. For upper-arm orientation, biceps CMEPs were 68% smaller (P= 0.001), and biceps MEPs 31% smaller (P= 0.012), with the arm hanging to the side compared with when the shoulder was flexed. For forearm orientation, both biceps CMEPs and MEPs were 34% smaller (both P< 0.046) in pronation compared with supination. Responses in triceps were influenced by upper-arm, but not forearm, orientation. Triceps CMEPs were 46% smaller (P= 0.007) with the arm hanging to the side compared with when the shoulder was flexed. Triceps MEPs and biceps and triceps MEP/CMEP ratios were unaffected by arm posture. The novel finding is that arm posture-dependent changes in corticospinal excitability in humans are largely spinal in origin. An interplay of multiple reflex inputs to motoneurons likely explains the results. Copyright © 2016 the American Physiological Society.

Arm posture-dependent changes in corticospinal excitability are largely spinal in origin

PubMed Central

Nuzzo, James L.; Trajano, Gabriel S.; Barry, Benjamin K.; Gandevia, Simon C.

2016-01-01

Biceps brachii motor evoked potentials (MEPs) from cortical stimulation are influenced by arm posture. We used subcortical stimulation of corticospinal axons to determine whether this postural effect is spinal in origin. While seated at rest, 12 subjects assumed several static arm postures, which varied in upper-arm (shoulder flexed, shoulder abducted, arm hanging to side) and forearm orientation (pronated, neutral, supinated). Transcranial magnetic stimulation over the contralateral motor cortex elicited MEPs in resting biceps and triceps brachii, and electrical stimulation of corticospinal tract axons at the cervicomedullary junction elicited cervicomedullary motor evoked potentials (CMEPs). MEPs and CMEPs were normalized to the maximal compound muscle action potential (Mmax). Responses in biceps were influenced by upper-arm and forearm orientation. For upper-arm orientation, biceps CMEPs were 68% smaller (P = 0.001), and biceps MEPs 31% smaller (P = 0.012), with the arm hanging to the side compared with when the shoulder was flexed. For forearm orientation, both biceps CMEPs and MEPs were 34% smaller (both P < 0.046) in pronation compared with supination. Responses in triceps were influenced by upper-arm, but not forearm, orientation. Triceps CMEPs were 46% smaller (P = 0.007) with the arm hanging to the side compared with when the shoulder was flexed. Triceps MEPs and biceps and triceps MEP/CMEP ratios were unaffected by arm posture. The novel finding is that arm posture-dependent changes in corticospinal excitability in humans are largely spinal in origin. An interplay of multiple reflex inputs to motoneurons likely explains the results. PMID:26864764

Validity of the Acti4 software using ActiGraph GT3X+accelerometer for recording of arm and upper body inclination in simulated work tasks.

PubMed

Korshøj, Mette; Skotte, Jørgen H; Christiansen, Caroline S; Mortensen, Pelle; Kristiansen, Jesper; Hanisch, Christiana; Ingebrigtsen, Jørgen; Holtermann, Andreas

2014-01-01

The validity of inclinometer measurements by ActiGraph GT3X+ (AG) accelerometer, when analysed with the Acti4 customised software, was examined by comparison of inclinometer measurements with a reference system (TrakStar) in a protocol with standardised arm movements and simulated working tasks. The sensors were placed at the upper arm (distal to the deltoid insertion) and at the spine (level of T1-T2) on eight participants. Root mean square errors (RMSEs) values of inclination between the two systems were low for the slow- and medium-speed standardised arm movements and in simulated working tasks. Fast arm movements caused the inclination estimated by the AG to deviate from the reference measurements (RMSE values up to ∼10°). Furthermore, it was found that AG positioned at the upper arm provided inclination data without bias compared to the reference system. These findings indicate that the AG provides valid estimates of arm and upper body inclination in working participants. Being inexpensive, small, water-resistant and without wires, ActiGraph GT3X+ seems to be a valid mean for direct long-term field measurements of arm and trunk inclinations when analysed by the Acti4 customised software.

Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy.

PubMed

Santos, Ana Célia Oliveira dos; Almeida, Ana Maria Rampeloti

2013-01-01

Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional deficits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4) cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and relate the findings to the albumin level, hemoglobin level and CD4 cell count. Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of significance was set to 0.05 (α = 5%). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 17.0 software for Windows. Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the definition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were significantly lower among patients with a body mass index of less than 18.5kg/m2. The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. These findings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

Effectiveness of a multimodal standard nursing program on health-related quality of life in Chinese mainland female patients with breast cancer: protocol for a single-blind cluster randomized controlled trial.

PubMed

Zhou, Kaina; Wang, Duolao; He, Xiaole; Huo, Lanting; An, Jinghua; Li, Minjie; Wang, Wen; Li, Xiaomei

2016-08-31

Breast cancer and its treatment-related adverse effects are harmful to physical, psychological, and social functioning, leading to health-related quality of life (HRQoL) impairment in patients. Many programs have been used with this population for HRQoL improvement; however, few studies have considered the physical, psychological, and social health domains comprehensively, and few have constructed multimodal standard nursing interventions based on specific theories. The purpose of this trial is to examine the effect of a health belief model (HBM)-based multimodal standard nursing program (MSNP) on HRQoL in female patients with breast cancer. This is a two-arm single-blind cluster randomized controlled trial (cRCT) in clinical settings. Twelve tertiary hospitals will be randomly selected from the 24 tertiary hospitals in Xi'an, China, and allocated to the intervention arm and control arm using a computer-generated random numbers table. Inpatient female patients with breast cancer from each hospital will receive either MSNP plus routine nursing care immediately after recruitment (intervention arm), or only routine nursing care (control arm). The intervention will be conducted by trained nurses for 12 months. All recruited female patients with breast cancer, participating clinical staff, and trained data collectors from the 12 hospitals will be blind with respect to group allocation. Patients of the control arm will not be offered any information about the MSNP during the study period to prevent bias. The primary outcome is HRQoL measured through the Functional Assessment of Cancer Therapy-Breast version 4.0 at 12 months. Secondary outcomes include pain, fatigue, sleep, breast cancer-related lymphedema, and upper limb function, which are evaluated by a visual analogue scale, the circumference method, and the Constant-Murley Score. This trial will provide important evidence on the effectiveness of multimodal nursing interventions delivered by nurses in clinical settings. Study findings will inform strategies for scaling up comprehensive standard intervention programs on health management in the population of female patients with breast cancer. Chictr.org.cn ChiCTR-IOR-16008253 (April 9, 2016).

Quantitative estimation of muscle shear elastic modulus of the upper trapezius with supersonic shear imaging during arm positioning.

PubMed

Leong, Hio-Teng; Ng, Gabriel Yin-Fat; Leung, Vivian Yee-Fong; Fu, Siu Ngor

2013-01-01

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87-0.97) and inter-observer (ICC = 0.78-0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders.

Quantitative Estimation of Muscle Shear Elastic Modulus of the Upper Trapezius with Supersonic Shear Imaging during Arm Positioning

PubMed Central

Leong, Hio-Teng; Ng, Gabriel Yin-fat; Leung, Vivian Yee-fong; Fu, Siu Ngor

2013-01-01

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87–0.97) and inter-observer (ICC = 0.78–0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders. PMID:23825641

A Randomized Controlled Trial Offering Higher- Compared with Lower-Dairy Second Meals Daily in Preschools in Guinea-Bissau Demonstrates an Attendance-Dependent Increase in Weight Gain for Both Meal Types and an Increase in Mid-Upper Arm Circumference for the Higher-Dairy Meal.

PubMed

Batra, Payal; Schlossman, Nina; Balan, Ionela; Pruzensky, William; Balan, Adrian; Brown, Carrie; Gamache, Madeleine G; Schleicher, Molly M; de Sa, Augusto Braima; Saltzman, Edward; Wood, Lauren; Roberts, Susan B

2016-01-01

Controversy remains over the most effective approaches to prevent childhood malnutrition. We tested the feasibility and effectiveness of delivering ready-to-use supplementary foods (RUSFs) as a second daily meal in preschool children aged 3-5 y in Guinea-Bissau, and compared RUSFs with different levels of dairy protein. This study was a 3 mo cluster-randomized controlled pilot trial of 2 RUSFs differing in dairy protein in 533 boys and girls from 9 preschools. Children receiving RUSFs were compared with wait-listed controls, and all students received a daily school lunch. The RUSFs were delivered 5 d/wk for 3 mo and contained 478 kcal and 11.5 g protein per 92-g daily serving. Deliveries included a ready-to-use supplementary food with 15% of protein from dairy sources (RUSF-15%) or one with 33% of protein from dairy sources (RUSF-33%). Intention-to-treat (ITT) and per-protocol analyses (>50 d of RUSF consumption) were conducted. Changes in the weight-for-age z score (WAZ) and height-for-age z score were primary outcomes. Additional outcomes included changes in mid-upper arm circumference (MUAC), hemoglobin, and retinol binding protein. Baseline anthropometry was not different between groups (WAZ, -0.48 ± 1.04) and increased significantly over time (P < 0.01) with no effects of the RUSFs in ITT analyses. However, children consuming RUSFs for >50 d had a significantly greater increase in WAZ relative to the increase in controls (+0.40 and +0.32 for RUSF-15% and RUSF-33%, respectively, compared with +0.24 in controls, P < 0.01 and P < 0.05, respectively). RUSF-33%, but not RUSF-15%, also eliminated a decrease in MUAC observed in controls (-0.01 cm in RUSF-33% compared with -0.34 cm in controls, P < 0.05). The only difference between RUSF-15% and RUSF-33% was a mean decrease in hemoglobin in children receiving RUSF-15% (-0.5 compared with -0.002 g/dL, P = 0.05). Implementation of 2-meal preschool feeding programs is feasible in low-income countries, and there are measurable benefits relative to 1-meal programs in children attending preschool regularly. In addition, MUAC and hemoglobin measurements indicate that meals with 33% compared with 15% of protein from dairy may help prevent wasting and anemia. © 2016 American Society for Nutrition.

Inconsistent diagnosis of acute malnutrition by weight-for-height and mid-upper arm circumference: contributors in 16 cross-sectional surveys from South Sudan, the Philippines, Chad, and Bangladesh.

PubMed

Roberfroid, Dominique; Huybregts, Lieven; Lachat, Carl; Vrijens, France; Kolsteren, Patrick; Guesdon, Benjamin

2015-08-25

The two anthropometric indicators of acute malnutrition in children under 5 years, i.e. a Mid-Upper Arm Circumference < 125 mm (MUAC125) or a Weight-for-Height Z-score<-2 (WHZ-2), correlate poorly. We aimed at assessing the contribution of age, sex, stunting (Height-for-Age HAZ<-2), and low sitting-standing height ratio Z-score (SSRZ in the 1st tertile of the study population, called hereafter 'longer legs') to this diagnosis discrepancy. Data from 16 cross-sectional nutritional surveys carried out by Action Against Hunger International in South Sudan, the Philippines, Chad, and Bangladesh fed multilevel, multivariate regression models, with either WHZ-2 or MUAC125 as the dependent variable and age, sex, stunting, and 'longer legs' as the independent ones. We also compared how the performance of MUAC125 and WHZ-2 to detect slim children, i.e. children with a low Weight-for-Age (WAZ<-2) but no linear growth retardation (HAZ≥-2), was modified by the contributors. Overall 23.1% of the 14,409 children were identified as acutely malnourished by either WHZ-2 or MUAC125, but only 28.5% of those (949/3,328) were identified by both indicators. Being stunted (+17.8%; 95 % CI: 14.8%; 22.8%), being a female (+16.5%; 95 % CI: 13.5%; 19.5%) and being younger than 24 months (+33.6%; 95 % CI: 30.4%; 36.7%) were factors strongly associated with being detected as malnourished by MUAC125 and not by WHZ-2, whereas having 'longer legs' moderately increased the diagnosis by WHZ-2 (+4.2%; 95 % CI: 0.7%; 7.6%). The sensitivity to detect slim children by MUAC125 was 31.0% (95 % CI: 26.8%; 35.2%) whereas it was 70.6% (95 % CI: 65.4%; 75.9%) for WHZ-2. The sensitivity of MUAC125 was particularly affected by age (57.4% vs. 18.1% in children aged < 24 months vs. ≥ 24 months). Specificity was high for both indicators. MUAC125 should not be used as a stand-alone criterion of acute malnutrition given its strong association with age, sex and stunting, and its low sensitivity to detect slim children. Having 'longer legs' moderately increases the diagnosis of acute malnutrition by WHZ-2. Prospective studies are urgently needed to elucidate the clinical and physiological outcomes of the various anthropometric indicators of malnutrition.

The arm posture in children with unilateral Cerebral Palsy is mainly related to antero-posterior gait instability.

PubMed

Meyns, Pieter; Duysens, Jacques; Desloovere, Kaat

2016-09-01

In this observational case-control study we aimed to determine whether altered arm postures in children with unilateral CP (uniCP) are related to gait instability in a specific direction. Antero-posterior and medio-lateral Foot Placement Estimator instability measures and arm posture measures (vertical and antero-posterior hand position, sagittal and frontal upper arm elevation angle) were determined in eleven uniCP (7 years-10 months) and twenty-four typically developing children (9 years-6 months) at two walking speeds. Spearman-rank correlation analyses were made to examine the relationship between antero-posterior and medio-lateral arm posture and gait instability. Arm posture in both planes was related to antero-posterior instability (e.g. sagittal and frontal upper arm elevation angle correlated moderately with antero-posterior instability; R=0.41, p<0.001, R=-0.47, p<0.001). In uniCP, increased antero-posterior instability was associated with a higher (R=-0.62, p=0.002) and more frontal position of the hemiplegic hand (R=-0.58, p=0.005), while the non-hemiplegic upper arm was rotated more backward (R=0.63, p=0.002) and both upper arms rotated more sideways (hemiplegic: R=-0.58, p=0.004; non-hemiplegic: R=-0.55, p=0.008). The altered non-hemiplegic (sagittal and frontal) arm posture in uniCP may be a compensation to reduce antero-posterior gait instability. Copyright © 2016 Elsevier B.V. All rights reserved.

Can validated wrist devices with position sensors replace arm devices for self-home blood pressure monitoring? A randomized crossover trial using ambulatory monitoring as reference.

PubMed

Stergiou, George S; Christodoulakis, George R; Nasothimiou, Efthimia G; Giovas, Periklis P; Kalogeropoulos, Petros G

2008-07-01

Electronic devices that measure blood pressure (BP) at the arm level are regarded as more accurate than wrist devices and are preferred for home BP (HBP) monitoring. Recently, wrist devices with position sensors have been successfully validated using established protocols. This study assessed whether HBP values measured with validated wrist devices are sufficiently reliable to be used for making patient-related decisions in clinical practice. This randomized crossover study compared HBP measurements taken using validated wrist devices (wrist-HBP, Omron R7 with position sensor) with those taken using arm devices (arm-HBP, Omron 705IT), and also with measurements of awake ambulatory BP (ABP, SpaceLabs), in 79 subjects (36 men and 43 women) with hypertension. The mean age of the study population was 56.7 +/- 11.8 years, and 33 of the subjects were not under treatment for hypertension. The average arm-HBP was higher than the average wrist-HBP (mean difference, systolic 5.2 +/- 9.1 mm Hg, P < 0.001, and diastolic 2.2 +/- 6.7, P < 0.01). Twenty-seven subjects (34%) had a > or =10 mm Hg difference between systolic wrist-HBP and arm-HBP and twelve subjects (15%) showed similar levels of disparity in diastolic HBP readings. Strong correlations were found between arm-HBP and wrist-HBP (r 0.74/0.74, systolic/diastolic, P < 0.0001). However, ABP was more strongly correlated with arm-HBP (r 0.73/0.76) than with wrist-HBP (0.55/0.69). The wrist-arm HBP difference was associated with systolic ABP (r 0.34) and pulse pressure (r 0.29), but not with diastolic ABP, sex, age, arm circumference, and wrist circumference. There might be important differences in HBP measured using validated wrist devices with position sensor vs. arm devices, and these could impact decisions relating to the patient in clinical practice. Measurements taken using arm devices are more closely related to ABP values than those recorded by wrist devices. More research is needed before recommending the widespread use of wrist monitors in clinical practice. American Journal of Hypertension doi:10.1038/ajh.2008.176American Journal of Hypertension (2008); 21, 7, 753-758. doi:10.1038/ajh.2008.176.

New values anthropometry for classification of nutritional status in the elderly.

PubMed

Silva Rodrigues, R A; Martinez Espinosa, M; Duarte Melo, C; Rodrigues Perracini, M; Rezende Fett, W C; Fett, C A

2014-07-01

Anthropometry provides information on the physical status of the individual and can be associated with aspects of health including nutritional status. Currently, the stratification of the arm and calf circumferences is classified into only two situations: "malnourished" and "well-nourished". A total of 513 interviews were conducted, and 391 elderly people (≥ 65 years) completed the assessment using the Mini Nutritional Assessment (MNA) and anthropometry of selected samples of the population of Cuiabá-MT. The body mass index (BMI, kg/m2) was calculated for the elderly people, establishing five new reference values for circumferences, arm relaxed (RAC), abdomen (AC), and calf (CC) in centimeters (cm). The median age was 71 years (64% women and 36% men) and was correlated to the RAC (r=-0.180, p<0.001) and CC (r=-0.202, pp<0.001). The BMI obtained the median of 27 (15% malnourished, risk of malnutrition 13%, eutrophic 24%; overweight 33%, obese 16%), and it was correlated to the RAC (r=0.798, pp<0.001), AC (r=0.823 p p<0.001) and CC (r=0.605, pp<0.001). The MNA was 26 (malnourished 13.8%, risk of malnutrition 12.3%, well-nourished, 73.9%). The BMI stratification by morbidity vs no morbidity was 27.50 (n=287) and 24.4 (n=104) to total sample respectively (pp<0,05). The RAC x AC (r=0.798, pp<0.001), RAC x CC (r=0.648, pp<0.001), and CC x AC (r=0.496, pp<0.001) were correlated between themselves. The eutrophic classification by circumference for both genders: RAC=27.1-29.00 cm, AC=88.1-95.00 cm, CC=32.60-33.00 cm. There are more overweight and obese than malnourished, which is a risk factor for morbidity and MNA only identifies malnutrition. Circumferences showed good association with BMI and are easy to apply. Therefore, the proposal of the circumferences can simplify and expand the nutritional assessment.

Temporal arteritis

MedlinePlus

... the blood vessels that supply blood to the head, neck, upper body and arms. It is also called ... the blood vessels that supply blood to the head, neck, upper body, and arms. It most commonly occurs ...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

Physical performance and its association with anthropometric and body composition variables in the elderly.

PubMed

Silva, Nathalie de Almeida; Pedraza, Dixis Figueroa; de Menezes, Tarciana Nobre

2015-12-01

The aging process leads to biological changes that affect the physical performance and nutritional status of older adults. The objective this study is to determine the association between physical performance and anthropometric and body composition variables in the elderly. This is a cross-sectional study. Were assessed: sex, age, handgrip strength (HGS), flexibility/mobility, balance, body mass index, waist and calf circumference, triceps skinfold thickness, arm fat area and arm muscle circumference. Multiple logistic regression was used (p<0.05). Overall, 420 elderly were evaluated. Malnourished individuals were more likely to show poor HGS. Elderly aged 70-79 years, 80 years or older and those malnourished were more likely to show poor balance. Older women were less likely to show poor flexibility/mobility. We conclude that lowercalf circumferencewas associatedwithworse performance inHGSand balance.The ageincreased the chanceof the elderlypresentinstability.The flexibility/mobilitydoesn't seem tobe influenced bychanges in body composition. Therefore, these resultsmay beimportantguidingspecific actionsto ensurehealthy aging.

Caucasian children's fat mass: routine anthropometry v. air-displacement plethysmography.

PubMed

Michels, Nathalie; Huybrechts, Inge; Bammann, Karin; Lissner, Lauren; Moreno, Luis; Peeters, Maarten; Sioen, Isabelle; Vanaelst, Barbara; Vyncke, Krishna; De Henauw, Stefaan

2013-04-28

The present paper will use fat mass percentage (FM%) obtained via BOD POD® air-displacement plethysmography (FMADP%) to examine the relative validity of (1) anthropometric measurements/indices and (2) of FM% assessed with equations (FMeq%) based on skinfold thickness and bioelectrical impedance (BIA). In 480 Belgian children (aged 5-11 years) weight, height, skinfold thickness (triceps and subscapular), body circumferences (mid-upper arm, waist and hip), foot-to-foot BIA (Tanita®) and FMADP% were measured. Anthropometric measurements and calculated indices were compared with FMADP%. Next, published equations were used to calculate FMeq% using impedance (equations of Tanita®, Tyrrell, Shaefer and Deurenberg) or skinfold thickness (equations of Slaughter, Goran, Dezenberg and Deurenberg). Both indices and equations performed better in girls than in boys. For both sexes, the sum of skinfold thicknesses resulted in the highest correlation with FMADP%, followed by triceps skinfold, arm fat area and subscapular skinfold. In general, comparing FMeq% with FMADP% indicated mostly an age and sex effect, and an increasing underestimation but less dispersion with increasing FM%. The Tanita® impedance equation and the Deurenberg skinfold equation performed the best, although none of the used equations were interchangeable with FMADP%. In conclusion, the sum of triceps and subscapular skinfold thickness is recommended as marker of FM% in the absence of specialised technologies. Nevertheless, the higher workload, cost and survey management of an immobile device like the BOD POD® remains justified.

Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children.

PubMed

Nerenberg, Kara A; Zarnke, Kelly B; Leung, Alexander A; Dasgupta, Kaberi; Butalia, Sonia; McBrien, Kerry; Harris, Kevin C; Nakhla, Meranda; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Padwal, Raj S; Tran, Karen C; Grover, Steven; Rabkin, Simon W; Moe, Gordon W; Howlett, Jonathan G; Lindsay, Patrice; Hill, Michael D; Sharma, Mike; Field, Thalia; Wein, Theodore H; Shoamanesh, Ashkan; Dresser, George K; Hamet, Pavel; Herman, Robert J; Burgess, Ellen; Gryn, Steven E; Grégoire, Jean C; Lewanczuk, Richard; Poirier, Luc; Campbell, Tavis S; Feldman, Ross D; Lavoie, Kim L; Tsuyuki, Ross T; Honos, George; Prebtani, Ally P H; Kline, Gregory; Schiffrin, Ernesto L; Don-Wauchope, Andrew; Tobe, Sheldon W; Gilbert, Richard E; Leiter, Lawrence A; Jones, Charlotte; Woo, Vincent; Hegele, Robert A; Selby, Peter; Pipe, Andrew; McFarlane, Philip A; Oh, Paul; Gupta, Milan; Bacon, Simon L; Kaczorowski, Janusz; Trudeau, Luc; Campbell, Norman R C; Hiremath, Swapnil; Roerecke, Michael; Arcand, Joanne; Ruzicka, Marcel; Prasad, G V Ramesh; Vallée, Michel; Edwards, Cedric; Sivapalan, Praveena; Penner, S Brian; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Dionne, Janis; Magee, Laura A; Logan, Alexander G; Côté, Anne-Marie; Rey, Evelyne; Firoz, Tabassum; Kuyper, Laura M; Gabor, Jonathan Y; Townsend, Raymond R; Rabi, Doreen M; Daskalopoulou, Stella S

2018-05-01

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included. Guidance is provided for the follow-up measurements of blood pressure, with the use of standardized methods and electronic (oscillometric) upper arm devices in individuals with hypertension, and either ambulatory blood pressure monitoring or home blood pressure monitoring in individuals with white coat effect. We specify that all individuals with hypertension should have an assessment of global cardiovascular risk to promote health behaviours that lower blood pressure. Finally, an angiotensin receptor-neprilysin inhibitor combination should be used in place of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in individuals with heart failure (with ejection fraction < 40%) who are symptomatic despite appropriate doses of guideline-directed heart failure therapies. The specific evidence and rationale underlying each of these guidelines are discussed. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Biometric study of the internal dimensions of subglottis and upper trachea in adult Indian population.

PubMed

Prasanna Kumar, S; Ravikumar, A

2014-01-01

The anatomy of the larynx and trachea is well described in literature, however the intraluminal dimensions and contour of the subglottis has not been well documented. Subglottis and trachea are dynamic structures and the internal dimensions and contours have been studied only on cadavers or by plain radiograph which has many technical and measurement errors. No data is available about the internal dimensions of the subglottic and trachea in Indian population. This is the first documented study to measure the dimensions of the trachea and subglottis in Indian population. The aim of this study is to measure the internal dimensions and contour of the subglottis and upper trachea of adult Indian population. We conducted cross-sectional, observational study in a university hospital in south India to measure the dimensions of the internal subglottic and upper tracheal lumen. CT scan with 3D reconstruction with multiplanar sections was used for precise measurements. Forty-eight subjects (30 male and 18 female) who had undergone CT scan of the neck and thorax for reasons other than airway compromise were included in the study. The internal coronal diameter (CD), sagittal diameter (SD), and circumference was measured at various levels from 5 to 70 mm below the level of glottis, in the subglottis and upper trachea. Measurements of the scan for each subject were done independently by a radiologist and ENT surgeon and average of the two were documented values of each subject. These measurements were then statistically analyzed using SSPS software. The mean CD of adult Indian male ranged from 13.18 to 17.68 mm. The average intraluminal circumference ranged from 48.82 mm at the subglottis 5 mm from the glottis to a maximum of 54.96 at 30 mm. The mean CD of adult Indian female ranged from 8.7 to 15.34 mm The average intraluminal circumference ranged from 36.5 at 5 mm and a maximum of 43.05 at 70 mm. The 95% CI for the coronal, sagittal and circumference of the subglottis and upper trachea for both genders have been calculated and discussed. We have observed that the average intraluminal dimensions of the subglottis and upper trachea in south Indian population is less than that reported in western literature and earlier studies.

Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases.

PubMed

Liu, Peng; Wang, Boshi; Yan, Xia; Cai, Jingjing; Wang, Yu

2016-12-01

To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases. This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People's Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms. After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT. Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment window in the laminar air flow rooms. After HSCT, it is recommended to combine MNA and SGA to fully evaluate the nutritional status, and thus provide timely and reasonable nutritional support.

The efficacy of SMART Arm training early after stroke for stroke survivors with severe upper limb disability: a protocol for a randomised controlled trial.

PubMed

Brauer, Sandra G; Hayward, Kathryn S; Carson, Richard G; Cresswell, Andrew G; Barker, Ruth N

2013-07-02

Recovery of upper limb function after stroke is poor. The acute to subacute phase after stroke is the optimal time window to promote the recovery of upper limb function. The dose and content of training provided conventionally during this phase is however, unlikely to be adequate to drive functional recovery, especially in the presence of severe motor disability. The current study concerns an approach to address this shortcoming, through evaluation of the SMART Arm, a non-robotic device that enables intensive and repetitive practice of reaching by stroke survivors with severe upper limb disability, with the aim of improving upper limb function. The outcomes of SMART Arm training with or without outcome-triggered electrical stimulation (OT-stim) to augment movement and usual therapy will be compared to usual therapy alone. A prospective, assessor-blinded parallel, three-group randomised controlled trial is being conducted. Seventy-five participants with a first-ever unilateral stroke less than 4 months previously, who present with severe arm disability (three or fewer out of a possible six points on the Motor Assessment Scale [MAS] Item 6), will be recruited from inpatient rehabilitation facilities. Participants will be randomly allocated to one of three dose-matched groups: SMART Arm training with OT-stim and usual therapy; SMART Arm training without OT-stim and usual therapy; or usual therapy alone. All participants will receive 20 hours of upper limb training over four weeks. Blinded assessors will conduct four assessments: pre intervention (0-weeks), post intervention (4-weeks), 26 weeks and 52 weeks follow-up. The primary outcome measure is MAS item 6. All analyses will be based on an intention-to-treat principle. By enabling intensive and repetitive practice of a functional upper limb task during inpatient rehabilitation, SMART Arm training with or without OT-stim in combination with usual therapy, has the potential to improve recovery of upper limb function in those with severe motor disability. The immediate and long-term effects of SMART Arm training on upper limb impairment, activity and participation will be explored, in addition to the benefit of training with or without OT-stim to augment movement when compared to usual therapy alone. ACTRN12608000457347.

3D Measurement of Forearm and Upper Arm during Throwing Motion using Body Mounted Sensor

NASA Astrophysics Data System (ADS)

Koda, Hideharu; Sagawa, Koichi; Kuroshima, Kouta; Tsukamoto, Toshiaki; Urita, Kazutaka; Ishibashi, Yasuyuki

The aim of this study is to propose the measurement method of three-dimensional (3D) movement of forearm and upper arm during pitching motion of baseball using inertial sensors without serious consideration of sensor installation. Although high accuracy measurement of sports motion is achieved by using optical motion capture system at present, it has some disadvantages such as the calibration of cameras and limitation of measurement place. Whereas the proposed method for 3D measurement of pitching motion using body mounted sensors provides trajectory and orientation of upper arm by the integration of acceleration and angular velocity measured on upper limb. The trajectory of forearm is derived so that the elbow joint axis of forearm corresponds to that of upper arm. Spatial relation between upper limb and sensor system is obtained by performing predetermined movements of upper limb and utilizing angular velocity and gravitational acceleration. The integration error is modified so that the estimated final position, velocity and posture of upper limb agree with the actual ones. The experimental results of the measurement of pitching motion show that trajectories of shoulder, elbow and wrist estimated by the proposed method are highly correlated to those from the motion capture system within the estimation error of about 10 [%].

Validation of a new formula for predicting body weight in a Mexican population with overweight and obesity.

PubMed

Quiroz-Olguín, Gabriela; Serralde-Zúñiga, Aurora Elizabeth; Saldaña-Morales, Vianey; Guevara-Cruz, Martha

2013-01-01

Body weight measurement is of critical importance when evaluating the nutritional status of patients entering a hospital. In some situations, such as the case of patients who are bedridden or in wheelchairs, these measurements cannot be obtained using standardized methods. We have designed and validated a formula for predicting body weight. To design and validate a formula for predicting body weight using circumference-based equations. The following anthropometric measurements were taken for a sample of 76 patients: weight (kg), calf circumference, average arm circumference, waist circumference, hip circumference, wrist circumference and demispan. All circumferences were taken in centimetres (cm), and gender and age were taken into account. This equation was validated in 85 individuals from a different population. The correlation with the new equation was analyzed and compared to a previously validated method. The equation for weight prediction was the following: Weight = 0.524 (WC) - 0.176 (age) + 0.484 (HC) + 0.613 (DS) + 0.704 (CC) + 2.75 (WrC) - 3.330 (if female) - 140.87. The correlation coefficient was 0.96 for the total group of patients, 0.971 for men and 0.961 for women (p < 0.0001 for all measurements). The equation we developed is accurate and can be used to estimate body weight in overweight and/or obese patients with mobility problems, such as bedridden patients or patients in wheelchairs. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

[Changes in nutritional status of patients with different diseases during hospitalization].

PubMed

Cui, H Y; Zhu, M W; Wei, J M; Chen, W; Yang, X; Zhu, S N

2017-04-01

Objective: To evaluate changes in nutritional status of hospitalized patients with different diseases by subjective global assessment (SGA) and nutritional risk screening (NRS-2002). Methods: A prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014. Hospitalized patients with the following diseases were investigated: malignant tumor (2 487 cases), benign disease of the digestive system (1 358 cases), benign disease of the nervous system (1 043 cases), benign bone disease (451 cases), benign disease of the respiratory system(395 cases), cardiovascular disease (227 cases), benign thyroid and breast disease (179 cases), and endocrine disease (149 cases). Patients above the age of 18 and hospitalization time between 7-30 days were included. Physical indexes were measured, the NRS-2002 and SGA scores were recorded, the nutritional support were recorded during hospitalization and 24 hours after discharge from hospital. Measurement data between groups were analyzed using t test or Wilcoxon rank sum test, enumeration data and ranked data between groups were analyzed using chi-square test or Fisher exact test. Results: There were 6 638 cases of hospitalized patients, 3 861 cases were males and 2 777 were females, the male/female ratio was 1.4∶1.0; the median age was 60 years; the median height was 1.66 m; the median weight was 62 kg; the median body mass index (BMI)was 22.89 kg/m(2). At discharge, compared with that of admission, the body weight, BMI, grip strength, upper arm and calf circumferences of patients with malignant tumor were significantly decreased ( t =20.15-259.67, all P <0.01); the body weight and calf circumference were significantly decreased ( t =35.27, 60.40, P <0.01)of patients with digestive benign disease; the body weight of patients with benign bone diseases was decreased ( t =2.12, P =0.033); the body weight, grip strength and upper arm circumference were decreased in patients with benign thyroid and breast disease ( t =2.79-10.18, all P <0.01); nutritional risk incidence rate (from NRS-2002) of patients with malignant tumor was significantly higher(χ(2)=21.275, P =0.000); moderate malnutrition (from SGA) incidence rate was significantly higher(χ(2)=62.318, P =0.000; χ(2)=11.312, P <0.01) in patients with malignant tumor and with orthopedics diseases. Compared with that of admission, records of the patients with other diseases had no statistically difference at discharge, no more than 50% of the patients under risk of nutritional deficiency(except those with digestive benign diseases )received nutritional support, while the proportion of non-parenteral nutrition application was higher. Conclusion: The patients with malignant tumor have higher incidence rate of malnutrition on admission and at discharge. Doctors should pay more attention to the nutritional status(screening and evaluation) of patients before discharge and use appropriate and adequate nutrition support in order to prevent the weight loss and improve the life quality of patients.

Validation of the A&D UM-201 device for office blood pressure measurement according to the European Society of Hypertension International Protocol Revision 2010.

PubMed

Fania, Claudio; Albertini, Federica; Palatini, Paolo

2017-08-01

The aim of this study was to determine the accuracy of the A&D UM-201 device coupled to several cuffs for different arm sizes for office blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension. Evaluation was carried out in 33 individuals. The mean age of the individuals was 59.3±13.2 years, systolic BP was 145.4±20.6 mmHg (range: 109-186 mmHg), diastolic BP was 87.3±18.0 mmHg (range: 50-124 mmHg), and arm circumference was 30.4±4.2 cm (range: 23-39 cm). The protocol requirements were followed precisely. The UM-201 monitor passed all requirements, fulfilling the standards of the protocol. On average, the device overestimated systolic BP by 3.0±2.1 mmHg and diastolic BP by 2.6±2.0 mmHg. These data show that the A&D UM-201 device coupled to several cuffs for different ranges of arm circumference fulfilled the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

Neck circumference correlates with tumor size and lateral lymph node metastasis in men with small papillary thyroid carcinoma.

PubMed

Kim, Mi Ra; Kim, Sang Soo; Huh, Jung Eun; Lee, Byung Joo; Lee, Jin Choon; Jeon, Yun Kyung; Kim, Bo Hyun; Kim, Seong Jang; Wang, Soo Geun; Kim, Yong Ki; Kim, In Joo

2013-01-01

Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution. In total, 401 patients with papillary thyroid carcinoma (PTC) measuring ≤ 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images. Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex. Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.

Color Doppler Sonographic and Cadaveric Study of the Arterial Vascularity of the Lateral Upper Arm Flap.

PubMed

Sun, Ruimei; Ding, Yu; Sun, Chuanzheng; Li, Xiaojiang; Wang, Jinde; Li, Lei; Yang, Jie; Ren, Yanxin; Zhong, Zhaoming

2016-04-01

To determine the importance of adequate preoperative assessment with color Doppler sonography to assist in the successful transfer of lateral upper arm flaps by studying the lateral upper arm flap with color Doppler sonography and analyzing the anatomic features of the radial collateral artery. A clinical case-control study was performed. The radial collateral artery was studied with color Doppler sonography in 15 healthy volunteers. The origins, courses, variations, and locations of the perforators of the radial collateral artery were recorded. The results and data from the color Doppler sonographic investigation were compared with an anatomic study that was performed on 22 adult cadaveric upper limb specimens. The volunteer group (14 of 15 volunteers) and the cadaveric group (19 of 22 upper arm specimens) clearly showed that the branch pattern of the arterial supply was as follows: brachial artery → deep brachial artery → radial collateral artery → posterior radial collateral artery → myocutaneous perforator. Variations in the origin of the radial collateral artery were identified in 1 volunteer bilaterally and in 3 upper arm specimens. The diameters of the artery and vein measured at the distal insertion of the deltoid and the origin of the deep brachial artery were not significantly different between the volunteer and cadaver groups (P > .05). Due to the difference in measuring methods, the length of the vascular pedicles was significantly different between the groups (P < .05). Color Doppler sonography can facilitate the preoperative assessment of the origin, course, variations, and locations of the radial collateral artery and therefore may increase the success rate of lateral upper arm flap transfer. © 2016 by the American Institute of Ultrasound in Medicine.

19. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD AND ENDPOST CONNECTION U-19, LOOKING SOUTHWEST - Jackson's Ferry Bridge, Route 52 over New River, 6.3 miles south of Route 94, Austinville, Wythe County, VA

Optimal Body Size and Limb Length Ratios Associated with 100-m Personal-Best Swim Speeds.

PubMed

Nevill, Alan M; Oxford, Samuel W; Duncan, Michael J

2015-08-01

This study aims to identify optimal body size and limb segment length ratios associated with 100-m personal-best (PB) swim speeds in children and adolescents. Fifty national-standard youth swimmers (21 males and 29 females age 11-16 yr; mean ± SD age, 13.5 ± 1.5 yr) participated in the study. Anthropometry comprised stature; body mass; skinfolds; maturity offset; upper arm, lower arm, and hand lengths; and upper leg, lower leg, and foot lengths. Swimming performance was taken as the PB time recorded in competition for the 100-m freestyle swim. To identify the optimal body size and body composition components associated with 100-m PB swim speeds (having controlled for age and maturity offset), we adopted a multiplicative allometric log-linear regression model, which was refined using backward elimination. Lean body mass was the singularly most important whole-body characteristic. Stature and body mass did not contribute to the model, suggesting that the advantage of longer levers was limb-specific rather than a general whole-body advantage. The allometric model also identified that having greater limb segment length ratios [i.e., arm ratio = (low arm)/(upper arm); foot-to-leg ratio = (foot)/(lower leg)] was key to PB swim speeds. It is only by adopting multiplicative allometric models that the above mentioned ratios could have been derived. The advantage of having a greater lower arm is clear; however, having a shorter upper arm (achieved by adopting a closer elbow angle technique or by possessing a naturally endowed shorter upper arm), at the same time, is a new insight into swimming performance. A greater foot-to-lower-leg ratio suggests that a combination of larger feet and shorter lower leg length may also benefit PB swim speeds.

20. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD, POST, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD, POST, AND DIAGONAL CONNECTION U-17, LOOKING NORTHWEST - Jackson's Ferry Bridge, Route 52 over New River, 6.3 miles south of Route 94, Austinville, Wythe County, VA

Three-dimensional circumferential liposuction of the overweight or obese upper arm.

PubMed

Hong, Yoon Gi; Sim, Hyung Bo; Lee, Mu Young; Seo, Sang Won; Chang, Choong Hyun; Yeo, Kwan Koo; Kim, June-kyu

2012-06-01

Due to recent trends in liposuction, anatomic consideration of the body's fatty layers is essential. Based on this knowledge, a circumferential approach to achieving maximal aesthetic results is highlighted. In the upper arm, aspiration of fat from only the posterolateral region can result in skin flaccidity and disharmony of the overall balance of the upper arm contour. Different suction techniques were applied depending on the degree of fat accumulation. If necessary, the operation area was extended around the axillary and scapular regions to overcome the limitations of the traditional method and to achieve optimal effects. To maximize skin contracture and redraping, the authors developed three-dimensional circumferential liposuction (3D-CL) based on two concepts: circumferential aspiration of the upper arm, to which was applied different fluid infiltration and liposuction techniques in three anatomic compartments (anteromedial, anterolateral, and posterolateral), and extension of liposuction to the periaxillar and parascarpular areas. A total of 57 female patients underwent liposuction of their excess arm fat using this technique. The authors achieved their aesthetic goals of a straightened inferior brachial border and a more slender body contour. Complications occurred for five patients including irregularity, incision-site scar, and transient pigmentation. Through 3D-CL, the limitations of traditional upper arm liposuction were overcome, and a slender arm contour with a straightened inferior brachial border was produced. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http://www.springer.com/00266.

An iPhone application for upper arm posture and movement measurements.

PubMed

Yang, Liyun; Grooten, Wilhelmus J A; Forsman, Mikael

2017-11-01

There is a need for objective methods for upper arm elevation measurements for accurate and convenient risk assessments. The aims of this study were (i) to compare a newly developed iOS application (iOS) for measuring upper arm elevation and angular velocity with a reference optical tracking system (OTS), and (ii) to compare the accuracy of the iOS incorporating a gyroscope and an accelerometer with using only an accelerometer, which is standard for inclinometry. The iOS-OTS limits of agreement for static postures (9 subjects) were -4.6° and 4.8°. All root mean square differences in arm swings and two simulated work tasks were <6.0°, and all mean correlation coefficients were >0.98. The mean absolute iOS-OTS difference of median angular velocity was <13.1°/s, which was significantly lower than only using an accelerometer (<43.5°/s). The accuracy of this iOS application compares well to that of today's research methods and it can be useful for practical upper arm measurements. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

VO2 Max in Variable Type Exercise Among Well-Trained Upper Body Athletes.

ERIC Educational Resources Information Center

Seals, Douglas R.; Mullin, John P.

1982-01-01

The maximal oxygen consumption (VO2 max) of well-trained upper body athletes was compared to that of untrained individuals in four types of exercise: arm cranking, legs only cycling, graded treadmill running, and combined arm cranking and leg cycling. Results of the study showed that well-trained upper body athletes attained a significantly higher…

Anthropometric data as predictors of Obstructive Sleep Apnea Severity.

PubMed

Pinto, José Antonio; Godoy, Luciana Ballester de Mello; Marquis, Valéria Wanderley Pinto Brandão; Sonego, Thiago Branco; Leal, Carolina de Farias Aires; Artico, Marina Spadari

2011-01-01

The Obstructive Sleep Apnea Syndrome is a chronic disease characterized by episodes upper airway collapse, and has been associated with increased cardiovascular morbidity. To correlate the neck, abdominal and pelvic circumference with the AHI and oxyhemoglobin saturation in OSA patients, and to correlate these values with disease severity. A prospective descriptive study of 82 patients evaluated complaints suggesting OSA, from July 2008 to March 2010. All patients underwent polysomnography, an ENT clinical exam, measures of the BMI, abdominal, pelvic, and cervical circumferences. The mean, standard deviations and Spearman's correlations were analyzed. The mean AHI in men was 39 events/hr; in women it was 21 events/hr in women. The mean neck circumference was 34. 5 cm in women and 41. 3 cm in men, the mean abdominal circumference was 94. 3 cm in women and 101. 5 cm in men, and the pelvic circumference was 105. 7 cm in men and 108. 7 cm in women. The neck circumference correlated more closely to the AHI in men (r = + 0. 389 p = 0. 001). The relationship between the abdominal circumference correlated more with AHI than with the BMI in men (AbC r = + 0. 358 p = 0. 003 BMI r = + 0. 321 p = 0. 009). The neck circumference is the best anthropometric measurement of respiratory disorder severity compared to the AbC or the BMI.

Nutritional and oral health status of an elderly population in Nairobi.

PubMed

Ngatia, E M; Gathece, L W; Macigo, F G; Mulli, T K; Mutara, L N; Wagaiyu, E G

2008-08-01

To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. A cross-sectional study. Households in Dagoretti Division of Nairobi. Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. The level of malnutrition using the mid upper arm circumference was 18.8% while by body mass index was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, with more females (48.0%) than males (25.9%) being overweight. The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility and edentulousness was common. Under-nutrition, obesity and dental problems are issues of concern among the elderly. There is need to develop policies that will look into the nutrition and dental health of the elderly in order to improve their welfare.

Nutritional status and dietary habits of urban and rural Polish adolescents.

PubMed

Suliga, Edyta

2006-12-01

The aim of this work was to compare the basic food ingredient level and some nutritional status indices between the two groups of adolescents: the first one from the urban environment and the other one from the rural environment. A series of tests were conducted on a 400-teenager-group (200 girls and 200 boys), which was divided into two age groups: 10.5-year-olds and 13.5-year-olds. Nutritional status was estimated on the basis of the following anthropometric measurements: body height, body mass index, upper arm circumference, triceps skinfold thickness. Food intake was assessed by means of a 24-h dietary recall. The analysis of the results of the investigation showed: rare overweight and obesity occur in rural children aged 10.5 years and a higher risk of undernutrition among rural children, especially boys; more frequent overweight and obesity in rural girls and urban boys aged 13.5 years; a lower protein consumption, especially animal protein, and a lower percentage of the accomplishment of the norm for many mineral components and vitamins in rural girls and boys.

Monitoring nutritional status accurately and reliably in adolescents with anorexia nervosa.

PubMed

Martin, Andrew C; Pascoe, Elaine M; Forbes, David A

2009-01-01

Accurate assessment of nutritional status is a vital aspect of caring for individuals with anorexia nervosa (AN) and body mass index (BMI) is considered an appropriate and easy to use tool. Because of the intense fear of weight gain, some individuals may attempt to mislead the physician. Mid-upper arm circumference (MUAC) is a simple, objective method of assessing nutritional status. The setting is an eating disorders clinic in a tertiary paediatric hospital in Western Australia. The aim of this study is to evaluate how well MUAC correlates with BMI in adolescents with AN. Prospective observational study to evaluate nutritional status in adolescents with AN. Fifty-five adolescents aged 12-17 years with AN were assessed between January 1, 2004 and January 1, 2006. MUAC was highly correlated with BMI (r = 0.79, P < 0.001) and individuals with MUAC >or=20 cm rarely required hospitalisation (negative predictive value 93%). MUAC reflects nutritional status as defined by BMI in adolescents with AN. Lack of consistency between longitudinal measurements of BMI and MUAC should be viewed suspiciously and prompt a more detailed nutritional assessment.

1998 Anthropometric Survey of U.S. Army Personnel: Bivariate Frequency Tables

DTIC Science & Technology

1990-05-01

trapezius landmark at the base of the neck and the acromion landmark at the tip of the shoulder. 94 SITTING HEIGHT (SITTHGHT) - vertical distance...wall against which the posterior trunk is in contact and the tip of the thumb when the arm is extended anteriorly. 110 VERTICAL TRUNK CIRCUMFERENCE

Anthropometry of elderly residents in the city of São Paulo, Brazil.

PubMed

Barbosa, Aline R; Souza, José M P; Lebrão, Maria L; Laurenti, Ruy; Marucci, Maria de Fátima N

2005-01-01

The article presents gender and age-specific selected anthropometric data for a representative sample of elderly Brazilians in the city of São Paulo. This was a cross-sectional, population-based household survey. A total of 1,894 older adults (men and women, > 60 years) were examined from January to March 2001. Data were presented as means and percentiles for body mass (BM); height or stature (ST); body mass index (BMI); waist (WC), hip (HC), arm (AC), and calf (CC) circumferences; triceps skinfold thickness (TST); and arm muscle circumference (AMC), and differences were described according to age (all variables) and gender (BMI). Except for HC (men), all anthropometric variables were lower in the oldest than in the youngest individuals (p < 0.01) in both genders. BMI was significantly higher (p < 0.01) in women than men (all age groups). The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (both genders). The data can be used in clinical practice and epidemiological studies based on interpretation of anthropometric measurements in the elderly in São Paulo.

Mid arm circumference (MAC) and body mass index (BMI)--the two important auxologic parameters in neonates.

PubMed

Nair, R Bindu; Elizabeth, K E; Geetha, S; Varghese, Sarath

2006-10-01

Even though birth weight is the most sensitive predictor of health and outcome, accurate weighing and proper recording are not done in most developing countries. Most neonates lose 10% of body weight soon after birth and when such babies subsequently come for medical care, it becomes difficult to know whether the baby was low birth weight (LBW) at birth or not, to predict the outcome. Among the many surrogate auxologic parameters to identify LBW babies, mid arm circumference (MAC) was found to be the most useful and simplest. At a cut off of 9 cm, with a sensitivity of 92% and a specificity of 90.5% to identify LBW, MAC is recommended as an alternative measurement. Ponderal index is measured in neonatal period to identify growth retardation. Body mass index (BMI) is a very useful index in children and adults to identify obesity/chronic energy deficiency (CED). Tracking of BMI from neonatal period to adulthood is recommended to plan intervention and predict outcome. The mean BMI observed in the present study was 12.86 kg/m2 close to the expected of 13.

Influence of basal ganglia on upper limb locomotor synergies. Evidence from deep brain stimulation and L-DOPA treatment in Parkinson's disease.

PubMed

Crenna, P; Carpinella, I; Lopiano, L; Marzegan, A; Rabuffetti, M; Rizzone, M; Lanotte, M; Ferrarin, M

2008-12-01

Clinical evidence of impaired arm swing while walking in patients with Parkinson's disease suggests that basal ganglia and related systems play an important part in the control of upper limb locomotor automatism. To gain more information on this supraspinal influence, we measured arm and thigh kinematics during walking in 10 Parkinson's disease patients, under four conditions: (i) baseline (no treatment), (ii) therapeutic stimulation of the subthalamic nucleus (STN), (iii)L-DOPA medication and (iv) combined STN stimulation and L-DOPA. Ten age-matched controls provided reference data. Under baseline conditions the range of patients' arm motion was severely restricted, with no correlation with the excursion of the thigh. In addition, the arm swing was abnormally coupled in time with oscillation of the ipsilateral thigh. STN stimulation significantly increased the gait speed and improved the spatio-temporal parameters of arm and thigh motion. The kinematic changes as a function of gait speed changes, however, were significantly smaller for the upper than the lower limb, in contrast to healthy controls. Arm motion was also less responsive after L-DOPA. Simultaneous deep brain stimulation and L-DOPA had additive effects on thigh motion, but not on arm motion and arm-thigh coupling. The evidence that locomotor automatisms of the upper and lower limbs display uncorrelated impairment upon dysfunction of the basal ganglia, as well as different susceptibility to electrophysiological and pharmacological interventions, points to the presence of heterogeneously distributed, possibly partially independent, supraspinal control channels, whereby STN and dopaminergic systems have relatively weaker influence on the executive structures involved in the arm swing and preferential action on those for lower limb movements. These findings might be considered in the light of phylogenetic changes in supraspinal control of limb motion related to primate bipedalism.

Activity of upper limb muscles during human walking.

PubMed

Kuhtz-Buschbeck, Johann P; Jing, Bo

2012-04-01

The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Prediction equations for fat percentage from body circumferences in prepubescent children].

PubMed

Gómez Campos, Rossana; De Marco, Ademir; de Arruda, Miguel; Martínez Salazar, Cristian; Margarita Salazar, Ciria; Valgas, Carmen; Fuentes, José Damián; Cossio-Bolaños, Marco Antonio

2013-01-01

The analysis of body composition through direct and indirect methods allows the study of the various components of the human body, becoming the central hub for assessing nutritional status. The objective of the study was to develop equations for predicting body fat% from circumferential body arm, waist and calf and propose percentiles to diagnose the nutritional status of school children of both sexes aged 4-10 years. We selected intentionally (non-probabilistic) 515 children, 261 children and 254 being girls belonging to Program interaction and development of children and adolescents from the State University of Campinas (Sao Paulo, Brazil). Anthropometric variables were evaluated for weight, height, triceps and subscapular skinfolds and body circumferences of arm, waist and calf, and the% fat determined by the equation proposed by Boileau, Lohman and Slaughter (1985). Through regression method 2 were generated equations to predict the percentage of fat from the body circumferences, the equations 1 and 2 were validated by cross validation method. The equations showed high predictive values ranging with a R² = 64-69%. In cross validation between the criterion and the regression equation proposed no significant difference (p > 0.05) and there was a high level of agreement to a 95% CI. It is concluded that the proposals are validated and shown as an alternative to assess the percentage of fat in school children of both sexes aged 4-10 years in the region of Campinas, SP (Brazil). Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Evaluation of nutritional indicators and body composition in patients with advanced liver disease enrolled for liver transplantation.

PubMed

Vulcano, Daniela Salate Biagioni; Carvalhaes, Maria Antonieta de Barros Leite; Bakonyi Neto, Alexandre

2013-10-01

Malnutrition is prevalent in patients with advanced liver disease (LD) related to multifactorial causes. Fluid retention can underestimate the nutritional status based on anthropometric measures. We evaluated nutritional indicators and body composition (BC) in patients with liver cirrhosis and correlated them with LD severity. Forty three patients with LD enrolled for liver transplantation were evaluated by Anthropometric measures, subjective evaluation (Global Assessment of Nutritional Status - SGA) and biochemical indicators. Single-frequency electrical bioimpedance (SFE-BIA) was used to evaluate body composition (BC). It measured resistance (R), reactance (Xc) and the phase angle (PA). LD severity was estimated by Child-Pugh and Meld criteria (Model for End-Stage Liver Disease). Child-Pugh index between patients was 7.11 ± 1.70 and Meld was 12.23 ± 4.22. Arm Circumference, Arm Muscle Circumference and Arm Muscle Area, SGA, hemoglobin, hematocrit and albumin showed better correlation with disease severity. Xc and PA showed correlation both with Meld and Child-Pugh score when BC were evaluated. PA was depleted in 55.8% of the patients. Diagnosis of malnutrition varied according to the method. Global assessment of nutritional status showed better correlation with disease severity than with objective methods. Single-frequency electrical bioimpedance for body composition analysis in cirrhotic patients must be cautiously used; however, primary vectors seems to be valid and promising in clinical practice.

A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery.

PubMed

Sebbag, Ilana; Massey, Simon R; Albert, Arianne Y K; Dube, Alison; Gunka, Vit; Douglas, M Joanne

2015-09-01

Shivering is common during cesarean delivery (CD) under neuraxial anesthesia and may disrupt the measurement of noninvasive blood pressure (BP). BP measured at the wrist may be less affected by shivering. There have been no studies comparing trends in BP measured on the upper arm and wrist. We hypothesized that wrist systolic blood pressure (sBP) would accurately trend with upper arm sBP measurements (agree within a limit of ±10%) in parturients undergoing elective CD under spinal anesthesia or combined spinal-epidural anesthesia. After initiation of spinal anesthesia, BP measurements were obtained simultaneously from the upper arm and wrist on opposite arms. The interval between measurements was 1 to 2 minutes, and data were collected for 20 minutes or until delivery. The primary outcome was agreement in dynamic changes in sBP measurements between the upper arm and the wrist. Bland-Altman plots indicating the levels of agreement between the methods were drawn for baseline measurements, over multiple measurements, and over multiple measurements on percentage change from baseline. Forty-nine patients were recruited and completed the study. The wrist sBP tended to overestimate the upper sBP for both baseline data (sBP bias = 13.4 mm Hg; 95% confidence interval = +10.4 to +16.4 mm Hg) and data obtained over multiple measurements (sBP bias = 12.8 mm Hg; 95% confidence interval = +9.3 to +16.3 mm Hg). For change in sBP from baseline over multiple measurements, the mean difference between the wrist and the arm sBP was -0.2 percentage points (99% limits of agreement -25 to +25 percentage points). The wrist measurement overestimated the reading relative to the upper arm measurement for multiple measurements over time. However, when the time series for each subject was examined for percentage change from baseline, the 2 methods mirrored each other in most cases. Nevertheless, our hypothesis was rejected as the limits of agreement were higher than ±10%. This finding suggests that wrist BP may not be an accurate method of detecting hypotension or hypertension during spinal or combined spinal-epidural anesthesia for CD.

Comparison study of upper arm and forearm non-invasive blood pressures in adult Emergency Department patients.

PubMed

Schimanski, Karen; Jull, Andrew; Mitchell, Nancy; McLay, Jessica

2014-12-01

Forearm blood pressures have been suggested as an alternative site to measure blood pressures when the upper arm is unavailable. However there is little evidence utilising clinical populations to support this substitution. To determine agreement between blood pressures measured in the left upper arm and forearm using a singular oscillometric non-invasive device in adult Emergency Department patients. The secondary objective was to explore the relationship of blood pressure differences with age, sex, ethnicity, smoking history and obesity. Single centre comparison study. Adult Emergency Department, Tertiary Trauma Centre. Forty-four participants who met inclusion/exclusion criteria selected sequentially from the Emergency Department arrival board. A random assignment of order of measurement for left upper arm and forearm blood pressures was utilised. Participants were eligible if they were aged 18 years or older, had been assigned an Australasian Triage Scale code of 2, 3, 4, or 5, were able to consent, and able to have blood pressures measured on their left arm whilst lying at a 45° angle. The Bland-Altman method of statistical analysis was used, with the level of agreement for clinical acceptability for the systolic, diastolic and mean arterial pressure defined as ±10 mmHg. The forearm measure overestimated systolic (mean difference 2.2 mmHg, 95% limits of agreement ±19 mmHg), diastolic (mean difference 3.4 mmHg, 95% limits of agreement ±14.4 mmHg), and mean arterial pressures (mean difference 4.1 mmHg, 95% limits of agreement ±13.7 mmHg). The systolic measure was not significantly different from zero. Evidence of better agreement was found with upper arm/forearm systolic measures below 140 mmHg compared to systolic measures above 140 mmHg using the Levene's test (p=0.002, F-statistic=11.09). Blood pressure disparity was not associated with participant characteristics. Forearm measures cannot routinely replace upper arm measures for blood pressure measurement. If the clinical picture requires use of forearm blood pressure, the potential variance from an upper arm measure is ±19 mmHg for systolic pressure, although the variability may be close to ±10 mmHg if the systolic blood pressure is below 140 mmHg. Copyright © 2014 Elsevier Ltd. All rights reserved.

Midupper Arm Circumference Outperforms Weight-Based Measures of Nutritional Status in Children with Diarrhea12

PubMed Central

Modi, Payal; Nasrin, Sabiha; Hawes, Meagan; Glavis-Bloom, Justin; Alam, Nur H; Hossain, M Iqbal; Levine, Adam C

2015-01-01

Background: Undernutrition contributes to 45% of all deaths in children <5 y of age worldwide, with a large proportion of those deaths caused by diarrhea. However, no validated tools exist for assessing undernutrition in children with diarrhea and possible dehydration. Objective: This study assessed the validity of different measures of undernutrition in children with diarrhea. Methods: A prospective cohort study was conducted at an urban hospital in Bangladesh. Children <60 mo of age presenting to the hospital rehydration unit with acute diarrhea were eligible for enrollment. Study staff randomly selected 1196 children for screening, of which 1025 were eligible, 850 were enrolled, and 721 had complete data for analysis. Anthropometric measurements, including weight-for-age z score (WAZ), weight-for-length z score (WLZ), midupper arm circumference (MUAC), and midupper arm circumference z score (MUACZ), were calculated pre- and posthydration in all patients. Measurements were evaluated for their ability to correctly identify undernutrition in children with varying degrees of dehydration. Results: Of the 721 patients with full data for analysis, the median percent dehydration was 4%. Of the 4 measures evaluated, MUAC and MUACZ demonstrated 92–94% agreement pre- and posthydration compared with 69–76% for WAZ and WLZ. Although each 1% change in hydration status was found to change weight-for-age by 0.0895 z scores and weight-for-length by 0.1304 z scores, MUAC and MUACZ were not significantly affected by dehydration status. Weight-based measures misclassified 12% of children with severe underweight and 14% with severe acute malnutrition (SAM) compared with only 1–2% for MUAC and MUACZ. Conclusions: MUAC and MUACZ were the most accurate predictors of undernutrition in children with diarrhea. WAZ and WLZ were significantly affected by dehydration status, leading to the misdiagnosis of many patients on arrival with severe underweight and SAM. This trial was registered at clinicaltrials.gov as NCT02007733. PMID:25972523

Midupper Arm Circumference Outperforms Weight-Based Measures of Nutritional Status in Children with Diarrhea.

PubMed

Modi, Payal; Nasrin, Sabiha; Hawes, Meagan; Glavis-Bloom, Justin; Alam, Nur H; Hossain, M Iqbal; Levine, Adam C

2015-07-01

Undernutrition contributes to 45% of all deaths in children <5 y of age worldwide, with a large proportion of those deaths caused by diarrhea. However, no validated tools exist for assessing undernutrition in children with diarrhea and possible dehydration. This study assessed the validity of different measures of undernutrition in children with diarrhea. A prospective cohort study was conducted at an urban hospital in Bangladesh. Children <60 mo of age presenting to the hospital rehydration unit with acute diarrhea were eligible for enrollment. Study staff randomly selected 1196 children for screening, of which 1025 were eligible, 850 were enrolled, and 721 had complete data for analysis. Anthropometric measurements, including weight-for-age z score (WAZ), weight-for-length z score (WLZ), midupper arm circumference (MUAC), and midupper arm circumference z score (MUACZ), were calculated pre- and posthydration in all patients. Measurements were evaluated for their ability to correctly identify undernutrition in children with varying degrees of dehydration. Of the 721 patients with full data for analysis, the median percent dehydration was 4%. Of the 4 measures evaluated, MUAC and MUACZ demonstrated 92-94% agreement pre- and posthydration compared with 69-76% for WAZ and WLZ. Although each 1% change in hydration status was found to change weight-for-age by 0.0895 z scores and weight-for-length by 0.1304 z scores, MUAC and MUACZ were not significantly affected by dehydration status. Weight-based measures misclassified 12% of children with severe underweight and 14% with severe acute malnutrition (SAM) compared with only 1-2% for MUAC and MUACZ. MUAC and MUACZ were the most accurate predictors of undernutrition in children with diarrhea. WAZ and WLZ were significantly affected by dehydration status, leading to the misdiagnosis of many patients on arrival with severe underweight and SAM. This trial was registered at clinicaltrials.gov as NCT02007733. © 2015 American Society for Nutrition.

Persistent arm pain is distinct from persistent breast pain following breast cancer surgery.

PubMed

Langford, Dale J; Paul, Steven M; West, Claudia; Abrams, Gary; Elboim, Charles; Levine, Jon D; Hamolsky, Deborah; Luce, Judith A; Kober, Kord M; Neuhaus, John M; Cooper, Bruce A; Aouizerat, Bradley E; Miaskowski, Christine

2014-12-01

Persistent pain following breast cancer surgery is well documented. However, it is not well characterized in terms of the anatomic site affected (ie, breast, arm). In 2 separate growth mixture modeling analyses, we identified subgroups of women (N = 398) with distinct breast pain and arm pain trajectories. The fact that these latent classes differed by anatomic site, types of tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. The purposes of this companion study were to identify demographic and clinical characteristics that differed between the 2 arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection sites, pain qualities, pain interference, and hand and arm function, as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the moderate arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and axillary lymph node dissection site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility. For persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

PERSISTENT ARM PAIN IS DISTINCT FROM PERSISTENT BREAST PAIN FOLLOWING BREAST CANCER SURGERY

PubMed Central

Langford, Dale J.; Paul, Steven M.; West, Claudia; Abrams, Gary; Elboim, Charles; Levine, Jon D.; Hamolsky, Deborah; Luce, Judith A.; Kober, Kord M.; Neuhaus, John M.; Cooper, Bruce A.; Aouizerat, Bradley E.; Miaskowski, Christine

2014-01-01

Persistent pain following breast cancer surgery is well-documented. However, it is not well characterized in terms of the anatomic site effected (i.e., breast, arm). In two separate growth mixture modeling analyses, we identified subgroups of women (n=398) with distinct breast pain and arm pain trajectories. Based on the fact that these latent classes differed by anatomic site, types if tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. Purposes of this companion study were to identify demographic and clinical characteristics that differed between the two arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection (ALND) sites, pain qualities, pain interference, and hand and arm function; as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the Moderate Arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and ALND site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility. Perspective: For persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women. PMID:25439319

Opportunity at Work Inside Victoria Crater

NASA Technical Reports Server (NTRS)

2007-01-01

NASA Mars Exploration Rover Opportunity used its front hazard-identification camera to capture this wide-angle view of its robotic arm extended to a rock in a bright-toned layer inside Victoria Crater.

The image was taken during the rover's 1,322nd Martian day, or sol (Oct. 13, 2007).

Victoria Crater has a scalloped shape of alternating alcoves and promontories around the crater's circumference. Opportunity descended into the crater two weeks earlier, within an alcove called 'Duck Bay.' Counterclockwise around the rim, just to the right of the arm in this image, is a promontory called 'Cabo Frio.'

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke.

PubMed

Levin, Mindy F; Liebermann, Dario G; Parmet, Yisrael; Berman, Sigal

2016-08-01

Background The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. Objectives To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion. Methods Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed. Results Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. Conclusions The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke. © The Author(s) 2015.

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Anthropometric predictors of body fat as measured by hydrostatic weighing in Guatemalan adults.

PubMed

Ramirez-Zea, Manuel; Torun, Benjamin; Martorell, Reynaldo; Stein, Aryeh D

2006-04-01

Most predictive equations currently used to assess percentage body fat (%BF) were derived from persons in industrialized Western societies. We developed equations to predict %BF from anthropometric measurements in rural and urban Guatemalan adults. Body density was measured in 123 women and 114 men by using hydrostatic weighing and simultaneous measurement of residual lung volume. Anthropometric measures included weight (in kg), height (in cm), 4 skinfold thicknesses [(STs) in mm], and 6 circumferences (in cm). Sex-specific multiple linear regression models were developed with %BF as the dependent variable and age, residence (rural or urban), and all anthropometric measures as independent variables (the "full" model). A "simplified" model was developed by using age, residence, weight, height, and arm, abdominal, and calf circumferences as independent variables. The preferred full models were %BF = -80.261 - (weight x 0.623) + (height x 0.214) + (tricipital ST x 0.379) + (abdominal ST x 0.202) + (abdominal circumference x 0.940) + (thigh circumference x 0.316); root mean square error (RMSE) = 3.0; and pure error (PE) = 3.4 for men and %BF = -15.471 + (tricipital ST x 0.332) + (subscapular ST x 0.154) + (abdominal ST x 0.119) + (hip circumference x 0.356); RMSE = 2.4; and PE = 2.9 for women. The preferred simplified models were %BF = -48.472 - (weight x 0.257) + (abdominal circumference x 0.989); RMSE = 3.8; and PE = 3.7 for men and %BF = 19.420 + (weight x 0.385) - (height x 0.215) + (abdominal circumference x 0.265); RMSE = 3.5; and PE = 3.5 for women. These equations performed better in this developing-country population than did previously published equations.

The association between upper trapezius activity and thorax movement in classical singing.

PubMed

Pettersen, V; Westgaard, R H

2004-12-01

This study aimed to examine in classical singing the phasing of the activity in upper trapezius (TR) to upper and lower thorax movement and to the phasing of activity in the intercostals (INT) and in the lateral abdominal (OBL) muscles. Electromyographic (EMG) activity was recorded from the TR, INT, and OBL muscles on the right side. Thorax movement (TX) was traced with two strain gauge sensors placed around the upper and lower thorax. Four professional opera singers (soprano, mezzo, tenor, and baritone) and four advanced student classical singers (three sopranos and one mezzo) participated. Three of the professional singers were 33 years, and one was 40 years. The students were between 23 and 30 years. Different arias, freely chosen by the singers from their professional repertoire, served as the singing task for the opera singers. All students sang "Summertime" from Porgy and Bess. All subjects performed their task three times with variation in vocal loudness (normal, forte, piano). Thereafter, for all subjects, a biofeedback (BF) procedure was performed on TR to lower TR activity and a repeat performance of the singing tasks was carried out. EMG activity from the three recording sites and upper and lower TX circumference were compared before and after BF. A phasing of upper TR activity to INT and OBL activity was discovered, all muscles supporting the expiration phase. During phonation, the upper TR contributes in the compression of upper TX, thus serving as an accessory muscle of expiration. Group results from both opera singers and student singers showed that EMG activity was significantly lowered after BF. The lowered TR activity resulted in an expanded upper TX circumference and less TX respiratory movement after BF.

Association between intramuscular fat in the arm following arm training and INSIG2.

PubMed

Popadic Gacesa, J Z; Secher, N H; Momcilovic, M; Grujic, N G

2014-12-01

Insulin-induced gene 2 (INSIG2) single-nucleotide polymorphism (SNP rs7566605) is linked to lipid metabolism, and this study assessed its potential influence on fat in the upper arm following arm training. Twenty healthy sedentary volunteers (22.0 ± 1.1 years, body mass index 25.4 ± 4.0 kg/m(2) ; mean ± standard deviation) carried out a 12-week two-arm elbow extensor training (10 maximal extensions with 1 min recovery between bouts) five times per day, five times per week. For 17 volunteers, upper arm muscle and adipose tissue [subcutaneous (SCAT) and intramuscular (IMAT)] volumes were evaluated by magnetic resonance imaging before, immediately after, and 12 months after training and variables were related to the subjects' INSIG2 SNP rs7566605 genotype. Muscle volume and SCAT for the upper arm, as the decrease in IMAT during training were not related to INSIG2 SNP rs7566605: GG: %IMAT 1.0 ± 0.9%; GC/CC: %IMAT 0.6 ± 0.5% (P > 0.05). However, in the year following the training, accumulation of upper arm IMAT was twice as large in participants homozygous for the G allele (GG: Δ%IMAT +2.5 ± 0.8%; GC/CC: Δ%IMAT +1.1 ± 0.7%; P < 0.01). This study suggests that the G allele in the INSIG2 SNP rs7566605 is more relevant for changes in IMAT following training than for the amount of subcutaneous fat. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements.

PubMed

Siu, Aaron; Schinkel-Ivy, Alison; Drake, Janessa Dm

2016-10-01

To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

PubMed

Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin

2017-10-01

The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial.

PubMed

Sato, Fumiko; Arinaga, Yoko; Sato, Naoko; Ishida, Takanori; Ohuchi, Noriaki

2016-03-01

The many women with breast cancer who underwent axillary lymph node dissection (ALND) suffer from the upper arm dysfunction. In this study, we investigated the effectiveness of a perioperative educational program for improving upper arm dysfunction in breast cancer patients following ALND. This study was a sub-analysis of a previous controlled trial with an educational program. The subjects of this analysis included 64 patients following ALND who completed measurements at 12 months. The perioperative educational program consisted of monitoring of arm dysfunction, exercises, massage, and lifestyle adjustments. The intervention group (37 patients) received this perioperative educational program over 12 months, while 27 patients in the control group received written information about shoulder exercise from on-site staff only before surgery. Primary outcomes were shoulder range of motion (ROM), arm girth, and grip strength. Secondary outcomes were evaluated with the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scores, the Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the Medical Outcome Study 36-Item Short-Form Health Survey v2 (SF-36v2). The SF-36v2 measures health-related quality of life (QOL). Primary and secondary outcomes were compared between groups at 1 week (after drainage tube removal) and 12 months after surgery, using the Mann-Whitney U test. The horizontal extension was significantly improved only in the intervention group. Moreover, the SPOFIA score was significantly improved in the intervention group, and other scores of the secondary outcomes were similar between the two groups. The perioperative educational program may improve postoperative upper arm dysfunction and symptoms.

Relationship between neck circumference, insulin resistance and arterial stiffness in overweight and obese subjects.

PubMed

Fantin, Francesco; Comellato, Gabriele; Rossi, Andrea P; Grison, Elisa; Zoico, Elena; Mazzali, Gloria; Zamboni, Mauro

2017-09-01

Background Only a few studies have investigated the relationship between neck circumference and cardiometabolic risk. The aim of this study was to assess the relationships between neck circumference, waist circumference, metabolic variables and arterial stiffness in a group of overweight and obese subjects evaluating a possible independent role of neck circumference in determining arterial stiffness. Methods and results We studied 95 subjects (53 women) with an age range of 20-77 years and body mass index range from 25.69 to 47.04 kg/m 2 . In each subject we evaluated body mass index, waist, hip and neck circumference, systolic and diastolic blood pressure, insulin, fasting glucose, cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWVcf) and carotid-radial pulse wave velocity (PWVcr). Both PWVcf and PWVcr were higher in subjects with high values of neck circumference compared with subjects with normal values of neck circumference. Subjects with high values of neck circumference and abdominal obesity presented higher values of mean arterial pressure, PWVcr and homeostasis model assessment (HOMA) index and lower values of high-density lipoprotein than subjects with only abdominal obesity. Two models of stepwise multiple regression were performed in order to evaluate the combined effect of independent variables on arterial stiffness. In the first model PWVcf was considered a dependent variable, and age, gender, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, waist circumference, neck circumference, HOMA index and the use of anti-hypertensive medications were considered independent variables. Age, systolic blood pressure, triglycerides and waist circumference were significant predictors of PWVcf, explaining 65% of its variance. In the second model, in which PWVcr was considered a dependent variable, neck circumference and gender were significant predictors of PWVcr, explaining 24% of its variance. Conclusions These findings emphasise the need to measure not only waist but even neck circumference to better stratify and identify individuals at increased cardiometabolic risk, as upper-body subcutaneous fat is a novel, easily measured fat depot.

Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis.

PubMed

Yeşilyaprak, Sevgi Sevi; Yüksel, Ertuğrul; Kalkan, Serpil

2016-05-01

Although a relationship between short pectoralis minor and upper trapezius and scapular dyskinesis has been postulated, no studies have investigated this theory. Understanding the effect of these muscle lengths on observable scapular dyskinesis may aid in determining risks and therefore making treatment decisions. Being aware of the magnitude of this effect would help gauge the significance of risks involved. Our aim was to evaluate the influence of pectoralis minor and upper trapezius lengths on scapular dyskinesis. Cross-sectional study. University research laboratory. Asymptomatic participants (n = 148; 296 arms) were evaluated. Scapular Dyskinesis Test (SDT) was used to identify scapular dyskinesis, Pectoralis Minor Index (PMI) and Upper Trapezius Length Testing were used to determine muscle length. SDT+ arms had shorter pectoralis minor resting length (PMI: 7.49 ± 0.38) (p < 0.001) and greater incidence of short upper trapezius (ISUT) (66.7%) (p < 0.001) compared to SDT- arms (PMI:8.58 ± 0.75, ISUT:22.5%). With each decrease in PMI, the likelihood of having scapular dyskinesis increased 96% (p < 0.001). Arms with short upper trapezius were 2.049 times more likely to exhibit scapular dyskinesis than those with normal length (p = 0.042). Having a shorter pectoralis minor and upper trapezius length substantially increased the likelihood of having visually observable scapular dyskinesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Thinness at birth in a northern industrial town.

PubMed

Law, C M; Barker, D J; Richardson, W W; Shiell, A W; Grime, L P; Armand-Smith, N G; Cruddas, A M

1993-08-01

To determine whether babies in an area of Britain with unusually high perinatal mortality have different patterns of fetal growth to those born elsewhere in the country. Measurement of body size in newborn babies. Burnley (perinatal mortality in 1988 15.9/1000 total births) and Salisbury (perinatal mortality 10.8/1000 total births), England. Subjects comprised 1544 babies born in Burnley, Pendle, and Rossendale Health District, and 1025 babies born in Salisbury Health District. Birthweight, length, head, arm and abdominal circumferences, and placental weight were determined. Compared with babies born in Salisbury, Burnley babies had lower mean birthweight (difference 116 g, 95% confidence interval (CI) 77,154), smaller head circumferences (difference 0.3 cm, 95% CI 0.2, 0.4), and were thinner as measured by arm circumference (difference 0.3 cm, 95% CI 0.3, 0.4), abdominal circumference (difference 0.5 cm, 95% CI 0.4, 0.6) and ponderal index (difference 0.8 kg/m3, 95% CI 0.6, 1.0). The ratio of placental weight to birthweight was higher in Burnley (difference 0.6%, 95% CI 0.4, 0.9). These differences were found in boys and girls and did not depend on differences in duration of gestation or on the different ethnic mix of the two districts. Mothers in Burnley were younger, shorter in stature, had had more children, were of lower social class, and more of them smoked during pregnancy than mothers in Salisbury. These differences did not explain the greater thinness of their babies. Babies born in Burnley, an area with high perinatal mortality, are thin. The reason is unknown. Poor maternal nutrition is suspected because Burnley babies have a higher ratio of placental weight to birthweight. The greater thinness at birth of Burnley babies could have long term consequences, including higher rates of cardiovascular disease.

Anthropometric Differences between HIV-Infected Individuals Prior to Antiretroviral Treatment and the General Population from 1998–2007: The AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) Cohort and NHANES

PubMed Central

Atkinson, Benjamin E.; Krishnan, Supriya; Cox, Gary; Hulgan, Todd; Collier, Ann C.

2013-01-01

Objective To assess differences in body circumferences and body mass index (BMI, kg/m2) between antiretroviral treatment (ART) naïve HIV-infected and HIV-uninfected persons. Methods Waist, arm, and thigh circumferences and BMI were measured within the ALLRT and NHANES cohorts between 1998 and 2007. ALLRT is a prospective, longitudinal study of U.S. participants enrolled in randomized HIV treatment studies conducted by the AIDS Clinical Trials Group (ACTG). NHANES is a representative group of the US population. The cohorts were analyzed in two time periods, to account for trends towards increased adiposity. Anthropometrics were displayed in percentiles by age and sex. Multiple linear regression models examined differences between cohorts. Results ALLRT had more males (82% versus 48%, p<0.0001), more black participants (32% versus 23%, p<0.0001), and less Hispanics (21% versus 30%, p<0.0001) than NHANES. Mean BMI was smaller in ALLRT males and females compared to NHANES by 1.6–2.4 kg/m2 (p<0.0001). Mean waist and arm circumferences in both sexes and time periods were significantly smaller in ALLRT than in NHANES (p<0.0001). Mean thigh circumference in ALLRT was also smaller than NHANES among males (p<0.0001 in both time periods) and females (p = 0.01 in the early time period). Conclusions Differences in anthropometrics existed prior to ART initiation, in this large national cohort of HIV-infected individuals, compared to a representative HIV-uninfected cohort, indicating that HIV and its complications have important effects on body shape. Further longitudinal examination of anthropometrics in this HIV-infected cohort may provide additional insight into disease risk. Trial Registration NCT00001137 at www.clinicaltrials.gov. PMID:23755215

People living with HIV on ART have accurate perception of lipodystrophy signs: a cross-sectional study.

PubMed

Alencastro, Paulo R; Barcellos, Nemora T; Wolff, Fernando H; Ikeda, Maria Letícia R; Schuelter-Trevisol, Fabiana; Brandão, Ajácio B M; Fuchs, Sandra C

2017-01-13

The prevalence of lipodystrophy ranges from 31 to 65%, depending on the criteria adopted for diagnosis. The usual methods applied in the diagnosis vary from self-perception, medical examination, skinfolds measurements, or even imaging assessment for confirmation of fat distribution changes. Although several methods have been developed, there is no gold standard for characterization of LA and LH, or mixed forms. This study aimed to compare self-reported signs of lipodystrophy with objective measures by skinfolds and circumferences, and to evaluate the prevalence of lipoatrophy (LA) and lipohypertrophy (LH) among subjects living with HIV/AIDS on ART. A cross-sectional study enrolled participants living with HIV/AIDS receiving ART, aged 18 years or older from an outpatient health care center, in Southern Brazil. Self-reported body fat enlargement in the abdomen, chest or breasts, and dorsocervical fat pad were used to determine LH, while LA was identified by self-reported fat wasting of the face, neck, legs, arms or buttocks. Measurements were obtained with a scientific caliper for infraorbital, buccal, and submandibular skinfolds, and using an inelastic tape to measure circumferences of waist, hip, neck, and arm. LH and LA were established by the presence of at least one self-reported sign. Comparisons of self-reported signs with objective measurements for men and women were carried out in 815 participants on ART, out of 1240 participants with HIV infection. Self-report of decreased facial fat and sunken cheeks was associated with lower infraorbital, buccal, and submandibular skinfolds. Participants who reported buffalo hump had, on average, greater neck circumference, as well as those who have increased waist circumference also reported abdominal enlargement, but no buttock wasting. Men were most commonly affected by lipoatrophy (73 vs. 53%; P < 0.001), and women by lipohypertrophy (79 vs. 56%; P < 0.001). In conclusion, self-reported signs of lipodystrophy and lipoatrophy are prevalent, differ by gender, and are associated with objective measurements in people living with HIV/AIDS.

Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema.

PubMed

Zhang, Lijuan; Fan, Aiqun; Yan, Jun; He, Yan; Zhang, Huiting; Zhang, Huizhen; Zhong, Qiaoling; Liu, Feng; Luo, Qinghua; Zhang, Liping; Tang, Hailin; Xin, Mingzhu

2016-06-01

Upper limb lymphedema is a common complication after radical mastectomy in patients with breast cancer. In this study, we examined the efficacy of self-manual lymph drainage (MLD) after modified radical mastectomy for the prevention of upper limb lymphedema, scar formation, or shoulder joint dysfunction in breast cancer patients. Breast cancer patients scheduled for modified radical mastectomy were randomly apportioned to undergo physical exercise only (PE group, the control; n = 500) or self-MLD as well as exercise (MLD group; n = 500) after surgery. In the PE group, patients started to undertake remedial exercises and progressive weight training after recovery from anesthesia. In the MLD group, in addition to receiving the same treatments as in the PE group, the patients were trained to perform self-MLD on the surgical incision for 10 min/session, 3 sessions/day, beginning after suture removal and incision closure (10 to 30 days after the surgery). Scar formation was evaluated at one week, and 1, 3, 6, and 12 months after the surgery, respectively. Upper limb circumference and shoulder abduction were measured 24 h before surgery, and at one week, and 1, 3, 6 and 12 months after the surgery. Compared to those in the PE group, patients in MLD group experienced significant improvements in scar contracture, shoulder abduction, and upper limb circumference. Self-MLD, in combination with physical exercise, is beneficial for breast cancer patients in preventing postmastectomy scar formation, upper limb lymphedema, and shoulder joint dysfunction.

Fat accumulation in the tongue is associated with male gender, abnormal upper airway measures and whole-body adiposity

PubMed Central

Godoy, Ivan R. B.; Martinez-Salazar, Edgar Leonardo; Eajazi, Alireza; Genta, Pedro R.; Bredella, Miriam A.; Torriani, Martin

2017-01-01

Objective To examine associations between tongue adiposity with upper airway measures, whole-body adiposity and gender. We hypothesized that increased tongue adiposity is higher in males and positively associated with abnormal upper airway measures and whole-body adiposity. Methods We studied subjects who underwent whole-body positron emission tomography/computed tomography to obtain tongue attenuation (TA) values and cross-sectional area, pharyngeal length (PL) and mandibular-hyoid distance (MPH), as well as abdominal circumference, abdominal subcutaneous and visceral (VAT) adipose tissue areas, neck circumference (NC) and neck adipose tissue area. Metabolic syndrome was determined from available clinical and laboratory data. Results We identified 206 patients (104 females, 102 males) with mean age 56±17y and mean body mass index (BMI) 28±6kg/m2 (range 16–47kg/m2). Males had lower TA values (P=0.0002) and higher upper airway measures (P< 0.0001) independent of age and BMI (P<0.001). In all subjects, TA was negatively associated with upper airway measures (P<0.001). TA was negatively associated with body composition parameters (all P<0.0001), most notably with VAT (r=−0.53) and NC (r=−0.47). TA values were lower in subjects with metabolic syndrome (P<0.0001). Conclusion Increased tongue adiposity is influenced by gender and is associated with abnormal upper airway patency and body composition parameters. PMID:27733254

Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity.

PubMed

Godoy, Ivan R B; Martinez-Salazar, Edgar Leonardo; Eajazi, Alireza; Genta, Pedro R; Bredella, Miriam A; Torriani, Martin

2016-11-01

To examine associations between tongue adiposity with upper airway measures, whole-body adiposity and gender. We hypothesized that increased tongue adiposity is higher in males and positively associated with abnormal upper airway measures and whole-body adiposity. We studied subjects who underwent whole-body positron emission tomography/computed tomography to obtain tongue attenuation (TA) values and cross-sectional area, pharyngeal length (PL) and mandibular plane to hyoid distance (MPH), as well as abdominal circumference, abdominal subcutaneous and visceral (VAT) adipose tissue areas, neck circumference (NC) and neck adipose tissue area. Metabolic syndrome was determined from available clinical and laboratory data. We identified 206 patients (104 females, 102 males) with mean age 56±17years and mean body mass index (BMI) 28±6kg/m 2 (range 16-47kg/m 2 ). Males had lower TA values (P=0.0002) and higher upper airway measures (P<0.0001) independent of age and BMI (P<0.001). In all subjects, TA was negatively associated with upper airway measures (P<0.001). TA was negatively associated with body composition parameters (all P<0.0001), most notably with VAT (r=-0.53) and NC (r=-0.47). TA values were lower in subjects with metabolic syndrome (P<0.0001). Increased tongue adiposity is influenced by gender and is associated with abnormal upper airway patency and body composition parameters. Copyright © 2016 Elsevier Inc. All rights reserved.

Isometric Arm Strength and Subjective Rating of Upper Limb Fatigue in Two-Handed Carrying Tasks

PubMed Central

Li, Kai Way; Chiu, Wen-Sheng

2015-01-01

Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks. PMID:25794159

Isometric arm strength and subjective rating of upper limb fatigue in two-handed carrying tasks.

PubMed

Li, Kai Way; Chiu, Wen-Sheng

2015-01-01

Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks.

Short-Term Upper Limb Immobilization Affects Action-Word Understanding

ERIC Educational Resources Information Center

Bidet-Ildei, Christel; Meugnot, Aurore; Beauprez, Sophie-Anne; Gimenes, Manuel; Toussaint, Lucette

2017-01-01

The present study aimed to investigate whether well-established associations between action and language can be altered by short-term upper limb immobilization. The dominant arm of right-handed participants was immobilized for 24 hours with a rigid splint fixed on the hand and an immobilization vest restraining the shoulder, arm, and forearm. The…

Non-contact versus contact-based sensing methodologies for in-home upper arm robotic rehabilitation.

PubMed

Howard, Ayanna; Brooks, Douglas; Brown, Edward; Gebregiorgis, Adey; Chen, Yu-Ping

2013-06-01

In recent years, robot-assisted rehabilitation has gained momentum as a viable means for improving outcomes for therapeutic interventions. Such therapy experiences allow controlled and repeatable trials and quantitative evaluation of mobility metrics. Typically though these robotic devices have been focused on rehabilitation within a clinical setting. In these traditional robot-assisted rehabilitation studies, participants are required to perform goal-directed movements with the robot during a therapy session. This requires physical contact between the participant and the robot to enable precise control of the task, as well as a means to collect relevant performance data. On the other hand, non-contact means of robot interaction can provide a safe methodology for extracting the control data needed for in-home rehabilitation. As such, in this paper we discuss a contact and non-contact based method for upper-arm rehabilitation exercises that enables quantification of upper-arm movements. We evaluate our methodology on upper-arm abduction/adduction movements and discuss the advantages and limitations of each approach as applied to an in-home rehabilitation scenario.

The impact of arm circumference on noninvasive oscillometric blood pressure referenced with intra-aortic blood pressure.

PubMed

Shangguan, Qing; Wu, Yanqing; Xu, Jinsong; Su, Hai; Li, Juxiang; Hong, Kui; Cheng, Xiaoshu

2015-12-01

To investigate the influence of arm circumference (AC) on the brachial blood pressure (BP) measured with an adult cuff. This study included 208 patients (150 men, 61.0±8.0 years) for coronary angiography. Intra-aortic BP and noninvasive right brachial oscillometric BP (noninvasive BP) were measured simultaneously before coronary angiography. The noninvasive BP was measured using an electronic oscillometric device with an adult cuff (12×22 cm). The mid-ACs were measured. Thus, proper cuff-arm (≤26 cm) and small cuff (>26 cm) groups were created. The difference in intra-aortic and noninvasive BP was calculated as BPi-n. The correlation coefficients (r) between noninvasive and invasive systolic blood pressure (SBP), mean artery pressure, and diastolic blood pressure (DBP) were 0.88, 0.76, and 0.58, respectively. The SBPi-n was higher (7.9±1.6 vs. 5.2±1.1 mmHg), but the DBPi-n (3.9±1.4 vs. 6.1±1.0 mmHg, P<0.05) was lower in the group ≤26 cm than in the group >26 cm. Among the four subgroups divided by 20-23, 24-26, 27-30, and 31-37 cm of AC, as the AC increased, the SBPi-n increased, but DBP decreased, resulting in noninvasive SBP 4.6 mmHg higher and noninvasive DBP 4.6 mmHg lower in the 31-37 cm group in comparison with the 20-23 cm group. When an adult cuff was used, the noninvasive oscillometric SBP was overestimated, but DBP was underestimated in the individuals with large arms against the intra-aortic BP.

Wii™-habilitation of upper extremity function in children with cerebral palsy. An explorative study.

PubMed

Winkels, Diny G M; Kottink, Anke I R; Temmink, Rutger A J; Nijlant, Juliëtte M M; Buurke, Jaap H

2013-01-01

Commercially available virtual reality systems can possibly support rehabilitation objectives in training upper arm function in children with Cerebral Palsy (CP). The present study explored the effect of the Nintendo Wii™ training on upper extremity function in children with CP. During six weeks, all children received twice a week training with the Wii™, with their most affected arm. The Melbourne Assessment of Upper Limb Function and ABILHAND-Kids were assessed pre- and post- training. In addition, user satisfaction of both children and health professionals was assessed after training. Enjoyment in gaming was scored on a visual analogue scale scale after each session by the children. Fifteen children with CP participated in the study. The quality of upper extremity movements did not change (-2.1, p > 0.05), while a significant increase of convenience in using hands/arms during performance of daily activities was found (0.6, p < 0.05). Daily activities seem to be easier performed after Wii™ training for most of the included children with CP.

Gravity-supported exercise with computer gaming improves arm function in chronic stroke.

PubMed

Jordan, Kimberlee; Sampson, Michael; King, Marcus

2014-08-01

To investigate the effect of 4 to 6 weeks of exergaming with a computer mouse embedded within an arm skate on upper limb function in survivors of chronic stroke. Intervention study with a 4-week postintervention follow-up. In home. Survivors (N=13) of chronic (≥6 mo) stroke with hemiparesis of the upper limb with stable baseline Fugl-Meyer assessment scores received the intervention. One participant withdrew, and 2 participants were not reassessed at the 4-week follow-up. No participants withdrew as a result of adverse effects. Four to 6 weeks of exergaming using the arm skate where participants received either 9 (n=5) or 16 (n=7) hours of game play. Upper limb component of the Fugl-Meyer assessment. There was an average increase in the Fugl-Meyer upper limb assessment score from the beginning to end of the intervention of 4.9 points. At the end of the 4-week period after the intervention, the increase was 4.4 points. A 4- to 6-week intervention using the arm skate significantly improved arm function in survivors of chronic stroke by an average of 4.9 Fugl-Meyer upper limb assessment points. This research shows that a larger-scale randomized trial of this device is warranted and highlights the potential value of using virtual reality technology (eg, computer games) in a rehabilitation setting. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rotary Series Elastic Actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2013-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

Rotary series elastic actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2012-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

A prospective randomised double-blind placebo-controlled trial to assess the effect of diuretics on shockwave lithotripsy of calculi.

PubMed

Sabharwal, Sagar; Jeyaseelan, L; Panda, Arabind; Gnanaraj, Lionel; Kekre, Nitin S; Devasia, Antony

2017-12-01

To assess the effect of diuretics with shockwave lithotripsy (SWL) on the treatment of renal and upper ureteric calculi. Adult patients with a solitary non-obstructive radio-opaque renal or upper ureteric calculus with normal renal function were included. They were prospectively randomised to receive either SWL with placebo or SWL with diuretics (40 mg parenteral furosemide) in a double-blind manner with a sample size of 48 patients in each arm. The primary outcomes were the SWL success and failure rates. The secondary outcomes were the number of shocks and sessions. Complete fragmentation was achieved in 89.6% of the patients in the furosemide arm as compared to 81.3% in the placebo arm. Clearance was achieved in 77.1% of the patients in the furosemide arm as compared to 70.8% in the placebo arm. The number of shocks and the number of sessions were higher in the placebo arm. These differences were not statistically significant. The use of diuretics along with SWL treatment of renal and upper ureteric calculi does not show a statistically significant improvement in fragmentation or clearance.

Sensory-Feedback Exoskeletal Arm Controller

NASA Technical Reports Server (NTRS)

An, Bin; Massie, Thomas H.; Vayner, Vladimir

2004-01-01

An electromechanical exoskeletal arm apparatus has been designed for use in controlling a remote robotic manipulator arm. The apparatus, called a force-feedback exoskeleton arm master (F-EAM) is comfortable to wear and easy to don and doff. It provides control signals from the wearer s arm to a robot arm or a computer simulator (e.g., a virtual-reality system); it also provides force and torque feedback from sensors on the robot arm or from the computer simulator to the wearer s arm. The F-EAM enables the wearer to make the robot arm gently touch objects and finely manipulate them without exerting excessive forces. The F-EAM features a lightweight design in which the motors and gear heads that generate force and torque feedback are made smaller than they ordinarily would be: this is achieved by driving the motors to power levels greater than would ordinarily be used in order to obtain higher torques, and by providing active liquid cooling of the motors to prevent overheating at the high drive levels. The F-EAM (see figure) includes an assembly that resembles a backpack and is worn like a backpack, plus an exoskeletal arm mechanism. The FEAM has five degrees of freedom (DOFs) that correspond to those of the human arm: 1. The first DOF is that of the side-to-side rotation of the upper arm about the shoulder (rotation about axis 1). The reflected torque for this DOF is provided by motor 1 via drum 1 and a planar four-bar linkage. 2. The second DOF is that of the up-and-down rotation of the arm about the shoulder. The reflected torque for this DOF is provided by motor 2 via drum 2. 3. The third DOF is that of twisting of the upper arm about its longitudinal axis. This DOF is implemented in a cable remote-center mechanism (CRCM). The reflected torque for this DOF is provided by motor 3, which drives the upper-arm cuff and the mechanism below it. A bladder inflatable by gas or liquid is placed between the cuff and the wearer s upper arm to compensate for misalignment between the exoskeletal mechanism and the shoulder. 4. The fourth DOF is that of flexion and extension of the elbow. The reflected torque for this DOF is provided by motor 4 and drum 4, which are mounted on a bracket that can slide longitudinally by a pin-and-slot engagement with the upper-arm cuff to compensate for slight variations in the position of the kinematic center of the elbow. Attached to drum 4 is an adapter plate to which is attached a CRCM for the lower arm. 5. The lower-arm CRCM implements the fifth DOF, which is the twist of the forearm about its longitudinal axis. Motor 5 provides the reflected torque for this DOF by driving the lower-arm cuff. A rod transmits twist and torsion between the lower-arm cuff and the hand cuff. With this system, the motion of the wearer s joints and the reflected torques applied to these joints can be measured and controlled in a relatively simple manner. This is because the anthropomorphic design of the mechanism imitates the kinematics of the human arm, eliminating the need for kinematic conversion of joint-torque and joint-angle data.

Anthropometric measurements in the elderly population of Santiago, Chile.

PubMed

Santos, J L; Albala, C; Lera, L; García, C; Arroyo, P; Pérez-Bravo, F; Angel, B; Peláez, M

2004-05-01

There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects. This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999. Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference. These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.

The appropriateness of the length of insulin needles based on determination of skin and subcutaneous fat thickness in the abdomen and upper arm in patients with type 2 diabetes.

PubMed

Sim, Kang Hee; Hwang, Moon Sook; Kim, Sun Young; Lee, Hye Mi; Chang, Ji Yeun; Lee, Moon Kyu

2014-04-01

Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

Application and comparison of different implanted ports in malignant tumor patients.

PubMed

Li, Yanhong; Cai, Yonghua; Gan, Xiaoqin; Ye, Xinmei; Ling, Jiayu; Kang, Liang; Ye, Junwen; Zhang, Xingwei; Zhang, Jianwei; Cai, Yue; Hu, Huabin; Huang, Meijin; Deng, Yanhong

2016-09-23

The current study aims to compare the application and convenience of the upper arm port with the other two methods of implanted ports in the jugular vein and the subclavian vein in patients with gastrointestinal cancers. Currently, the standard of practice is placement of central venous access via an internal jugular vein approach. Perioperative time, postoperative complications, and postoperative comfort level in patients receiving an implanted venous port in the upper arm were retrospectively compared to those in the jugular vein and the subclavian vein from April 2013 to November 2014. Three hundred thirty-four patients are recruited for this analysis, consisting of 107 in the upper arm vein group, 70 in the jugular vein group, and 167 in the subclavian vein group. The occurrence of catheter misplacement in the upper arm vein is higher than that in the other two groups (13.1 vs. 2.9 vs. 5.4 %, respectively, P = 0.02), while the other complications in the perioperative period were not significantly different. The occurrence of transfusion obstacle of the upper arm vein group is significantly lower than that of the jugular and subclavian groups (0.9 vs. 7.1 vs. 7.2 %, P = 0.01). The occurrence of thrombus is also lower than that of other two groups (0.9 vs. 4.3 vs. 3.6 %, P = 0.03). Regarding the postoperative comfort, the influences of appearance (0 vs. 7.1 vs. 2.9 %, P = 0.006) and sleep (0.9 vs. 4.2 vs. 10.7 %, P = 0.003) are significantly better than those of the jugular and subclavian vein groups. Compared to the jugular and the subclavian vein groups, the implanted venous port in the upper arm vein has fewer complications and more convenience and comfort, and might be a superior novel choice for patients requiring long-term chemotherapy or parenteral nutrition.

The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes

PubMed Central

Sim, Kang Hee; Kim, Sun Young; Lee, Hye Mi; Chang, Ji Yeun; Lee, Moon Kyu

2014-01-01

Background Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. Methods First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. Results The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. Conclusion It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes. PMID:24851206

Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia).

PubMed

Poh, Bee Koon; Ng, Boon Koon; Siti Haslinda, Mohd Din; Nik Shanita, Safii; Wong, Jyh Eiin; Budin, Siti Balkis; Ruzita, Abd Talib; Ng, Lai Oon; Khouw, Ilse; Norimah, A Karim

2013-09-01

The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.

Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study.

PubMed

Yılmaz, Damla; Çapan, Nermin; Canbakan, Sema; Besler, Halit Tanju

2015-04-10

Fat-free mass (FFM) depletion has been shown to be a better predictor of mortality than BMI in chronic obstructive pulmonary disease (COPD) patients. The specific aim of the current study was to assess the nutritional status of stable COPD patients in relation to fat free mass index profiles. We investigated 65 male moderate-to-severe stable COPD patients. A self-reported questionnaire was applied about general characteristics and smoking history. Nutritional intake was assessed by using a 54-item quantitative food frequency questionnaire. Weight, height, mid-upper arm circumference (MUAC), waist circumference (WC), handgrip strength and body composition measurements were taken by a trained dietitian. The data were analyzed with SPSS 15.0 software. The mean age of the patients was 62.1 ± 8.9 years. Among all of the patients 13.8% was underweight (BMI < 21 kg/m(2)) and 18.5% had a low fat-free mass index (FFMI < 16 kg/m(2)). The percentages of the patients who did not meet the daily recommended intakes (RNI) were highest for magnesium (93.8%) and calcium (92.3%). Mean daily consumptions of milk-yogurt, red meat and fruits were significantly low in the low FFMI group compared to normal FFMI group (for all; p < 0.05). Patients with normal FFMI had significantly higher weight, height, WC, MUAC, handgrip strength, fat and fat-free mass than the patients with low FFMI (for all; p < 0.05). Dieticians should be aware of COPD patients with low FFMI in order to evaluate the nutritional intake and therefore plan nutritional strategies to improve prognosis of the disease.

ANTHROPOMETRIC CHARACTERISTICS AND FUNCTIONAL CAPACITY OF ELITE ROWERS AND HANDBALL PLAYERS.

PubMed

Karaba Jakovljevic, Dea; Jovanovic, Gordana; Eric, Mirela; Klasnja, Aleksandar; Slavic, Danijel; Lukac, Damir

2016-09-01

Anthropometric and anaerobic profile of elite athletes are fundamental for the assessment of their respective performance. The present study was designed to evaluate the anthro- pornetric parameters, body composition and anaerobic characteristics of elite male handball players and rowers, and to compare them in relation to specific sport demands. The study group consisted of 41 elite national level athletes: 20 handball players (aged 23.7±3.72) and 21 rowers (aged 19.7±2.84). Anthropometric characteristics (body mass, body height, skinfold thickness, body circumferences), and body fat mass were evaluated, and Wingate anaerobic test for anaerobic power assessment Iwas applied. The significant differences were noted in chest-upper arm, waist and hip circumferences, and supraspinal and calf skinfolds between the two investigated groups. Rowers showed higher values of fat body mass (13.2±3.76 vs. 10.7±3.76%), but lower body mass index (22.0±1,92 vs. 25.7?2.31 kg/in12) compared to handball players. When analyzing the Wingate test parameters, significantly higher values of absolute anaerobic power (786±127 vs. 691±140 W), absolute explosive power in the handball players compared to the rowers were recorded ( 18±26.3 vs. 105±27.8 W/s), whi le rowers achieved higher relative anaerobic capacity (192±3 1.2 vs. 177±E20.8 J/ kg). Specific body composition and anthropometri- cal assessment as a part of morphological analysis should complement physiological profile of elite athletes. The analysis of the anaerobic performance shows that the handball players have greater alactic anaerobic and explosive power component, compared to the rowers in whom the anaerobic endurance and specific training have the greatest effect on the consumption of dominant metabolic substrate during the race.

Comparison of anthropometric and training characteristics between recreational male marathoners and 24-hour ultramarathoners.

PubMed

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas

2012-01-01

Of the anthropometry and training variables used to predict race performance in a 24-hour ultrarun, the personal best marathon time is the strongest predictor in recreational male 24-hour ultramarathoners. This finding raises the question of whether similarities exist between male recreational 24-hour ultramarathoners and male recreational marathoners. The association between age, anthropometric variables (ie, body mass, body height, body mass index, percent body fat, skeletal muscle mass, limb circumference, and skinfold thickness at the pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac, front thigh, and medial calf sites), previous experience and training characteristics (ie, volume, speed, and personal best time), and race time for 79 male recreational 24-hour ultramarathoners and 126 male recreational marathoners was investigated using bivariate and multivariate analysis. The 24-hour ultramarathoners were older (P < 0.05), had a lower circumference at both the upper arm (P < 0.05) and thigh (P < 0.01), and a lower skinfold thickness at the pectoral, axillary, and suprailiac sites (P < 0.05) compared with the marathoners. During training, the 24-hour ultramarathoners were running for more hours per week (P < 0.001) and completed more kilometers (P < 0.001), but were running slower (P < 0.01) compared with the marathoners. In the 24-hour ultramarathoners, neither anthropometric nor training variables were associated with kilometers completed in the race (P > 0.05). In the marathoners, percent body fat (P < 0.001) and running speed during training (P < 0.0001) were related to marathon race times. In summary, differences in anthropometric and training predictor variables do exist between male recreational 24-hour ultramarathoners and male recreational marathoners for race performance.

Comparison of anthropometric and training characteristics between recreational male marathoners and 24-hour ultramarathoners

PubMed Central

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas

2012-01-01

Background Of the anthropometry and training variables used to predict race performance in a 24-hour ultrarun, the personal best marathon time is the strongest predictor in recreational male 24-hour ultramarathoners. This finding raises the question of whether similarities exist between male recreational 24-hour ultramarathoners and male recreational marathoners. Methods The association between age, anthropometric variables (ie, body mass, body height, body mass index, percent body fat, skeletal muscle mass, limb circumference, and skinfold thickness at the pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac, front thigh, and medial calf sites), previous experience and training characteristics (ie, volume, speed, and personal best time), and race time for 79 male recreational 24-hour ultramarathoners and 126 male recreational marathoners was investigated using bivariate and multivariate analysis. Results The 24-hour ultramarathoners were older (P < 0.05), had a lower circumference at both the upper arm (P < 0.05) and thigh (P < 0.01), and a lower skinfold thickness at the pectoral, axillary, and suprailiac sites (P < 0.05) compared with the marathoners. During training, the 24-hour ultramarathoners were running for more hours per week (P < 0.001) and completed more kilometers (P < 0.001), but were running slower (P < 0.01) compared with the marathoners. In the 24-hour ultramarathoners, neither anthropometric nor training variables were associated with kilometers completed in the race (P > 0.05). In the marathoners, percent body fat (P < 0.001) and running speed during training (P < 0.0001) were related to marathon race times. Conclusion In summary, differences in anthropometric and training predictor variables do exist between male recreational 24-hour ultramarathoners and male recreational marathoners for race performance. PMID:24198595

Early invitation to food and/or multiple micronutrient supplementation in pregnancy does not affect body composition in offspring at 54 months: follow-up of the MINIMat randomised trial, Bangladesh.

PubMed

Khan, Ashraful Islam; Kabir, Iqbal; Hawkesworth, Sophie; Ekström, Eva-Charlotte; Arifeen, Shams; Frongillo, Edward A; Persson, Lars Åke

2015-07-01

Growth patterns in early life are associated with later health. The effect of nutrition during in utero development on later body composition is unclear. We evaluated whether prenatal early invitation to food and/or multiple micronutrient supplementation (MMS) in pregnancy has an effect on offspring body composition at 54 months of age. In Maternal and Infant Nutrition Interventions in Matlab trial (ISRCTN16581394) in Bangladesh, 4436 pregnant women were randomised into six equally sized groups: double-masked supplementation with capsules of either 30 mg Fe and 400 μg folic acid, or 60 mg Fe and 400 μg folic acid, or MMS (15 micronutrients), was combined with a randomised early invitation (around 9 weeks) or a usual invitation (around 20 weeks) to start food supplementation (608 kcal 6 days per week). At 54 months, the body composition of the offspring was assessed by leg-to-leg bioelectrical impedance analysis. Of the 3267 live singletons with birth anthropometry, 2290 children were measured at 54 months, representing 70% of the live births. There was no interaction between the food and micronutrient supplementation on body composition outcomes. There were no significant differences in a range of anthropometric and body composition measurements, including weight, height, mid-upper arm circumference, head circumference, skinfold thickness, and fat mass and fat-free mass between the different prenatal food and micronutrient groups using an intention-to-treat analysis. This analysis shows that early invitation to food supplementation and MMS provided to rural Bangladeshi women during pregnancy did not affect offspring body composition at 54 months of age. © 2012 Blackwell Publishing Ltd.

Disease and Non-Battle Injuries among Navy and Marine Corps Personnel during Operation Desert Shield/Desert Storm

DTIC Science & Technology

1991-10-01

KNEE I SHOULDER V SHIN /CALF 357 OTITIS EXTERNA 17 HEAT EXHAUSTION J, UPPER ARM W ANKLE T358 OITIS MEDIA K ELBOW X FOOT 0 337 CONJUNCTIVITIS - 18...OTHER, SPECIFY:__ 17 HEAT EXHAUSTION a CHEST T UPPER LEG S18 HEAT STROKE H RIBS U KNEE EYEAR: _ 19 LACERATION I SHOULDER V SHIN ,-LF 0 38010...GROINoGENITAL 03 ALERT 0 VERBAL RESPONSE I SHOULDER V UPPER LEG C3 PAIN RESPONSE 0’ UNRESPONSIVE J UPPER ARM W KNEE K ELBOW X SHIN /CALF MEDICATION L

Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke.

PubMed

Ekstrand, Elisabeth; Lexell, Jan; Brogårdh, Christina

2015-09-01

To evaluate the test-retest reliability of isometric and isokinetic muscle strength measurements in the upper extremity after stroke. A test-retest design. Forty-five persons with mild to moderate paresis in the upper extremity > 6 months post-stroke. Isometric arm strength (shoulder abduction, elbow flexion), isokinetic arm strength (elbow extension/flexion) and isometric grip strength were measured with electronic dynamometers. Reliability was evaluated with intra-class correlation coefficients (ICC), changes in the mean, standard error of measurements (SEM) and smallest real differences (SRD). Reliability was high (ICCs: 0.92-0.97). The absolute and relative (%) SEM ranged from 2.7 Nm (5.6%) to 3.0 Nm (9.4%) for isometric arm strength, 2.6 Nm (7.4%) to 2.9 Nm (12.6%) for isokinetic arm strength, and 22.3 N (7.6%) to 26.4 N (9.2%) for grip strength. The absolute and relative (%) SRD ranged from 7.5 Nm (15.5%) to 8.4 Nm (26.1%) for isometric arm strength, 7.1 Nm (20.6%) to 8.0 Nm (34.8%) for isokinetic arm strength, and 61.8 N (21.0%) to 73.3 N (25.6%) for grip strength. Muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. Isometric measurements yield smaller measurement errors than isokinetic measurements and might be preferred, but the choice depends on the research question.

22. View showing main anchor arm, as viewed from main ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. View showing main anchor arm, as viewed from main cantilever arm looking south. Note upper chord eyebar arrangement. - Williamstown-Marietta Bridge, Spanning Ohio River between Williamstown & Marietta, Williamstown, Wood County, WV

Profiles of muscularity in junior Olympic weight lifters.

PubMed

Kanehisa, H; Funato, K; Abe, T; Fukunaga, T

2005-03-01

This study aimed to investigate the muscularity of strength-trained junior athletes. Muscle thickness (Mt) values at 10 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, abdomen, back, anterior thigh, posterior thigh, anterior lower leg, and posterior lower leg) were determined in junior Olympic weight lifters (OWL, n=7, 15.1+/-0.3 y, mean+/-SD) and non-athletes (CON, n=13, 15.1+/-0.3 y) using a brightness mode ultrasonography. Skeletal age assessed with the Tanner-Whitehouse II method (20 hand-wrist bones) was similar in OWL (16.4+/-0.7 y) and CON (16.3+/-0.6 y). At the 6 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, back and anterior thigh), OWL showed significantly greater Mt values than CON even in terms of Mt relative to body mass(1/3) Mt x BM(-1/3). On the other hand, there were no significant differences between the 2 groups in the Mt ratios of the anterior to posterior site in the upper arm, thigh and lower leg and those of the back to either the chest or abdomen in the trunk. For OWL only, skeletal age was significantly correlated to Mt x BM(-1/3) at the abdomen (r=0.869, p<0.05) and anterior thigh (r=0.883, p<0.05). The findings here indicate that 1) as compared to adolescent non-athletes, junior Olympic weight lifters show a greater muscularity in the upper body and anterior thigh without predominant development in either of anterior and posterior sites within the same body segment, 2) for junior Olympic weight lifters, the muscularity of abdominal and knee extensor muscles is influenced by the biological maturation.

Controlling a multi-degree of freedom upper limb prosthesis using foot controls: user experience.

PubMed

Resnik, Linda; Klinger, Shana Lieberman; Etter, Katherine; Fantini, Christopher

2014-07-01

The DEKA Arm, a pre-commercial upper limb prosthesis, funded by the DARPA Revolutionizing Prosthetics Program, offers increased degrees of freedom while requiring a large number of user control inputs to operate. To address this challenge, DEKA developed prototype foot controls. Although the concept of utilizing foot controls to operate an upper limb prosthesis has been discussed for decades, only small-sized studies have been performed and no commercial product exists. The purpose of this paper is to report amputee user perspectives on using three different iterations of foot controls to operate the DEKA Arm. Qualitative data was collected from 36 subjects as part of the Department of Veterans Affairs (VA) Study to Optimize the DEKA Arm through surveys, interviews, audio memos, and videotaped sessions. Three major, interrelated themes were identified using the constant comparative method: attitudes towards foot controls, psychomotor learning and physical experience of using foot controls. Feedback about foot controls was generally positive for all iterations. The final version of foot controls was viewed most favorably. Our findings indicate that foot controls are a viable control option that can enable control of a multifunction upper limb prosthesis (the DEKA Arm). Multifunction upper limb prostheses require many user control inputs to operate. Foot controls offer additional control input options for such advanced devices, yet have had minimal study. This study found that foot controls were a viable option for controlling multifunction upper limb prostheses. Most of the 36 subjects in this study were willing to adopt foot controls to control the multiple degrees of freedom of the DEKA Arm. With training and practice, all users were able to develop the psychomotor skills needed to successfully operate food controls. Some had initial difficulty, but acclimated over time.

The time course of short-term hypertrophy in the absence of eccentric muscle damage.

PubMed

Stock, Matt S; Mota, Jacob A; DeFranco, Ryan N; Grue, Katherine A; Jacobo, A Unique; Chung, Eunhee; Moon, Jordan R; DeFreitas, Jason M; Beck, Travis W

2017-05-01

It has been proposed that the increase in skeletal muscle mass observed during the initial weeks of initiating a resistance training program is concomitant with eccentric muscle damage and edema. We examined the time course of muscle hypertrophy during 4 weeks of concentric-only resistance training. Thirteen untrained men performed unilateral concentric-only dumbbell curls and shoulder presses twice per week for 4 weeks. Sets of 8-12 repetitions were performed to failure, and training loads were increased during each session. Subjects consumed 500 ml of whole milk during training. Assessments of soreness, lean mass, echo intensity, muscle thickness, relaxed and flexed arm circumference, and isokinetic strength were performed every 72 or 96 h. Soreness, echo intensity, relaxed circumference, and peak torque data did not significantly change. Significant increases in lean mass, muscle thickness, and flexed circumference were observed within seven training sessions. Lean mass was elevated at tests #7 (+109.3 g, p = .002) and #8 (+116.1 g, p = .035), with eight different subjects showing changes above the minimal difference of 139.1 g. Muscle thickness was elevated at tests #6 (+0.23 cm, p = .004), #7 (+0.31 cm, p < .001), and #8 (+0.27 cm, p < .001), with ten subjects exceeding the minimal difference of 0.24 cm. There were no changes for the control arm. In individuals beginning a resistance training program, small but detectable increases in hypertrophy may occur in the absence of eccentric muscle damage within seven training sessions.

Appropriateness of advanced upper limb prosthesis prescription for a patient with cognitive impairment: a case report.

PubMed

Barredo, Jennifer; Acluche, Frantzy; Disla, Roxanne; Fantini, Christopher; Fishelis, Leah; Sasson, Nicole; Resnik, Linda

2017-08-01

To describe a participant with scapulo-thoracic amputation and cognitive impairment trained to use the DEKA Arm and discuss factors relevant to the determination that he was not an appropriate candidate for independent home use of the device. The participant underwent 40 h of in-laboratory training with the DEKA Arm Advanced Upper Limb Prosthesis. Pre-training neuropsychological measures of cognition were collected. Qualitative and quantitative data related to functional performance, quality of life and pain were collected after 10 h of training, and at the conclusion of training. Using a constant comparative approach, data were binned into major themes; elements within each theme were identified. Six themes were relevant to the determination that the participant was inappropriate for home use of the DEKA Arm: physical and mental health; learning, memory and cognition; adult role function; functional performance; user safety and judgement and capacity for independent device use. Issues contraindicating unsupervised device use included: uncontrolled health symptoms, poor knowledge application, safety concerns, absenteeism and performance degradation under stress. The findings have implications for training with and prescription of the DEKA Arm and other complex upper limb prostheses. Further research is needed to develop a model to guide prescription of technologically complex upper limb prostheses. Implications for Rehabilitation Advanced upper limb prostheses, like the DEKA Arm, promise greater functionality, but also may be cognitively demanding, raising questions of when, and if, prescription is appropriate for patients with cognitive impairment. At this time, no formal criteria exist to guide prescription of advanced upper limb prostheses. Each clinical team applies their own informal standards in decision-making. In this case report, we described six factors that were considered in determining whether or not a research participant, with scapulo-thoracic amputation and cognitive impairment was appropriate for home use of a complex upper limb prosthesis. The findings have implications for training with and prescription of the DEKA Arm, and highlights the need for further research to develop prescription guidelines for advanced assistive devices.

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

PubMed

Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

2017-01-01

The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial

PubMed Central

Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

2017-01-01

Objective The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. Materials and Methods The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. Results After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Conclusions Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs. PMID:28331763

Predicting Directly Measured Trunk and Upper Arm Postures in Paper Mill Work From Administrative Data, Workers' Ratings and Posture Observations.

PubMed

Heiden, Marina; Garza, Jennifer; Trask, Catherine; Mathiassen, Svend Erik

2017-03-01

A cost-efficient approach for assessing working postures could be to build statistical models for predicting results of direct measurements from cheaper data, and apply these models to samples in which only the latter data are available. The present study aimed to build and assess the performance of statistical models predicting inclinometer-assessed trunk and arm posture among paper mill workers. Separate models were built using administrative data, workers' ratings of their exposure, and observations of the work from video recordings as predictors. Trunk and upper arm postures were measured using inclinometry on 28 paper mill workers during three work shifts each. Simultaneously, the workers were video filmed, and their postures were assessed by observation of the videos afterwards. Workers' ratings of exposure, and administrative data on staff and production during the shifts were also collected. Linear mixed models were fitted for predicting inclinometer-assessed exposure variables (median trunk and upper arm angle, proportion of time with neutral trunk and upper arm posture, and frequency of periods in neutral trunk and upper arm inclination) from administrative data, workers' ratings, and observations, respectively. Performance was evaluated in terms of Akaike information criterion, proportion of variance explained (R2), and standard error (SE) of the model estimate. For models performing well, validity was assessed by bootstrap resampling. Models based on administrative data performed poorly (R2 ≤ 15%) and would not be useful for assessing posture in this population. Models using workers' ratings of exposure performed slightly better (8% ≤ R2 ≤ 27% for trunk posture; 14% ≤ R2 ≤ 36% for arm posture). The best model was obtained when using observational data for predicting frequency of periods with neutral arm inclination. It explained 56% of the variance in the postural exposure, and its SE was 5.6. Bootstrap validation of this model showed similar expected performance in other samples (5th-95th percentile: R2 = 45-63%; SE = 5.1-6.2). Observational data had a better ability to predict inclinometer-assessed upper arm exposures than workers' ratings or administrative data. However, observational measurements are typically more expensive to obtain. The results encourage analyses of the cost-efficiency of modeling based on administrative data, workers' ratings, and observation, compared to the performance and cost of measuring exposure directly. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

[A man with a painful upper arm after bench press exercise].

PubMed

Sijtsma, Ben C T; van der Veen, Hugo C; van Raay, Jos J A M

2015-01-01

A 22-year-old male bodybuilder presented with pain and a haematoma of his right upper arm after bench press exercises. Suspicion of a pectoralis muscle tear was confirmed by MRI and surgical repair was performed. Ruptures of the pectoralis major muscle are rare, but may occur in young male bodybuilders, typically after bench press exercises.

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

Skin tightening with a combined unipolar and bipolar radiofrequency device.

PubMed

Mayoral, Flor A

2007-02-01

Monopolar radiofrequency (RF) devices are well established treatment modalities for tightening facial skin. A 60-year-old woman presented with a desire to tighten the lax skin and improve the appearance of both upper arms. A combination unipolar and bipolar RF device may provide volume reduction as well as skin tightening in the upper arm.

Birth in the Peruvian Andes: Physical and Behavioral Consequences in the Neonate.

ERIC Educational Resources Information Center

Saco-Pollitt, Carmen

1981-01-01

Neonates born without complications to healthy mothers at 14,000 feet or at 490 feet above sea level were evaluated at 24-36- and 48-60-hours-of-life. In comparison with low-altitude infants, high-altitude infants were significantly lighter, shorter, had a smaller arm circumference, and presented more signs of behavioral immaturity in interactive…

Nutritional evaluation in cirrhosis: Emphasis on the phase angle.

PubMed

Fernandes, Sabrina Alves; de Mattos, Angelo Alves; Tovo, Cristiane Valle; Marroni, Claudio Augusto

2016-10-18

Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients' overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.

Full-Shift Trunk and Upper Arm Postures and Movements Among Aircraft Baggage Handlers.

PubMed

Wahlström, Jens; Bergsten, Eva; Trask, Catherine; Mathiassen, Svend Erik; Jackson, Jennie; Forsman, Mikael

2016-10-01

The present study assessed full-shift trunk and upper arm postural exposure amplitudes, frequencies, and durations among Swedish airport baggage handlers and aimed to determine whether exposures differ between workers at the ramp (loading and unloading aircraft) and baggage sorting areas. Trunk and upper arm postures were measured using inclinometers during three full work shifts on each of 27 male baggage handlers working at a large Swedish airport. Sixteen of the baggage handlers worked on the ramp and 11 in the sorting area. Variables summarizing postures and movements were calculated, and mean values and variance components between subjects and within subject (between days) were estimated using restricted maximum likelihood algorithms in a one-way random effect model. In total, data from 79 full shifts (651h) were collected with a mean recording time of 495min per shift (range 319-632). On average, baggage handlers worked with the right and left arm elevated >60° for 6.4% and 6.3% of the total workday, respectively. The 90th percentile trunk forward projection (FP) was 34.1°, and the 50th percentile trunk movement velocity was 8° s(-1). For most trunk (FP) and upper arm exposure variables, between-subject variability was considerable, suggesting that the flight baggage handlers were not a homogeneously exposed group. A notable between-days variability pointed to the contents of the job differing on different days. Peak exposures (>90°) were higher for ramp workers than for sorting area workers (trunk 0.6% ramp versus 0.3% sorting; right arm 1.3% ramp versus 0.7% sorting). Trunk and upper arm postures and movements among flight baggage handlers measured by inclinometry were similar to those found in other jobs comprising manual material handling, known to be associated with increased risks for musculoskeletal disorders. The results showed that full-shift trunk (FP) and, to some extent, peak arm exposures were higher for ramp workers compared with sorting workers. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial.

PubMed

Kim, TaeHoon; Kim, SeongSik; Lee, ByoungHee

2016-03-01

The purpose of this study was to investigate whether action observational training (AOT) plus brain-computer interface-based functional electrical stimulation (BCI-FES) has a positive influence on motor recovery of paretic upper extremity in patients with stroke. This was a hospital-based, randomized controlled trial with a blinded assessor. Thirty patients with a first-time stroke were randomly allocated to one of two groups: the BCI-FES group (n = 15) and the control group (n = 15). The BCI-FES group administered to AOT plus BCI-FES on the paretic upper extremity five times per week during 4 weeks while both groups received conventional therapy. The primary outcomes were the Fugl-Meyer Assessment of the Upper Extremity, Motor Activity Log (MAL), Modified Barthel Index and range of motion of paretic arm. A blinded assessor evaluated the outcomes at baseline and 4 weeks. All baseline outcomes did not differ significantly between the two groups. After 4 weeks, the Fugl-Meyer Assessment of the Upper Extremity sub-items (total, shoulder and wrist), MAL (MAL-Activity of Use and Quality of Movement), Modified Barthel Index and wrist flexion range of motion were significantly higher in the BCI-FES group (p < 0.05). AOT plus BCI-based FES is effective in paretic arm rehabilitation by improving the upper extremity performance. The motor improvements suggest that AOT plus BCI-based FES can be used as a therapeutic tool for stroke rehabilitation. The limitations of the study are that subjects had a certain limited level of upper arm function, and the sample size was comparatively small; hence, it is recommended that future large-scale trials should consider stratified and lager populations according to upper arm function. Copyright © 2015 John Wiley & Sons, Ltd.

The development of an arm activity survey for breast cancer survivors using the Protection Motivation Theory.

PubMed

Lee, Teresa S; Kilbreath, Sharon L; Sullivan, Gerard; Refshauge, Kathryn M; Beith, Jane M

2007-05-08

Current research evidence indicates that women should return to normal use of their arm after breast cancer surgery. However, it appears some women continue to hold the view that they are supposed to protect their arm from strenuous activities because of the risk of lymphoedema. Many factors contribute to women's perceptions about lymphoedema and their ability to use their affected arm, and it is the aim of this study to explore and understand these perceptions. A survey, based on the Protection Motivation Theory, has been developed and tested. The survey assesses whether subjective norms, fear and/or coping attributes predict women's intention to use their affected arm. In addition, the survey includes questions regarding cancer treatment and demographic characteristics, arm and chest symptoms, and arm function. Recruitment of 170 breast cancer survivors has begun at 3 cancer treatment sites in Sydney, Australia. This study will identify perceptions that help predict the extent women use their affected arm. The results will also determine whether upper limb impairments arise secondary to over-protection of the affected arm. Identification of factors that limit arm use will enable appropriate prevention and better provision of treatment to improve upper limb outcomes.

Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.

PubMed

Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

2016-12-01

We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure. Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups. We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %). Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

Brachioplasty outcomes: a review of a multipractice cohort.

PubMed

Zomerlei, Terri A; Neaman, Keith C; Armstrong, Shannon D; Aitken, Marguerite E; Cullen, William T; Ford, Ronald D; Renucci, John D; VanderWoude, Douglas L

2013-04-01

Upper arm deformities secondary to massive weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures such as brachioplasty. The records of all patients who underwent a brachioplasty procedure from a multipractice medical center were reviewed. Outcomes measured included patient demographics, operative interventions, and postoperative course. Ninety-six patients were analyzed. Fifty-three patients (55.2 percent) underwent a concomitant procedure, with 53.1 percent undergoing arm liposuction at the time of brachioplasty. Major and minor complications rates were 17.7 percent and 44.8 percent, respectively. Common complications included hypertrophic scarring (24.0 percent) and infection (14.6 percent). The total revision rate was 22.9 percent, with residual contour deformity (40.9 percent of revisions) and hypertrophic scarring (36.4 percent of revisions) representing the most common causes for revision. Patients who underwent a previous bariatric procedure were at an increased risk of developing a major complication (p = 0.02). Concomitant upper arm liposuction and concomitant procedures were not associated with a significantly increased complication rate. Brachioplasty, despite being an effective treatment for contour irregularities of the upper arm, is associated with significant revision and complication rates. Post-bariatric surgery patients should be informed of the potential for increased complications. Additional procedures performed at the time of brachioplasty do not significantly increase complications. Liposuction of the upper arm can be performed safely in conjunction with brachioplasty.

Aerobic exercise and respiratory muscle strength in patients with cystic fibrosis.

PubMed

Dassios, Theodore; Katelari, Anna; Doudounakis, Stavros; Dimitriou, Gabriel

2013-05-01

The beneficial role of exercise in maintaining health in patients with cystic fibrosis (CF) is well described. Few data exist on the effect of exercise on respiratory muscle function in patients with CF. Our objective was to compare respiratory muscle function indices in CF patients that regularly exercise with those CF patients that do not. This cross-sectional study assessed nutrition, pulmonary function and respiratory muscle function in 37 CF patients that undertook regular aerobic exercise and in a control group matched for age and gender which consisted of 44 CF patients that did not undertake regular exercise. Respiratory muscle function in CF was assessed by maximal inspiratory pressure (Pimax), maximal expiratory pressure (Pemax) and pressure-time index of the respiratory muscles (PTImus). Median Pimax and Pemax were significantly higher in the exercise group compared to the control group (92 vs. 63 cm H2O and 94 vs. 64 cm H2O respectively). PTImus was significantly lower in the exercise group compared to the control group (0.089 vs. 0.121). Upper arm muscle area (UAMA) and mid-arm muscle circumference were significantly increased in the exercise group compared to the control group (2608 vs. 2178 mm2 and 23 vs. 21 cm respectively). UAMA was significantly related to Pimax in the exercising group. These results suggest that CF patients that undertake regular aerobic exercise maintain higher indices of respiratory muscle strength and lower PTImus values, while increased UAMA values in exercising patients highlight the importance of muscular competence in respiratory muscle function in this population. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identification and classification of upper limb motions using PCA.

PubMed

Veer, Karan; Vig, Renu

2018-03-28

This paper describes the utility of principal component analysis (PCA) in classifying upper limb signals. PCA is a powerful tool for analyzing data of high dimension. Here, two different input strategies were explored. The first method uses upper arm dual-position-based myoelectric signal acquisition and the other solely uses PCA for classifying surface electromyogram (SEMG) signals. SEMG data from the biceps and the triceps brachii muscles and four independent muscle activities of the upper arm were measured in seven subjects (total dataset=56). The datasets used for the analysis are rotated by class-specific principal component matrices to decorrelate the measured data prior to feature extraction.

Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.

PubMed

Hoe, Victor C W; Urquhart, Donna M; Kelsall, Helen L; Sim, Malcolm R

2012-08-15

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.

A strategy for computer-assisted mental practice in stroke rehabilitation.

PubMed

Gaggioli, Andrea; Meneghini, Andrea; Morganti, Francesca; Alcaniz, Mariano; Riva, Giuseppe

2006-12-01

To investigate the technical and clinical viability of using computer-facilitated mental practice in the rehabilitation of upper-limb hemiparesis following stroke. A single-case study. Academic-affiliated rehabilitation center. A 46-year-old man with stable motor deficit of the upper right limb following subcortical ischemic stroke. Three computer-enhanced mental practice sessions per week at the rehabilitation center, in addition to usual physical therapy. A custom-made virtual reality system equipped with arm-tracking sensors was used to guide mental practice. The system was designed to superimpose over the (unseen) paretic arm a virtual reconstruction of the movement registered from the nonparetic arm. The laboratory intervention was followed by a 1-month home-rehabilitation program, making use of a portable display device. Pretreatment and posttreatment clinical assessment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment and the Action Research Arm Test. Performance of the affected arm was evaluated using the healthy arm as the control condition. The patient's paretic limb improved after the first phase of intervention, with modest increases after home rehabilitation, as indicated by functional assessment scores and sensors data. Results suggest that technology-supported mental training is a feasible and potentially effective approach for improving motor skills after stroke.

Effects of wrist tendon vibration on targeted upper-arm movements in poststroke hemiparesis.

PubMed

Conrad, Megan O; Scheidt, Robert A; Schmit, Brian D

2011-01-01

Impaired motor control of the upper extremity after stroke may be related to lost sensory, motor, and integrative functions of the brain. Artificial activation of sensory afferents might improve control of movement by adding excitatory drive to sensorimotor control structures. The authors evaluated the effect of wrist tendon vibration (TV) on paretic upper-arm stability during point-to-point planar movements. TV (70 Hz) was applied to the forearm wrist musculature of 10 hemiparetic stroke patients as they made center-out planar arm movements. End-point stability, muscle activity, and grip pressure were compared as patients stabilized at the target position for trials completed before, during, and after the application of the vibratory stimulus. Prior to vibration, hand position fluctuated as participants attempted to maintain the hand at the target after movement termination. TV improved arm stability, as evidenced by decreased magnitude of hand tangential velocity at the target. Improved stability was accompanied by a decrease in muscle activity throughout the arm as well as a mean decrease in grip pressure. These results suggest that vibratory stimulation of the distal wrist musculature enhances stability of the proximal arm and can be studied further as a mode for improving end-point stability during reaching in hemiparetic patients.

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Thorax without arm. 572.196 Section 572.196... Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Thorax without arm. 572.196 Section 572.196... Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

PubMed

Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

2015-01-01

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome.

PubMed

Chan, Kitty S; Mourtzakis, Marina; Aronson Friedman, Lisa; Dinglas, Victor D; Hough, Catherine L; Ely, E Wesley; Morris, Peter E; Hopkins, Ramona O; Needham, Dale M

2018-04-01

Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

Factors Associated With Anthropometric Indicators of Nutritional Status in Children With Chronic Kidney Disease Undergoing Peritoneal Dialysis, Hemodialysis, and After Kidney Transplant.

PubMed

García De Alba Verduzco, Julieta; Hurtado López, Erika Fabiola; Pontón Vázquez, Consuelo; de la Torre Serrano, Adriana; Romero Velarde, Enrique; Vásquez Garibay, Edgar Manuel

2018-05-11

The objective of the study was to demonstrate that there are differences in the factors associated with anthropometric indicators of nutritional status, with particular emphasis on arm indicators, in children with end-stage kidney disease undergoing peritoneal dialysis (PD), hemodialysis (HD), and after kidney transplant (KT). An analytical cross-sectional study of consecutive cases included 130 children and adolescents with end-stage kidney disease undergoing substitutive treatment: 49 patients who underwent KT, 33 undergoing PD, and 47 undergoing HD. Socioeconomic data were obtained from all the 3 groups; anthropometric indicators of nutritional status were calculated. Student's t-test and analysis of variance were used for parametric variables. Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and odds ratio (OR) were used for nonparametric variables. The number of parents living as couples was higher for patients who underwent KT (OR = 3.5 [95% confidence interval {CI} 1.34-9.0]) and undergoing PD (OR = 3.0 [95% CI 1.06-8.8]) than those undergoing HD. The number of mothers who worked outside the home was higher for patients who underwent KT and undergoing PD than the mothers of patients undergoing HD (OR = 13.7 [95% CI: 4.56-41.05]; OR = 15.4 [CI 95% 4.8-49], respectively). Family income was higher for patients who underwent KT and undergoing PD (P = .019, P = .093, respectively). More than 40% of patients in all the 3 groups had growth impairment. Body mass index, mid-upper arm circumference, tricipital and subscapular skinfolds, total arm area, and arm fat area were affected in HD and PD groups (9 to 40%), while of the patients who underwent KT, 36.7% were overweight or obese. More than 50% of patients who underwent KT and undergoing HD and PD had involvement in the arm muscular area. Socioeconomic conditions are more influential for children in the HD program. The nutritional status of children after KT improves; however, not all anthropometric indicators are fully recovered. Children after KT are up to 9 times more likely to be overweight or obese. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Electrically Stimulated Antagonist Muscle Contraction Increased Muscle Mass and Bone Mineral Density of One Astronaut - Initial Verification on the International Space Station.

PubMed

Shiba, Naoto; Matsuse, Hiroo; Takano, Yoshio; Yoshimitsu, Kazuhiro; Omoto, Masayuki; Hashida, Ryuki; Tagawa, Yoshihiko; Inada, Tomohisa; Yamada, Shin; Ohshima, Hiroshi

2015-01-01

Musculoskeletal atrophy is one of the major problems of extended periods of exposure to weightlessness such as on the International Space Station (ISS). We developed the Hybrid Training System (HTS) to maintain an astronaut's musculoskeletal system using an electrically stimulated antagonist to resist the volitional contraction of the agonist instead of gravity. The present study assessed the system's orbital operation capability and utility, as well as its preventative effect on an astronaut's musculoskeletal atrophy. HTS was attached to the non-dominant arm of an astronaut staying on the ISS, and his dominant arm without HTS was established as the control (CTR). 10 sets of 10 reciprocal elbow curls were one training session, and 12 total sessions of training (3 times per week for 4 weeks) were performed. Pre and post flight ground based evaluations were performed by Biodex (muscle performance), MRI (muscle volume), and DXA (BMD, lean [muscle] mass, fat mass). Pre and post training inflight evaluations were performed by a hand held dynamometer (muscle force) and a measuring tape (upper arm circumference). The experiment was completed on schedule, and HTS functioned well without problems. Isokinetic elbow extension torque (Nm) changed -19.4% in HTS, and -21.7% in CTR. Isokinetic elbow flexion torque changed -23.7% in HTS, and there was no change in CTR. Total Work (Joule) of elbow extension changed -8.3% in HTS, and +0.3% in CTR. For elbow flexion it changed -23.3% in HTS and -32.6% in CTR. Average Power (Watts) of elbow extension changed +22.1% in HTS and -8.0% in CTR. For elbow flexion it changed -6.5% in HTS and -4.8% in CTR. Triceps muscle volume according to MRI changed +11.7% and that of biceps was +2.1% using HTS, however -0.1% and -0.4% respectively for CTR. BMD changed +4.6% in the HTS arm and -1.2% for CTR. Lean (muscle) mass of the arm changed only +10.6% in HTS. Fat mass changed -12.6% in HTS and -6.4% in CTR. These results showed the orbital operation capability and utility, and the preventive effect of HTS for an astronaut's musculoskeletal atrophy. The initial flight data together with the ground data obtained so far will be utilized in the future planning of human space exploration.

Body Composition Predicts Growth in Infants and Toddlers With Chronic Liver Disease.

PubMed

Hurtado-López, Erika F; Vásquez-Garibay, Edgar M; Trujillo, Xóchitl; Larrosa-Haro, Alfredo

2017-12-01

This cross-sectional study was conducted on 15 infants and toddlers with chronic liver disease to validate arm anthropometry as an accurate measure of body composition (BC) compared to dual-energy x-ray absorptiometry and to predict growth from BC. The z score means of the anthropometric indicators were <-2 standard deviation, except for body fat index and subscapular skinfold, which were between -2 and +2 standard deviation. Fat mass was predicted by arm adiposity indicators and fat-free mass by arm muscle area. Bone mineral content explained 87% of variation in length. Two multiple regression models predicted length: 1 with fat mass plus fat-free mass; and the second with fat mass and bone mineral content. These observations suggest that arm anthropometry is a useful tool to estimate BC and the nutritional status in infants and toddlers with chronic liver disease. Length and head circumference can be predicted by fat mass, fat-free mass, and bone mineral content.

World and Olympic mountain bike champions' anthropometry, body composition and somatotype.

PubMed

Sánchez-Muñoz, Cristóbal; Muros, José J; Zabala, Mikel

2018-06-01

The aim of the study was to describe the anthropometric profile of male Olympic cross country (XCO) mountain bikers. Fifty one XCO bikers participated in this study, divided into an elite group who competed in top level international competitions, and a non-elite group who competed at a national level. The elite group was further classified according to whether they had been world or Olympic champion mountain bikers (WOC) or not (NWOC). The anthropometric profiles included the measurements of height, weight, arm span, skinfolds, girths, and breadths. Body Mass Index (BMI), body composition and somatotype were also calculated. Variables was described as mean, standard deviation and range. The standardizing of the variables was carried out using the Shapiro-Wilk with Lillieforts correction and homoscedasticity was analyzed using the Levene Test. After verifying that the variables were normal, the data were analyzed using non-paired t-tests (elite vs. non-elite and WOC vs. NWOC). Elite riders had significantly lower BMI, lower percentage of fat, total thigh area and larger thigh muscle area than the sub-elite riders, and presented significantly lower values for the endomorphic component and higher values for the ectomorphic component. The mean somatotype of the elite riders could be defined as ecto-mesomorphic (1.7-4.6-3.1). Comparisons between of WOC riders and NWOC, showed that the WOC bikers had a significantly higher value for weight, arm span, upper arm girth relaxed and upper arm girth flexed and tensed, calf girth, total upper arm area, and upper arm muscle area than the NWOC riders group.

Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses.

PubMed

Akhtar, Aadeel; Aghasadeghi, Navid; Hargrove, Levi; Bretl, Timothy

2017-08-01

In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R 2 =0.72) and mirrored bilateral (R 2 =0.72) reaches and of forearm pronation/supination during unilateral (R 2 =0.77) and mirrored bilateral (R 2 =0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R 2 =0.82) and mirrored bilateral (R 2 =0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R 2 =0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R 2 =0.88) for these subjects, a contradictory result that merits further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel nonrobotic device: a randomized clinical trial.

PubMed

Barker, Ruth N; Brauer, Sandra G; Carson, Richard G

2008-06-01

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting stroke survivors with severe paresis to practice a constrained reaching task. A single-blind, randomized clinical trial was conducted with 42 stroke survivors with severe and chronic paresis. Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electromyography-triggered electrical stimulation, 13 received training using the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 1-hour sessions over 4 weeks. The primary outcome measure was "upper arm function," item 6 of the Motor Assessment Scale. Secondary outcome measures included impairment measures; triceps muscle strength, reaching force, modified Ashworth scale; and activity measures: reaching distance and Motor Assessment Scale. Assessments were administered before (0 weeks) and after training (4 weeks) and at 2 months follow-up (12 weeks). Both SMART Arm groups demonstrated significant improvements in all impairment and activity measures after training and at follow-up. There was no significant difference between these 2 groups. There was no change in the control group. Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis, highlighting the benefits of intensive task-oriented practice, even in the context of severe paresis.

A pre-post pilot study of peer nutritional counseling and food insecurity and nutritional outcomes among antiretroviral therapy patients in Honduras.

PubMed

Derose, Kathryn P; Felician, Melissa; Han, Bing; Palar, Kartika; Ramírez, Blanca; Farías, Hugo; Martínez, Homero

Food insecurity and poor nutrition are key barriers to anti-retroviral therapy (ART) adherence. Culturally-appropriate and sustainable interventions that provide nutrition counseling for people on ART and of diverse nutritional statuses are needed, particularly given rising rates of overweight and obesity among people living with HIV (PLHIV). As part of scale-up of a nutritional counseling intervention, we recruited and trained 17 peer counselors from 14 government-run HIV clinics in Honduras to deliver nutritional counseling to ART patients using a highly interactive curriculum that was developed after extensive formative research on locally available foods and dietary patterns among PLHIV. All participants received the intervention; at baseline and 2 month follow-up, assessments included: 1) interviewer-administered, in-person surveys to collect data on household food insecurity (15-item scale), nutritional knowledge (13-item scale), dietary intake and diversity (number of meals and type and number of food groups consumed in past 24 hours); and 2) anthropometric measures (body mass index or BMI, mid-upper arm and waist circumferences). We used multivariable linear regression analysis to examine changes pre-post in food insecurity and the various nutritional outcomes while controlling for baseline characteristics and clinic-level clustering. Of 482 participants at baseline, we had complete follow-up data on 356 (74%), of which 62% were women, median age was 39, 34% reported having paid work, 52% had completed primary school, and 34% were overweight or obese. In multivariate analyses adjusting for gender, age, household size, work status, and education, we found that between baseline and follow-up, household food insecurity decreased significantly among all participants (β=-0.47, p<.05) and among those with children under 18 (β=-1.16, p<.01), while nutritional knowledge and dietary intake and diversity also significantly improved, (β=0.88, p<.001; β=0.30, p<.001; and β=0.15, p<.001, respectively). Nutritional status (BMI, mid-arm and waist circumferences) showed no significant changes, but the brief follow-up period may not have been sufficient to detect changes. A peer-delivered nutritional counseling intervention for PLHIV was associated with improvements in dietary quality and reduced food insecurity among a population of diverse nutritional statuses. Future research should examine if such an intervention can improve adherence among people on ART.

Nutritional status and its response to treatment of children, with and without HIV infection, hospitalized for the management of tuberculosis.

PubMed

Schaaf, H Simon; Cilliers, Karien; Willemse, Marianne; Labadarios, Demetre; Kidd, Martin; Donald, Peter R

2012-05-01

The association of childhood tuberculosis (TB) and malnutrition is known, but treatment response, the influence of the acute-phase response (APR) and concomitant HIV infection are not well documented. To evaluate the nutritional response and APR in HIV-infected and uninfected children hospitalised for the treatment of TB and receiving standard anti-tuberculosis chemotherapy. During a study of the pharmacokinetics of standard anti-tuberculosis agents, anthropometric parameters were measured and blood concentrations of nutrients and C-reactive protein (CRP) determined at 1 and 4 months after initiation of chemotherapy. 24 HIV-infected and 34 HIV-uninfected children were studied. On enrollment, 31.6% of HIV-infected and 2.9% of HIV-uninfected children were underweight, and 31.6% and 14.7%, respectively, were stunted. Mean values of weight, height/length, head circumference and mid-upper-arm circumference on enrollment and at 4-month assessment in HIV-infected and uninfected children did not differ. Mean triceps skinfold (TSF) (8.17 and 9.73 cm) and subscapular skinfold (SSF) thicknesses (5.75 and 7.5 cm) on enrollment differed significantly (P = 0.03 and P = 0.003); by 4 months, TSF had declined to 5.97 cm (P<0.001) and 8.87 cm (P = 0.05), respectively, and SSF to 5.57 cm (P = 0.79) and 6.73 cm (P = 0.04); the arm muscle area (AMA) was low in a majority of children on enrollment and remained so at the second assessment. CRP was raised in 66.6% and 53.3% of HIV-infected and -uninfected children on enrollment, but at 4-month assessment was raised in 63.2% and 15.2%, respectively. Other micronutrient and haematological findings probably reflect an APR, but no children had sub-normal zinc or magnesium values; most selenium and vitamin C and E values were normal. An elevated platelet count (> 420 × 10(9)/L) was significantly more common in HIV-uninfected children, and was still raised in 39% at 4 months. A majority of HIV-infected and uninfected children had an APR but it had resolved by 4 months in most HIV-uninfected children. In both groups, low and declining skinfolds and a persistently low AMA indicate a persistent disturbance of fat and protein metabolism, despite successful chemotherapy.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1988-03-15

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, John R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are doweled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

Validation of anthropometry and foot-to-foot bioelectrical resistance against a three-component model to assess total body fat in children: the IDEFICS study.

PubMed

Bammann, K; Huybrechts, I; Vicente-Rodriguez, G; Easton, C; De Vriendt, T; Marild, S; Mesana, M I; Peeters, M W; Reilly, J J; Sioen, I; Tubic, B; Wawro, N; Wells, J C; Westerterp, K; Pitsiladis, Y; Moreno, L A

2013-04-01

To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe. Multicentre validation study. Seventy-eight preschool/school children aged 4-10 years from four different European countries. A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two-six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales. With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height-weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44 kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models. When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91 kg in normal weight children and of 2.94 kg in overweight or obese children.

The Plasma Proteome Is Associated with Anthropometric Status of Undernourished Nepalese School-Aged Children.

PubMed

Lee, Sun Eun; Stewart, Christine P; Schulze, Kerry J; Cole, Robert N; Wu, Lee S-F; Yager, James D; Groopman, John D; Khatry, Subarna K; Adhikari, Ramesh Kant; Christian, Parul; West, Keith P

2017-03-01

Background: Malnutrition affects body growth, size, and composition of children. Yet, few functional biomarkers are known to be associated with childhood morphology. Objective: This cross-sectional study examined associations of anthropometric indicators of height, musculature, and fat mass with plasma proteins by using proteomics in a population cohort of school-aged Nepalese children. Methods: Height, weight, midupper arm circumference (MUAC), triceps and subscapular skinfolds, upper arm muscle area (AMA), and arm fat area (AFA) were assessed in 500 children 6-8 y of age. Height-for-age z scores (HAZs), weight-for-age z scores (WAZs), and body mass index-for-age z scores (BAZs) were derived from the WHO growth reference. Relative protein abundance was quantified by using tandem mass spectrometry. Protein-anthropometry associations were evaluated by linear mixed-effects models and identified as having a false discovery rate ( q ) <5%. Results: Among 982 proteins, 1, 10, 14, and 17 proteins were associated with BAZ, HAZ, MUAC, and AMA, respectively ( q < 0.05). Insulin-like growth factor (IGF)-I, 2 IGF-binding proteins, and carnosinase-1 were associated with both HAZ and AMA. Proteins involved in nutrient transport, activation of innate immunity, and bone mineralization were associated with HAZ. Several extracellular matrix proteins were positively associated with AMA alone. The proteomes of MUAC and AMA substantially overlapped, whereas no proteins were associated with AFA or triceps and subscapular skinfolds. Myosin light-chain kinase, possibly reflecting leakage from muscle, was inversely associated with BAZ. The proteome of WAZ was the largest ( n = 33) and most comprehensive, including proteins involved in neural development and oxidative stress response, among others. Conclusions: Plasma proteomics confirmed known biomarkers of childhood growth and revealed novel proteins associated with lean mass in chronically undernourished children. Identified proteins may serve as candidates for assessing growth and nutritional status of children in similar undernourished settings. The antenatal micronutrient supplementation trial yielding the study cohort of children was registered at clinicaltrials.gov as NCT00115271.

Relationship between performance test and body composition/physical strength characteristic in sprint canoe and kayak paddlers

PubMed Central

Hamano, Saki; Ochi, Eisuke; Tsuchiya, Yosuke; Muramatsu, Erina; Suzukawa, Kazuhiro; Igawa, Shoji

2015-01-01

Objective Canoe sprint is divided into canoe and kayak. The difference between the two competitions is in physical performance. The aim of the present study was to compare and investigate the relationship between physical characteristics and fitness between the two canoe sprint competitors. Methods Subjects were 11 canoe paddlers (C) and 12 kayak paddlers (K). They underwent anthropometric characteristics, body composition and fitness tests, and 120 s all-out tests using a canoe and kayak ergometer. The unpaired t-test was used to test for significant differences between disciplines, while Pearson’s correlation coefficient was used to examine the association between each measurement item and the performance test. Results The age, height, body mass, body mass index, and total body fat were, C: 20.6±0.9 yr, 172.8±5.2 cm, 70.8±7.8 kg, 23.7±1.9, 14.4%±3.5%; and K: 19.7±1.2 yr, 172.8±5.3 cm, 69.5±7.8 kg, 23.2±2.1, 12.1%±3.6%, respectively. No significant differences were seen in any of the items for physical characteristics or fitness between C and K. A correlation analysis of performance tests and each measurement item revealed a positive correlation with low-speed isokinetic knee extension and flexion strength for C only (extension: r=0.761; flexion: r=0.784; P<0.01). In addition, performance tests were positively correlated with the circumference of arm (upper arm: r=0.876; forearm: r=0.820; P<0.01) and lower limb (thigh: r=0.781; calf: r=0.753; P<0.01) in C and with height (r=0.549, P<0.05), arm span (r=0.639, P<0.05), and leg length (r=0.621, P<0.01) in K. Conclusion We suggest that the factors correlating with the performance test differ depending on the competitions. PMID:26150737

Nutritional status among older residents with dementia in open versus special care units in municipal nursing homes: an observational study

PubMed Central

2013-01-01

Background Undernutrition is widespread among institutionalised elderly, and people suffering from dementia are at particularly high risk. Many elderly with dementia live in open units or in special care units in nursing homes. It is not known whether special care units have an effect on the nutritional status of the residents. The aim of this study was therefore to examine the nutritional status of residents with dementia in both open units and in special care units. Methods Among Oslo’s 29 municipal nursing homes, 21 participated with 358 residents with dementia or cognitive impairment, of which 46% lived in special care units. Nutritional status was assessed using the Malnutrition Universal Screening Tool and anthropometry. Results We found no differences (p > 0.05) in risk of undernutrition, body mass index, mid-upper arm muscle circumference or triceps skinfold thickness between residents in open units and those in special care units. Residents in special care units were significantly younger and stronger when measured with a hand-grip test. Conclusions We found no difference in nutritional status between nursing home residents with dementia/cognitive impairment in open units versus in special care units. PMID:23496975

Age of onset, nutritional determinants, and seasonal variations in menarche in rural Bangladesh.

PubMed

Rah, Jee H; Shamim, Abu Ahmed; Arju, Ummeh T; Labrique, Alain B; Rashid, Mahbubur; Christian, Parul

2009-12-01

Menarche is an important milestone in the development of female adolescents. The study assessed the age at menarche using recall, its seasonality, and association with marital and nutritional status (using mid-upper arm circumference [MUAC]) among 3,923 female adolescents aged 12-19 years in a rural area of Bangladesh. At the time of assessment, most (88%) adolescents had attained menarche at the mean (standard deviation [SD]) age of 12.8 (1.4) years. Age of onset of menarche among married adolescents (13%) occurred earlier than in those who were unmarried (12.6 +/- 1.3 years vs 12.9 +/- 1.4 years, p < 0.01). Age at menarche was negatively associated with MUAC after adjusting for age and marital status (beta = -0.10, p < 0.01). More than 50% of the adolescents had an onset of menarche during winter (chi2 = 634.97; p < 0.001), with peaks in December and January. In this rural population, the current age at menarche was found to be slightly lower than the previous estimates of 13.0 years in Bangladesh. An early onset of menarche was associated with season and better nutritional status of the female adolescents and may be associated with early marriage.

Assessment of protein nutritional status in children.

PubMed

Pencharz, Paul B

2008-02-01

When considering the effects of disease on nutritional status it is useful to think of the body consisting of lean mass and fat mass. The latter relates to energy status and the former to protein nutritional status. In addition, childhood growth in length/height is to a high degree dependent upon having an adequate protein intake. If insufficient non-protein energy is fed, then protein is used to help meet energy needs. Hence achieving an optimum protein nutritional status also requires receiving sufficient energy. Assessment of protein nutritional status starts with measurement of length/height and weight in relationship to growth standards. Next comes using mid-upper arm parameters in which the measurement of muscle area or circumference is a reflection of protein nutritional status while triceps skin-fold thickness is a measurement of energy status. Serum albumin remains the number one short term parameter reflecting protein nutritional status followed by serum transferrin. Plasma amino acid profiles can be measured but are mostly dependent on recent dietary intake and so are hard to interpret. Classically, nitrogen balance has been used as a reflection of dietary protein intake. While it has been used extensively on a research basis its clinical applicability is limited. (c) 2007 Wiley-Liss, Inc.

Prevalence and risk factors for scrub typhus in South India.

PubMed

Trowbridge, Paul; P, Divya; Premkumar, Prasanna S; Varghese, George M

2017-05-01

To determine the prevalence and risk factors of scrub typhus in Tamil Nadu, South India. We performed a clustered seroprevalence study of the areas around Vellore. All participants completed a risk factor survey, with seropositive and seronegative participants acting as cases and controls, respectively, in a risk factor analysis. After univariate analysis, variables found to be significant underwent multivariate analysis. Of 721 people participating in this study, 31.8% tested seropositive. By univariate analysis, after accounting for clustering, having a house that was clustered with other houses, having a fewer rooms in a house, having fewer people living in a household, defecating outside, female sex, age >60 years, shorter height, lower weight, smaller body mass index and smaller mid-upper arm circumference were found to be significantly associated with seropositivity. After multivariate regression modelling, living in a house clustered with other houses, female sex and age >60 years were significantly associated with scrub typhus exposure. Overall, scrub typhus is much more common than previously thought. Previously described individual environmental and habitual risk factors seem to have less importance in South India, perhaps because of the overall scrub typhus-conducive nature of the environment in this region. © 2017 John Wiley & Sons Ltd.

Nuclear reactor internals alignment configuration

DOEpatents

Gilmore, Charles B [Greensburg, PA; Singleton, Norman R [Murrysville, PA

2009-11-10

An alignment system that employs jacking block assemblies and alignment posts around the periphery of the top plate of a nuclear reactor lower internals core shroud to align an upper core plate with the lower internals and the core shroud with the core barrel. The distal ends of the alignment posts are chamfered and are closely received within notches machined in the upper core plate at spaced locations around the outer circumference of the upper core plate. The jacking block assemblies are used to center the core shroud in the core barrel and the alignment posts assure the proper orientation of the upper core plate. The alignment posts may alternately be formed in the upper core plate and the notches may be formed in top plate.

Upper extremity sensorimotor control among collegiate football players.

PubMed

Laudner, Kevin G

2012-03-01

Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p < 0.05). The football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.

Forearm versus upper arm grafts for vascular access.

PubMed

Gage, Shawn M; Lawson, Jeffrey H

2017-03-06

Forearm and upper arm arteriovenous grafts perform similarly in terms of patency and complications. Primary patency at 1 year for forearm arteriovenous grafts versus upper arm grafts ranges from 22%-50% versus 22%-42%, and secondary patency at 1 year ranges from 78%-89% versus 52%-67%), respectively. Secondary patency at 2 years, ranges from 30%-64% versus 35%-60% for forearm and upper arteriovenous graft, respectively. Ample pre-operative planning is essential to improved clinical success and the decision to place a graft at one location versus the other should be based solely on previous access history, physical exam, appropriate venous imaging, and other factors that make up the clinical picture. Operative implant strategies and risk of complications are very similar between the two configurations. Postoperative ischemia due to steal syndrome is a potential complication that requires immediate attention. Utilization of the proximal radial or ulnar artery for inflow for the graft can minimize risk of clinically relevant steal syndrome.

The Effect of Restricted Arm Swing on Energy Expenditure in Healthy Men

ERIC Educational Resources Information Center

Yizhar, Ziva; Boulos, Spiro; Inbar, Omri; Carmeli, Eli

2009-01-01

Arm swing in human walking is an active natural motion involving the upper extremities. Earlier studies have described the interrelationship between arms and legs during walking, but the effect of arm swing on energy expenditure and dynamic parameters during normal gait, is inconclusive. The aim of this study was to investigate the effect of…

CT dose modulation using automatic exposure control in whole-body PET/CT: effects of scout imaging direction and arm positioning.

PubMed

Inoue, Yusuke; Nagahara, Kazunori; Kudo, Hiroko; Itoh, Hiroyasu

2018-01-01

Automatic exposure control (AEC) modulates tube current and consequently X-ray exposure in CT. We investigated the behavior of AEC systems in whole-body PET/CT. CT images of a whole-body phantom were acquired using AEC on two scanners from different manufactures. The effects of scout imaging direction and arm positioning on dose modulation were evaluated. Image noise was assessed in the chest and upper abdomen. On one scanner, AEC using two scout images in the posteroanterior (PA) and lateral (Lat) directions provided relatively constant image noise along the z-axis with the arms at the sides. Raising the arms increased tube current in the head and neck and decreased it in the body trunk. Image noise increased in the upper abdomen, suggesting excessive reduction in radiation exposure. AEC using the PA scout alone strikingly increased tube current and reduced image noise in the shoulder. Raising the arms did not substantially influence dose modulation and decreased noise in the abdomen. On the other scanner, AEC using the PA scout alone or Lat scout alone resulted in similar dose modulation. Raising the arms increased tube current in the head and neck and decreased it in the trunk. Image noise was higher in the upper abdomen than in the middle and lower chest, and was not influenced by arm positioning. CT dose modulation using AEC may vary greatly depending on scout direction. Raising the arms tended to decrease radiation exposure; however, the effect depends on scout direction and the AEC system.

Human arm joints reconstruction algorithm in rehabilitation therapies assisted by end-effector robotic devices.

PubMed

Bertomeu-Motos, Arturo; Blanco, Andrea; Badesa, Francisco J; Barios, Juan A; Zollo, Loredana; Garcia-Aracil, Nicolas

2018-02-20

End-effector robots are commonly used in robot-assisted neuro-rehabilitation therapies for upper limbs where the patient's hand can be easily attached to a splint. Nevertheless, they are not able to estimate and control the kinematic configuration of the upper limb during the therapy. However, the Range of Motion (ROM) together with the clinical assessment scales offers a comprehensive assessment to the therapist. Our aim is to present a robust and stable kinematic reconstruction algorithm to accurately measure the upper limb joints using only an accelerometer placed onto the upper arm. The proposed algorithm is based on the inverse of the augmented Jaciobian as the algorithm (Papaleo, et al., Med Biol Eng Comput 53(9):815-28, 2015). However, the estimation of the elbow joint location is performed through the computation of the rotation measured by the accelerometer during the arm movement, making the algorithm more robust against shoulder movements. Furthermore, we present a method to compute the initial configuration of the upper limb necessary to start the integration method, a protocol to manually measure the upper arm and forearm lengths, and a shoulder position estimation. An optoelectronic system was used to test the accuracy of the proposed algorithm whilst healthy subjects were performing upper limb movements holding the end effector of the seven Degrees of Freedom (DoF) robot. In addition, the previous and the proposed algorithms were studied during a neuro-rehabilitation therapy assisted by the 'PUPArm' planar robot with three post-stroke patients. The proposed algorithm reports a Root Mean Square Error (RMSE) of 2.13cm in the elbow joint location and 1.89cm in the wrist joint location with high correlation. These errors lead to a RMSE about 3.5 degrees (mean of the seven joints) with high correlation in all the joints with respect to the real upper limb acquired through the optoelectronic system. Then, the estimation of the upper limb joints through both algorithms reveal an instability on the previous when shoulder movement appear due to the inevitable trunk compensation in post-stroke patients. The proposed algorithm is able to accurately estimate the human upper limb joints during a neuro-rehabilitation therapy assisted by end-effector robots. In addition, the implemented protocol can be followed in a clinical environment without optoelectronic systems using only one accelerometer attached in the upper arm. Thus, the ROM can be perfectly determined and could become an objective assessment parameter for a comprehensive assessment.

The effects of virtual reality-based bilateral arm training on hemiplegic children's upper limb motor skills.

PubMed

Do, Ji-Hye; Yoo, Eun-Young; Jung, Min-Ye; Park, Hae Yean

2016-01-01

Hemiplegic cerebral palsy is a neurological symptom appearing on the unilateral arm and leg of the body that causes affected upper/lower limb muscle weakening and dysesthesia and accompanies tetany and difficulties in postural control due to abnormal muscle tone, and difficulties in body coordination. The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability. The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs. The study's results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after completion of the intervention, during the baseline regression period, revealed that upper limb motor skills on the affected side and bilateral coordination ability were better than in the baseline period for all subjects. This study confirmed that for children with hemiplegic with cerebral palsy, bilateral arm training based on virtual reality can be an effective intervention method for enhancing the upper limb motor skills on the affected side, as well as bilateral coordination ability.

Does lower birth order amplify the association between high socioeconomic status and central adiposity in young adult Filipino males?

PubMed

Dahly, D L; Adair, L S

2010-04-01

To test the hypothesis that lower birth order amplifies the positive association between socioeconomic status and central adiposity in young adult males from a lower income, developing country context. The Cebu Longitudinal Health and Nutrition Survey is an ongoing community-based, observational study of a 1-year birth cohort (1983). 970 young adult males, mean age 21.5 years (2005). Central adiposity measured by waist circumference; birth order; perinatal maternal characteristics including height, arm fat area, age and smoking behavior; socioeconomic status at birth and in young adulthood. Lower birth order was associated with higher waist circumference and increased odds of high waist circumference, even after adjustment for socioeconomic status in young adulthood and maternal characteristics that could impact later offspring adiposity. Furthermore, the positive association between socioeconomic status and central adiposity was amplified in individuals characterized by lower birth order. This research has failed to reject the mismatch hypothesis, which posits that maternal constraint of fetal growth acts to program developing physiology in a manner that increases susceptibility to the obesogenic effects of modern environments.

Body composition of obese adolescents: association between adiposity indicators and cardiometabolic risk factors.

PubMed

Araújo, A J S; Santos, A C O; Prado, W L

2017-04-01

The association between obesity during adolescence and the increased risk of cardiometabolic diseases indicates the need to identify reproducible and cost effective methods for identifying individuals who are at increased risk of developing diseases. The present cross-sectional study investigated the occurrence of metabolic consequences of obesity in adolescents and the use of adiposity indicators as predictors of cardiometabolic risk. A fasting blood sample was taken in 93 pubertal obese adolescents aged 13-18 years old (39 males, 54 females) for the assessment of cardiometabolic risk markers (glucose, lipid profiles, insulin resistence, and inflammatory and endothelial dysfunction markers). Together with anthropometry, total fat mass and lean mass were determined by dual-energy X-ray absorptiometry (DXA). The prevalence of dyslipidaemia and disorders in glucose metabolism are noticeably higher in the present study. There was no correlation between the percentage of body fat according to DXA and most indicators of adiposity. For boys, the arm circumference values predicted the increase in fasting insulin (r² = 0.200), homeostasis model assessment of insulin resistance (r² = 0.267) and cardiometabolic risk score (r² = 0.338). The percentage of body fat according to DXA predicted the inflammation score (r² = 0.172). For girls, body mass index was the parameter that best described the variability of fasting insulin (r² = 0.079) and inflammation score (r² = 0.263). The waist-to-stature ratio was able to predict the triglyceride values (r² = 0.090). Anthropometric measures of adiposity, such a body mass index, waist-to-stature ratio, arm circumference and waist circumference,should be considered in the clinical evaluation of obese adolescents. © 2016 The British Dietetic Association Ltd.

Development of a parent‐reported questionnaire evaluating upper limb activity limitation in children with cerebral palsy

PubMed Central

Preston, N.; Levesley, M.; Mon‐Williams, M.; O'Connor, R.J.

2017-01-01

Abstract Background and purpose Upper limb activity measures for children with cerebral palsy have a number of limitations, for example, lack of validity and poor responsiveness. To overcome these limitations, we developed the Children's Arm Rehabilitation Measure (ChARM), a parent‐reported questionnaire validated for children with cerebral palsy aged 5–16 years. This paper describes both the development of the ChARM items and response categories and its psychometric testing and further refinement using the Rasch measurement model. Methods To generate valid items for the ChARM, we collected goals of therapy specifically developed by therapists, children with cerebral palsy, and their parents for improving activity limitation of the upper limb. The activities, which were the focus of these goals, formed the basis for the items. Therapists typically break an activity into natural stages for the purpose of improving activity performance, and these natural orders of achievement formed each item's response options. Items underwent face validity testing with health care professionals, parents of children with cerebral palsy, academics, and lay persons. A Rasch analysis was performed on ChARM questionnaires completed by the parents of 170 children with cerebral palsy from 12 hospital paediatric services. The ChARM was amended, and the procedure repeated on 148 ChARMs (from children's mean age: 10 years and 1 month; range: 4 years and 8 months to 16 years and 11 months; 85 males; Manual Ability Classification System Levels I = 9, II = 26, III = 48, IV = 45, and V = 18). Results The final 19‐item unidimensional questionnaire displayed fit to the Rasch model (chi‐square p = .18), excellent reliability (person separation index = 0.95, α = 0.95), and no floor or ceiling effects. Items showed no response bias for gender, distribution of impairment, age, or learning disability. Discussion The ChARM is a psychometrically sound measure of upper limb activity validated for children with cerebral palsy aged 5–16 years. The ChARM is freely available for use to clinicians and nonprofit organisations. PMID:28112465

Upper arm elevation and repetitive shoulder movements: a general population job exposure matrix based on expert ratings and technical measurements.

PubMed

Dalbøge, Annett; Hansson, Gert-Åke; Frost, Poul; Andersen, Johan Hviid; Heilskov-Hansen, Thomas; Svendsen, Susanne Wulff

2016-08-01

We recently constructed a general population job exposure matrix (JEM), The Shoulder JEM, based on expert ratings. The overall aim of this study was to convert expert-rated job exposures for upper arm elevation and repetitive shoulder movements to measurement scales. The Shoulder JEM covers all Danish occupational titles, divided into 172 job groups. For 36 of these job groups, we obtained technical measurements (inclinometry) of upper arm elevation and repetitive shoulder movements. To validate the expert-rated job exposures against the measured job exposures, we used Spearman rank correlations and the explained variance[Formula: see text] according to linear regression analyses (36 job groups). We used the linear regression equations to convert the expert-rated job exposures for all 172 job groups into predicted measured job exposures. Bland-Altman analyses were used to assess the agreement between the predicted and measured job exposures. The Spearman rank correlations were 0.63 for upper arm elevation and 0.64 for repetitive shoulder movements. The expert-rated job exposures explained 64% and 41% of the variance of the measured job exposures, respectively. The corresponding calibration equations were y=0.5%time+0.16×expert rating and y=27°/s+0.47×expert rating. The mean differences between predicted and measured job exposures were zero due to calibration; the 95% limits of agreement were ±2.9% time for upper arm elevation >90° and ±33°/s for repetitive shoulder movements. The updated Shoulder JEM can be used to present exposure-response relationships on measurement scales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Upper limb discomfort profile due to intermittent isometric pronation torque at different postural combinations of the shoulder-arm system.

PubMed

Mukhopadhyay, Prabir; O'Sullivan, Leonard W; Gallwey, Timothy J

2009-05-01

Twenty-seven right-handed male university students participated in this study, which comprised a full factorial model consisting of three forearm rotation angles (60% prone and supine and neutral range of motion), three elbow angles (45 degrees , 90 degrees and 135 degrees ), three upper arm angles (45 degrees flexion/extension and neutral), one exertion frequency (15 per min) and one level of pronation torque (20% maximum voluntary contraction (MVC) relative to MVC at each articulation). Discomfort rating after the end of each 5 min treatment was recorded on a visual analogue scale. Results of a repeated measures analysis of covariance on discomfort score, with torque endurance time as covariate, indicated that none of the factors was significant including torque endurance time (p = 0.153). An initial data collection phase preceded the main experiment in order to ensure that participants exerted exactly 20% MVC of the particular articulation. In this phase MVC pronation torque was measured at each articulation. The data revealed a significant forearm rotation angle effect (p = 0.001) and participant effect (p = 0.001). Of the two-way interactions, elbow*participant (p = 0.004), forearm*participant (p = 0.001) and upper arm*participant (p = 0.005) were the significant factors. Electromyographic activity of the pronator teres and biceps brachii muscles revealed no significant change in muscle activity in most of the articulations. Industrial jobs involving deviated upper arm postures are typical in industry but have a strong association with injury. Data from this study will enable better understanding of the effects of deviated upper arm postures on musculoskeletal disorders and can also be used to identify and control high-risk tasks in industry.

The development of an arm activity survey for breast cancer survivors using the Protection Motivation Theory

PubMed Central

Lee, Teresa S; Kilbreath, Sharon L; Sullivan, Gerard; Refshauge, Kathryn M; Beith, Jane M

2007-01-01

Background Current research evidence indicates that women should return to normal use of their arm after breast cancer surgery. However, it appears some women continue to hold the view that they are supposed to protect their arm from strenuous activities because of the risk of lymphoedema. Many factors contribute to women's perceptions about lymphoedema and their ability to use their affected arm, and it is the aim of this study to explore and understand these perceptions. Methods/design A survey, based on the Protection Motivation Theory, has been developed and tested. The survey assesses whether subjective norms, fear and/or coping attributes predict women's intention to use their affected arm. In addition, the survey includes questions regarding cancer treatment and demographic characteristics, arm and chest symptoms, and arm function. Recruitment of 170 breast cancer survivors has begun at 3 cancer treatment sites in Sydney, Australia. Discussion This study will identify perceptions that help predict the extent women use their affected arm. The results will also determine whether upper limb impairments arise secondary to over-protection of the affected arm. Identification of factors that limit arm use will enable appropriate prevention and better provision of treatment to improve upper limb outcomes. PMID:17488497

Everyday movement and use of the arms: Relationship in children with hemiparesis differs from adults.

PubMed

Sokal, Brad; Uswatte, Gitendra; Vogtle, Laura; Byrom, Ezekiel; Barman, Joydip

2015-01-01

In adults with hemiparesis amount of movement of the more-affected arm is related to its amount of use in daily life. In children, little is known about everyday arm use. This report examines the relationships between everyday movement of the more-affected arm and its (a) everyday use and (b) motor capacity in children with hemiparesis. Participants were 28 children with a wide range of upper-extremity hemiparesis subsequent to cerebral palsy due to pre- or peri-natal stroke. Everyday movement of the more-affected arm was assessed by putting accelerometers on the children's forearms for three days. Everyday use of that arm and its motor capacity were assessed with the Pediatric Motor Activity Log-Revised and Pediatric Arm Function Test, respectively. Intensity of everyday movement of the more-affected arm was correlated with its motor capacity (rs ≥ 0.52, ps ≤ 0.003). However, everyday movement of that arm was not correlated with its everyday use (rs ≤ 0.30, ps ≥ $ 0.126). In children with upper-extremity hemiparesis who meet the study intake criteria amount of movement of the more-affected arm in daily life is not related to its amount to use, suggesting that children differ from adults in this respect.

[Nutritional status of urban and rural Chilean school children of the metropolitan area].

PubMed

Ivanović, R; Olivares, M; Ivanović, D

1990-01-01

The objective of this study was to assess the nutritional status of chilean students by geographic area. In this respect, a representative sample of 4,509 students from elementary and high school was chosen from the Metropolitan Region of Chile (representative of 38.0% of chilean school population). Nutritional status was assessed through anthropometric measurements. Percent weight for age (% W/A), height for age (% H/A) and weight for height (% W/H) were compared with WHO standard; head circumference for age (% HC/A) with Tanner standard; arm circumference for age (% AC/A), triceps skinfold for age (% TS/A), arm muscle area for age (% AMA/A) and arm fat area/age (% AFA/A) with Frisancho norms. Socioeconomic status (SES) was measured through Graffar modified scale. Percent W/H is a better indicator of nutritional status due to growth failure which was thus detected in 27.6% of the whole sample (24.2% and 46.8%, respectively, in urban and rural area, p less than 0.001). According to % W/H, the frequencies of obesity were 13.4% and 10.5%, and those for undernutrition 5.7% and 8.2%, in urban and rural area, respectively, (p less than 0.05). Students from rural area showed significantly lower values for % HC/A, % AC/A, % TS/A and % AFA/A (p less than 0.001). There were no differences for % AMA/A. The fact that 90.5% of rural students belong to low SES must be taken into account to explain differences in the nutritional status of students of different geographic areas.

CUTOFF POINT OF THE PHASE ANGLE IN PRE-RADIOTHERAPY CANCER PATIENTS.

PubMed

Souza Thompson Motta, Rachel; Alves Castanho, Ivany; Guillermo Coca Velarde, Luis

2015-11-01

malnutrition is a common complication for cancer patients. The phase angle (PA), direct measurement of bioelectrical impedance analysis (BIA), has been considered a predictor of body cell mass and prognostic indicator. Cutoff points for phase angle (PA) associated with nutritional risk in cancer patients have not been determined yet. assess the possibility of determining the cutoff point for PA to identify nutritional risk in pre-radiotherapy cancer patients. sample group: Patients from both genders diagnosed with cancer and sent for ambulatory radiotherapy. body mass index (BMI), percentage of weight loss (% WL), mid-arm circumference (MAC), triceps skinfold thickness (TST), mid-arm muscle circumference (MAMC), mid-arm muscle area (MAMA), score and categorical assessment obtained using the Patient-Generated Subjective Global Assessment (PG-SGA) form, PA and standardized phase angle (SPA). Kappa coefficient was used to test the degree of agreement between the diagnoses of nutritional risk obtained from several different methods of nutritional assessment. Cutoff points for the PA through anthropometric indicators and PG-SGA were determined by using Receiver Operating Characteristic (ROC) curves, and patient survival was analyzed with the Cox regression method. the cutoff points with the greatest discriminatory power were those obtained from BMI (5.2) and the categorical assessment of PG-SGA (5.4). The diagnosis obtained using these cutoff points showed a significant association with risk of death for the patients in the sample group. we recommend using the cutoff point 5.2 for the PA as a criterion for identifying nutritional risk in pre-radiotherapy cancer patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Effect of memantine on C-reactive protein and lipid profiles in bipolar disorder.

PubMed

Chang, Hui Hua; Chen, Po See; Wang, Tzu-Yun; Lee, Sheng-Yu; Chen, Shiou-Lan; Huang, San-Yuan; Hong, Jau-Shyong; Yang, Yen Kuang; Lu, Ru-Band

2017-10-15

Balance in the immune system plays roles in bipolar disorder (BD) and its metabolic co-morbidities. Memantine is an NMDA receptor antagonist with anti-inflammatory effects. However, the effects of memantine adjunct treatment on metabolic status of BD are unclear. During the 12 weeks period, a total of 191 BD patients were enrolled and split into valproate (VPA) + placebo and VPA + memantine (5mg/day) arms. The fasting plasma levels of high-sensitivity C-reactive protein (CRP) and metabolic indices were assessed. BD patients were stratified according to their initial CRP level. A cut-off value of initial CRP level of 2322ng/mL discriminated the waist circumference in these BD patients after 12-week VPA treatment. In the high CRP (> 2322ng/mL) group, patients in the VPA + memantine arm had a significantly decreased in their CRP (p= 0.009), total cholesterol (p= 0.002), LDL (p= 0.002) levels, BMI (p= 0.001), and waist circumference (p< 0.001), compared to those in the VPA + placebo arm. However, analysis of the low CRP group did not showed the effect. We recruited BD patients in depressed states and the sample size was relative small. The effects of the fixed dose of memantine on metabolic indices were 12-week follow up in BD patients treated with VPA. BD patients with high initial CRP levels receiving memantine adjunct treatment have a reduced risk of inflammation and metabolic imbalance. Prospective studies are needed to confirm the long-term outcome for memantine adjunct therapy in BD patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Robot-Assisted Therapy for the Upper Limb After Stroke.

PubMed

Veerbeek, Janne M; Langbroek-Amersfoort, Anneli C; van Wegen, Erwin E H; Meskers, Carel G M; Kwakkel, Gert

2017-02-01

Robot technology for poststroke rehabilitation is developing rapidly. A number of new randomized controlled trials (RCTs) have investigated the effects of robot-assisted therapy for the paretic upper limb (RT-UL). To systematically review the effects of poststroke RT-UL on measures of motor control of the paretic arm, muscle strength and tone, upper limb capacity, and basic activities of daily living (ADL) in comparison with nonrobotic treatment. Relevant RCTs were identified in electronic searches. Meta-analyses were performed for measures of motor control (eg, Fugl-Meyer Assessment of the arm; FMA arm), muscle strength and tone, upper limb capacity, and basic ADL. Subgroup analyses were applied for the number of joints involved, robot type, timing poststroke, and treatment contrast. Forty-four RCTs (N = 1362) were included. No serious adverse events were reported. Meta-analyses of 38 trials (N = 1206) showed significant but small improvements in motor control (~2 points FMA arm) and muscle strength of the paretic arm and a negative effect on muscle tone. No effects were found for upper limb capacity and basic ADL. Shoulder/elbow robotics showed small but significant effects on motor control and muscle strength, while elbow/wrist robotics had small but significant effects on motor control. RT-UL allows patients to increase the number of repetitions and hence intensity of practice poststroke, and appears to be a safe therapy. Effects on motor control are small and specific to the joints targeted by RT-UL, whereas no generalization is found to improvements in upper limb capacity. The impact of RT-UL started in the first weeks poststroke remains unclear. These limited findings could mainly be related to poor understanding of robot-induced motor learning as well as inadequate designing of RT-UL trials, by not applying an appropriate selection of stroke patients with a potential to recovery at baseline as well as the lack of fixed timing of baseline assessments and using an insufficient treatment contrast early poststroke.

A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study

PubMed Central

Mramba, Lazarus; Ngari, Moses; Mwangome, Martha; Muchai, Lilian; Bauni, Evasius; Walker, A Sarah; Gibb, Diana M; Fegan, Gregory

2017-01-01

Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality. Design Growth curve construction and longitudinal cohort study. Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe. Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year. Main outcome measures Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores. Results The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of −2 to −3 and less than−3, compared with −2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval −0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002). Conclusions The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research. PMID:28774873

Numerical analysis of stress distribution in the upper arm tissues under an inflatable cuff: Implications for noninvasive blood pressure measurement

NASA Astrophysics Data System (ADS)

Deng, Zhipeng; Liang, Fuyou

2016-10-01

An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement. However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element (FE) models were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evidence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm surface and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In particular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pressure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.

Piezoelectric micromotor using a metal-ceramic composite structure.

PubMed

Koc, B; Bouchilloux, P; Uchino, K

2000-01-01

This paper presents a new piezoelectric micromotor design, in which a uniformly electroded piezoelectric ring bonded to a metal ring is used as the stator. Four inward arms at the inner circumference of the metal ring transfer radial displacements into tangential displacements. The rotor ends in a truncated cone shape and touches the tips of the arms. A rotation takes place by exciting coupled modes of the stator element, such as a radial mode and a second bending mode of the arms. The behavior of the free stator was analyzed using the ATILA finite element software. Torque vs. speed relationship was measured from the transient speed change with a motor load. A starting torque of 17 microNm was obtained at 20 Vrms. The main features of this motor are low cost and easy assembly because of a simple structure and small number of components.

Vibrations transmitted from human hands to upper arm, shoulder, back, neck, and head.

PubMed

Xu, Xueyan S; Dong, Ren G; Welcome, Daniel E; Warren, Christopher; McDowell, Thomas W; Wu, John Z

2017-12-01

Some powered hand tools can generate significant vibration at frequencies below 25 Hz. It is not clear whether such vibration can be effectively transmitted to the upper arm, shoulder, neck, and head and cause adverse effects in these substructures. The objective of this study is to investigate the vibration transmission from the human hands to these substructures. Eight human subjects participated in the experiment, which was conducted on a 1-D vibration test system. Unlike many vibration transmission studies, both the right and left hand-arm systems were simultaneously exposed to the vibration to simulate a working posture in the experiment. A laser vibrometer and three accelerometers were used to measure the vibration transmitted to the substructures. The apparent mass at the palm of each hand was also measured to help in understanding the transmitted vibration and biodynamic response. This study found that the upper arm resonance frequency was 7-12 Hz, the shoulder resonance was 7-9 Hz, and the back and neck resonances were 6-7 Hz. The responses were affected by the hand-arm posture, applied hand force, and vibration magnitude. The transmissibility measured on the upper arm had a trend similar to that of the apparent mass measured at the palm in their major resonant frequency ranges. The implications of the results are discussed. Musculoskeletal disorders (MSDs) of the shoulder and neck are important issues among many workers. Many of these workers use heavy-duty powered hand tools. The combined mechanical loads and vibration exposures are among the major factors contributing to the development of MSDs. The vibration characteristics of the body segments examined in this study can be used to help understand MSDs and to help develop more effective intervention methods.

Vibrations transmitted from human hands to upper arm, shoulder, back, neck, and head

PubMed Central

Xu, Xueyan S.; Dong, Ren G.; Welcome, Daniel E.; Warren, Christopher; McDowell, Thomas W.; Wu, John Z.

2016-01-01

Some powered hand tools can generate significant vibration at frequencies below 25 Hz. It is not clear whether such vibration can be effectively transmitted to the upper arm, shoulder, neck, and head and cause adverse effects in these substructures. The objective of this study is to investigate the vibration transmission from the human hands to these substructures. Eight human subjects participated in the experiment, which was conducted on a 1-D vibration test system. Unlike many vibration transmission studies, both the right and left hand-arm systems were simultaneously exposed to the vibration to simulate a working posture in the experiment. A laser vibrometer and three accelerometers were used to measure the vibration transmitted to the substructures. The apparent mass at the palm of each hand was also measured to help in understanding the transmitted vibration and biodynamic response. This study found that the upper arm resonance frequency was 7–12 Hz, the shoulder resonance was 7–9 Hz, and the back and neck resonances were 6–7 Hz. The responses were affected by the hand-arm posture, applied hand force, and vibration magnitude. The transmissibility measured on the upper arm had a trend similar to that of the apparent mass measured at the palm in their major resonant frequency ranges. The implications of the results are discussed. Relevance to industry Musculoskeletal disorders (MSDs) of the shoulder and neck are important issues among many workers. Many of these workers use heavy-duty powered hand tools. The combined mechanical loads and vibration exposures are among the major factors contributing to the development of MSDs. The vibration characteristics of the body segments examined in this study can be used to help understand MSDs and to help develop more effective intervention methods. PMID:29123326

Factors Predictive of Improved Abdominal Ultrasound Visualization after Oral Administration of Simethicone.

PubMed

Marsico, Maria; Gabbani, Tommaso; Casseri, Tommaso; Biagini, Maria Rosa

2016-11-01

Ultrasonography is a non-invasive, accurate and low-cost technique used to study the upper abdomen, but it has reduced reliability in the study of the pancreas and retroperitoneum. Simethicone is a well-known emulsifying agent that has been used to improve ultrasonographic visualization. The aim of this study was to identify anthropometric parameters that are able to predict a good response to simethicone in improving ultrasonographic visualization of abdominal structures. One hundred twenty-seven patients were recruited. After basal examination, their anthropometric parameters were collected. Patients with an incomplete upper abdominal examination because of gastrointestinal gas have greater body mass index, waist circumference and abdominal wall thickness. In our study, the best anthropometric parameter for identifying patients with poor visualization at abdominal ultrasound examination is waist circumference. Using a cutoff of 84 cm, we can identify patients with poor visibility at abdominal ultrasound examination (group B) with a sensitivity of 90%. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

PubMed Central

Geroin, Christian; Bortolami, Marta; Saltuari, Leopold; Manganotti, Paolo

2018-01-01

Background Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood. Objective To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients. Methods In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges. Results Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1 and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0. Conclusions A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network. PMID:29780410

Effectiveness of Functional Electrical Stimulation in Improving Clinical Outcomes in the Upper Arm following Stroke: A Systematic Review and Meta-Analysis

PubMed Central

Vafadar, Amir K.; Côté, Julie N.; Archambault, Philippe S.

2015-01-01

Background. Different therapeutic methods are being used to prevent or decrease long-term impairments of the upper arm in stroke patients. Functional electrical stimulation (FES) is one of these methods, which aims to stimulate the nerves of the weakened muscles so that the resulting muscle contractions resemble those of a functional task. Objectives. The objective of this study was to review the evidence for the effect of FES on (1) shoulder subluxation, (2) pain, and (3) upper arm motor function in stroke patients, when added to conventional therapy. Methods. From the 727 retrieved articles, 10 (9 RCTs, 1 quasi-RCT) were selected for final analysis and were rated based on the PEDro (Physiotherapy Evidence Database) scores and the Sackett's levels of evidence. A meta-analysis was performed for all three considered outcomes. Results. The results of the meta-analyses showed a significant difference in shoulder subluxation in experimental groups compared to control groups, only if FES was applied early after stroke. No effects were found on pain or motor function outcomes. Conclusion. FES can be used to prevent or reduce shoulder subluxation early after stroke. However, it should not be used to reduce pain or improve upper arm motor function after stroke. PMID:25685805

Quantifying anti-gravity torques for the design of a powered exoskeleton.

PubMed

Ragonesi, Daniel; Agrawal, Sunil K; Sample, Whitney; Rahman, Tariq

2013-03-01

Designing an upper extremity exoskeleton for people with arm weakness requires knowledge of the joint torques due to gravity and joint stiffness, as well as, active residual force capabilities of users. The objective of this research paper is to describe the characteristics of the upper limb of children with upper limb impairment. This paper describes the experimental measurements of the torque on the upper limb due to gravity and joint stiffness of three groups of subjects: able-bodied adults, able-bodied children, and children with neuromuscular disabilities. The experiment involves moving the arm to various positions in the sagittal plane and measuring the resultant force at the forearm. This force is then converted to torques at the elbow and shoulder. These data are compared to a two-link lumped mass model based on anthropomorphic data. Results show that the torques based on anthropometry deviate from experimentally measured torques as the arm goes through the range. Subjects with disabilities also maximally pushed and pulled against the force sensor to measure maximum strength as a function of arm orientation. For all subjects, the maximum voluntary applied torque at the shoulder and elbow in the sagittal plane was found to be lower than gravity torques throughout the disabled subjects' range of motion. This experiment informs designers of upper limb orthoses on the contribution of passive human joint torques due to gravity and joint stiffness and the strength capability of targeted users.

Cut-off of anthropometry measurement and nutritional status among elderly outpatient in Indonesia: multi-centre study.

PubMed

Setiati, Siti; Istanti, Rahmi; Andayani, Rejeki; Kuswardhani, R A Tuty; Aryana, I G P Suka; Putu, I Dewa; Apandi, M; Ichwani, Jusri; Soewoto, Sumarmi; Dinda, Rose; Mustika, Syifa

2010-10-01

To obtain the cut-off value of anthropometric measurements and nutritional status of elderly in Indonesia. A multicentre-cross sectional study was performed at 9 hospitals in Indonesia. The data collected comprises of samples characteristics, anthropometric measurements (weight, height, trisep, bisep, subscapular, suprailiac, and circumference of the hip, waist, arm, calf, and thigh), albumin value, MNA score and ADL Index of Barthel. A total of 702 subjects were collected. The average value of serum albumin is 4.28 g/dl, with 98% subjects had normal serum albumin (> 3.5 g/dl). The mean MNA score and BMI was 23.07 and 22.54 respectively. Most of subjects (56.70%) had risk of malnutrition based on MNA score, and 45.01% had normal nutritional status based on body mass index. Average value of several anthropometric measures (weight, stature, and body mass index; sub-scapular and supra-iliac skinfolds; thigh, calf, mid-arm, and waist circumferences) in various age groups in both groups of women and men were obtained. Cut-off values of various anthropometric indicators were also analyzed in this study with MNA as a gold standard. This study showed age related anthropometric measurement differences in both men and women aged 60 years and older.

The nutritional status of hospitalized children: Has this subject been overlooked?

PubMed

Kapçı, Nermin; Akçam, Mustafa; Koca, Tuğba; Dereci, Selim; Kapcı, Mücahit

2015-07-01

To determine the nutritional status of hospitalized children at the time of admission and to investigate the relationship between diagnosis and nutritional status. Body weight, height, triceps skinfold thickness, and mid-arm circumference were measured on admission and percentages of weight-for-age, weight-for-height, body mass index, mid-arm circumference, and triceps skinfold thickness were calculated. The nutritional status was evaluated using the Waterlow, Gomez, and other anthropometric assessments. A total of 511 patients were included in the study with a mean age of 5.8±4.9 years. Malnutrition was determined in 52.7% of patients according to the Waterlow classification. Mild malnutrition was determined in 39%, moderate in 12%, and severe in 1.7%, with the characteristics of acute malnutrition in 23.9%, acute-chronic in 7.3%, and chronic in 21.5%. The highest rate of malnutrition was in the 0-2 years age group (62.3%). According to the Gomez classification, malnutrition rate was determined as 46.8%. The rates of malnutrition in malignant, gastrointestinal, and infectious diseases were 60%, 59.8%, and 54.5%, respectively. The prevalence of malnutrition in hospitalized children was noticeably high. The nutritional evaluation of all patients and an early start to nutritional support could provide a significant positive contribution.

Effects of an antenatal dietary intervention on maternal anthropometric measures in pregnant women with obesity

PubMed Central

Kannieappan, Lavern M.; Grivell, Rosalie M.; Deussen, Andrea R.; Moran, Lisa J.; Yelland, Lisa N.; Owens, Julie A.

2015-01-01

Objective The effect of providing antenatal dietary and lifestyle advice on secondary measures of maternal anthropometry was evaluated and their correlation with both gestational weight gain and infant birth weight was assessed. Methods In a multicenter, randomized controlled trial, pregnant women with BMI of ≥25 kg/m2 received either Lifestyle Advice or Standard Care. Maternal anthropometric outcomes included arm circumference, biceps, triceps, and subscapular skinfold thickness measurements (SFTM), percentage body fat (BF), gestational weight gain, and infant birth weight. The intention to treat principles were utilized by the analyses. Results The measurements were obtained from 807 (74.7%) women in the Lifestyle Advice Group and 775 (72.3%) women in the Standard Care Group. There were no statistically significant differences identified between the treatment groups with regards to arm circumference, biceps, triceps, and subscapular SFTM, or percentage BF at 36‐week gestation. Maternal anthropometric measurements were not significantly correlated with either gestational weight gain or infant birth weight. Conclusions Among pregnant women with a BMI of ≥25 kg/m2, maternal SFTM were not modified by an antenatal dietary and lifestyle intervention. Furthermore, maternal SFTM correlate poorly with both gestational weight gain and infant birth weight. PMID:26175260

[Nutritional status of school children from indigenous and non indigenous ancestry].

PubMed

Amigo, H; Bustos, P; Erazo, M; Radrigán, M E

1999-08-01

The few studies in Chile assessing the nutritional status of indigenous children show a high prevalence of stunting, excess weight and feeding problems. To compare anthropometric indices in children from indigenous and non indigenous ancestry. School children aged 6 to 8 years old, living in locations with three clear cut levels of social vulnerability were studied. Children were considered indigenous if their last names, as well as those of their parents were of Mapuche origin. Non indigenous were those whose last names were of Spanish origin. Four hundred and fifty indigenous and 684 non indigenous children were studied. Indigenous children from high vulnerability communities were approximately 0.5 z score shorter than those of non indigenous origin. Heights of indigenous and non indigenous children were similar in communities with intermediate and low social vulnerability. The proportion of the lower segment followed the same trend. Weight/height ratios were higher among indigenous children in the three vulnerability levels. Among indigenous children coming from areas of low vulnerability arm circumference was 1 cm broader than that of their non indigenous counterparts. Stunting is prevalent among school children from areas of high socioeconomic vulnerability, mainly rural, and independent from ethnicity. Among indigenous school children overweight and a broader arm circumference are frequent. These results urgently call for located and specific nutrition interventions.

Interarm blood pressure difference and target organ damage in the general population.

PubMed

Johansson, Jouni K; Puukka, Pauli J; Jula, Antti M

2014-02-01

The objective of the study was to investigate interarm differences of blood pressure (BP) and its determinants, and to clarify whether both arms are equally good in assessing BP and target organ damage in the general population. We studied a representative sample of Finnish adult population with 484 study participants, ages 25-74 years. BP was measured twice by an oscillometric monitor simultaneously on both arms. Study participants underwent a clinical examination including measurements of serum lipids, glucose and indicators of target organ damage. BP was 2.3/0.2 mmHg higher on right than on left arm (P < 0.001/P = 0.15 for SBP/DBP differences). SBP and DBP measured on right and left arms correlated equally with left ventricular mass index (LVMI), interventricular septal thickness (IVST), posterior wall thickness (PWT), pulse wave velocity (PWV) and albuminuria. Higher SBP level was an independent determinant of both greater systolic and diastolic interarm BP difference. Exaggerated absolute diastolic interarm BP difference (>5 mmHg) was associated with higher BMI, arm circumference, LVMI, IVST and PWT, whereas exaggerated absolute systolic interarm BP difference (>10 mmHg) was not associated with any clinical variables. There was only a small difference in BP between arms in a healthy general population. Both arms are equally good determinants of target organ damage. BP should be measured at least once on both arms and prefer the arm with higher BP readings in the future BP measurements.

The effect of arm support combined with rehabilitation games on upper-extremity function in subacute stroke: a randomized controlled trial.

PubMed

Prange, Gerdienke B; Kottink, Anke I R; Buurke, Jaap H; Eckhardt, Martine M E M; van Keulen-Rouweler, Bianca J; Ribbers, Gerard M; Rietman, Johan S

2015-02-01

Use of rehabilitation technology, such as (electro)mechanical devices or robotics, could partly relieve the increasing strain on stroke rehabilitation caused by an increasing prevalence of stroke. Arm support (AS) training showed improvement of unsupported arm function in chronic stroke. To examine the effect of weight-supported arm training combined with computerized exercises on arm function and capacity, compared with dose-matched conventional reach training in subacute stroke patients. In a single-blind, multicenter, randomized controlled trial, 70 subacute stroke patients received 6 weeks of training with either an AS device combined with computerized exercises or dose-matched conventional training (CON). Arm function was evaluated pretraining and posttraining by Fugl-Meyer assessment (FM), maximal reach distance, Stroke Upper Limb Capacity Scale (SULCS), and arm pain via Visual Analogue Scale, in addition to perceived motivation by Intrinsic Motivation Inventory posttraining. FM and SULCS scores and reach distance improved significantly within both groups. These improvements and experienced pain did not differ between groups. The AS group reported higher interest/enjoyment during training than the CON group. AS training with computerized exercises is as effective as conventional therapy dedicated to the arm to improve arm function and activity in subacute stroke rehabilitation, when applied at the same dose. © The Author(s) 2014.

Effect of Resistance Exercises on the Indicators of Muscle Reserves and Handgrip Strength in Adult Patients on Hemodialysis.

PubMed

Olvera-Soto, Ma Guadalupe; Valdez-Ortiz, Rafael; López Alvarenga, Juan Carlos; Espinosa-Cuevas, María de Los Ángeles

2016-01-01

Although resistance exercise has been associated with improvement in the muscle reserves, muscle strength and quality of life in end-stage renal disease patients, the objective of this paper is to evaluate the effect of resistance exercise performed during hemodialysis sessions on the anthropometric indicators of muscle reserve and handgrip strength in sedentary malnourished patients with end-stage renal disease. Patients were randomized to perform resistance exercise during hemodialysis sessions with ankle weights and resistance bands. The exercises were performed twice a week over the course of 12 weeks. The control group underwent a hemodialysis session alone. The outcomes measures were the following anthropometric measurements: arm muscle circumference and arm muscle area. Dynamometry was used to measure the handgrip strength. Sixty-one sedentary patients with a median age of 29 years (interquartile range [IQR] 21-39 years), and 83% presenting with some grade of malnutrition were equally randomized to either the intervention or control group. In the resistance exercise group, there was an increase in the arm muscle circumference from 233.6 (IQR 202-254) mm to 241.4 (IQR 203-264) mm (P= .001), arm muscle area from 35.9 (26-41) cm(2) to 36.6 (IQR 26-46) cm(2) (P= .002), and handgrip strength from 19.6 (IQR 11-28) kg to 21.2 (IQR 13-32) kg between the basal and final measurements (P < .05). The tolerance to exercise was adequate, and no adverse events were reported during the practical exercise. Resistance exercise at least twice a week is safe and represents an opportunity for improving the muscle mass and strength in adult patients who are on hemodialysis, including in those with malnutrition. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Using virtual reality environment to facilitate training with advanced upper-limb prosthesis.

PubMed

Resnik, Linda; Etter, Katherine; Klinger, Shana Lieberman; Kambe, Charles

2011-01-01

Technological advances in upper-limb prosthetic design offer dramatically increased possibilities for powered movement. The DEKA Arm system allows users 10 powered degrees of movement. Learning to control these movements by utilizing a set of motions that, in most instances, differ from those used to obtain the desired action prior to amputation is a challenge for users. In the Department of Veterans Affairs "Study to Optimize the DEKA Arm," we attempted to facilitate motor learning by using a virtual reality environment (VRE) program. This VRE program allows users to practice controlling an avatar using the controls designed to operate the DEKA Arm in the real world. In this article, we provide highlights from our experiences implementing VRE in training amputees to use the full DEKA Arm. This article discusses the use of VRE in amputee rehabilitation, describes the VRE system used with the DEKA Arm, describes VRE training, provides qualitative data from a case study of a subject, and provides recommendations for future research and implementation of VRE in amputee rehabilitation. Our experience has led us to believe that training with VRE is particularly valuable for upper-limb amputees who must master a large number of controls and for those amputees who need a structured learning environment because of cognitive deficits.

A review of bilateral training for upper extremity hemiparesis.

PubMed

Stoykov, Mary Ellen; Corcos, Daniel M

2009-01-01

Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. (c) 2009 John Wiley & Sons, Ltd.

CRUX: a Compliant Robotic Upper-Extremity eXosuit for Lightweight, Portable, Multi-DoF Muscular Augmentation

NASA Technical Reports Server (NTRS)

Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Teodorescu, Mircea; Kurniawan,Sri; Agogino, Adrian; Kurniawan, Sri

2017-01-01

Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the users movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the complexity of the underlying human body. In this paper, we present a compliant, robotic exosuit for upper-extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible design for portability. We also show how CRUX maintains full flexibility of the upper-extremities for its users while providing multi- DoF augmentative strength to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

No impaired hemoglobin oxygenation in forearm muscles of patients with chronic CRPS-1.

PubMed

Brunnekreef, Jaap J J; Oosterhof, Jan; Wolff, André P; Crul, Ben J P; Wilder-Smith, Oliver H G; Oostendorp, Rob A B

2009-01-01

Physiotherapy is considered an important treatment option in patients with upper limb complex regional pain syndrome type-1 (CRPS-1). In case of chronic CRPS-1, exercise therapy of the affected limb forms an important part of the physiotherapeutic program. We investigated whether muscle loading in chronic CRPS-1 patients is associated with impairments in muscle circulation of the forearm of the affected limb. Thirty patients with chronic CRPS-1 unilaterally affecting their upper limbs, and 30 age-matched and sex-matched control participants were included in this study. Local muscle blood flow and hemoglobin oxygenation were measured by near infrared spectroscopy within the muscles of the forearm at rest, after 1-minute isometric handgrip exercises, and after arterial occlusion. Main outcome parameters were: local muscle blood flow, O2 consumption (mVO2), and postischemic reoxygenation (ReOx). We found no differences in baseline muscle blood flow, mVO2, and ReOx between the affected CRPS-1, unaffected CRPS-1, and control arms. After exercise, mVO2 of the affected CRPS-1 arms was not different from the clinically unaffected CRPS-1 arms. Furthermore, in comparison with the control arms, unaffected CRPS-1 arms showed no difference in mVO2 or ReOx. Muscle loading does not seems to be related to impairments in muscle oxygen uptake in forearm muscles of upper limbs affected by chronic CRPS-1. Our results suggest that exercise therapy can be safely used in physiotherapeutic training programs for chronic CRPS-1 of the upper limb.

A method to determine the orientation of the upper arm about its longitudinal axis during dynamic motions.

PubMed

Gordon, Brian J; Dapena, Jesús

2013-01-04

Inaccuracy in determining the orientation of the upper arm about its longitudinal axis (twist orientation) has been a pervasive problem in sport biomechanics research. The purpose of this study was to develop a method to improve the calculation of the upper arm twist orientation in dynamic sports activities. The twist orientation of the upper arm is defined by the orientation of its mediolateral axis. The basis for the new method is that at any angle in the flexion/extension range of an individual's elbow, it is possible to define a true mediolateral axis and also a surrogate mediolateral axis perpendicular to the plane containing the shoulder, elbow and wrist joints. The difference between the twist orientations indicated by these two versions of the mediolateral axis will vary from one elbow angle to another, but if the elbow joint deforms equally in different activities, for any given subject the difference should be constant at any given value of the elbow angle. Application of the new method required individuals to execute sedate elbow extension trials prior to the dynamic trials. Three-dimensional motion analysis of the sedate extension trials allowed quantification of the difference between the true and surrogate mediolateral axes for all angles in the entire flexion/extension range of an individual's elbow. This made it possible to calculate in any dynamic trial the twist orientation defined by the true mediolateral axis from the twist orientation defined by the surrogate mediolateral axis. The method was tested on a wooden model of the arm. Copyright © 2012 Elsevier Ltd. All rights reserved.

Malnutrition and body composition in urban and rural schoolchildren: A cross-sectional study in San Rafael, Mendoza (Argentina).

PubMed

Garraza, Mariela; Cesani, María F; Navone, Graciela T; Oyhenart, Evelia E

2016-11-01

The aim of the present study was to analyze the nutritional status and body composition of children from San Rafael, Mendoza, avoiding urban and rural categorization by generating subpopulations as a function of their socio-environmental characteristics. A cross-sectional study was performed in 3,596 schoolchildren from 4.0 to 13.9 years of age. Body weight, height, upper arm circumference, and triceps skinfold were measured. Body mass index, total muscle, and fat areas of the arm were calculated. To estimate nutritional status and body composition, the NHANES III reference was used. The socio-environmental variables were surveyed using a structured questionnaire. These variables were processed by categorical principal-component analysis (catPCA). The catPCA allowed the differentiation of four groups, three with urban characteristics (high urban, medium urban, impoverished urban), and a rural group. Stunting occurred at a higher rate in the impoverished urban group, and the occurrence of underweight children was higher in the rural group. The prevalence of excess weight varied in the range of 20-26%. The latter value corresponded to children of the high urban group, who also did not show reduced muscle mass. Children from San Rafael presented differences in nutritional condition and body composition associated with pronounced socio-environmental heterogeneity. Thus, we could observe a gradient from the "high urban" group, with better social, economic, and sanitation conditions and at the same time a more obesogenic environment to the "impoverished urban" and "rural" groups, whose vulnerability reflected a higher prevalence of child undernutrition and the association with excess weight and reduced muscle mass. Am. J. Hum. Biol. 28:796-803, 2016. © 2016Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Diet and anthropometry at 2 years of age following an oral health promotion programme for Australian Aboriginal children and their carers: a randomised controlled trial.

PubMed

Smithers, Lisa G; Lynch, John; Hedges, Joanne; Jamieson, Lisa M

2017-12-01

There are marked disparities between indigenous and non-indigenous children's diets and oral health. Both diet and oral health are linked to longer-term health problems. We aimed to investigate whether a culturally appropriate multi-faceted oral health promotion intervention reduced Aboriginal children's intake of sugars from discretionary foods at 2 years of age. We conducted a single-blind, parallel-arm randomised controlled trial involving women who were pregnant or had given birth to an Aboriginal child in the previous 6 weeks. The treatment group received anticipatory guidance, Motivational Interviewing, health and dental care for mothers during pregnancy and children at 6, 12 and 18 months. The control group received usual care. The key dietary outcome was the percent energy intake from sugars in discretionary foods (%EI), collected from up to three 24-h dietary recalls by trained research officers who were blind to intervention group. Secondary outcomes included intake of macronutrients, food groups, anthropometric z scores (weight, height, BMI and mid-upper arm circumference) and blood pressure. We enrolled 224 children to the treatment group and 230 to the control group. Intention-to-treat analyses showed that the %EI of sugars in discretionary foods was 1·6 % lower in the treatment group compared with control (95 % CI -3·4, 0·2). This culturally appropriate intervention at four time-points from pregnancy to 18 months resulted in small changes to 2-year-old Aboriginal children's diets, which was insufficient to warrant broader implementation of the intervention. Further consultation with Aboriginal communities is necessary for understanding how to improve the diet and diet-related health outcomes of young Aboriginal children.

Systemic inflammatory responses to maximal versus submaximal lengthening contractions of the elbow flexors.

PubMed

Peake, Jonathan M; Nosaka, Kazunori; Muthalib, Makii; Suzuki, Katsuhiko

2006-01-01

We compared changes in markers of muscle damage and systemic inflammation after submaximal and maximal lengthening muscle contractions of the elbow flexors. Using a cross-over design, 10 healthy young men not involved in resistance training completed a submaximal trial (10 sets of 60 lengthening contractions at 10% maximum isometric strength, 1 min rest between sets), followed by a maximal trial (10 sets of three lengthening contractions at 100% maximum isometric strength, 3 min rest between sets). Lengthening contractions were performed on an isokinetic dynamometer. Opposite arms were used for the submaximal and maximal trials, and the trials were separated by a minimum of two weeks. Blood was sampled before, immediately after, 1 h, 3 h, and 1-4 d after each trial. Total leukocyte and neutrophil numbers, and the serum concentration of soluble tumor necrosis factor-alpha receptor 1 were elevated after both trials (P < 0.01), but there were no differences between the trials. Serum IL-6 concentration was elevated 3 h after the submaximal contractions (P < 0.01). The concentrations of serum tumor necrosis factor-alpha, IL-1 receptor antagonist, IL-10, granulocyte-colony stimulating factor and plasma C-reactive protein remained unchanged following both trials. Maximum isometric strength and range of motion decreased significantly (P < 0.001) after both trials, and were lower from 1-4 days after the maximal contractions compared to the submaximal contractions. Plasma myoglobin concentration and creatine kinase activity, muscle soreness and upper arm circumference all increased after both trials (P < 0.01), but were not significantly different between the trials. Therefore, there were no differences in markers of systemic inflammation, despite evidence of greater muscle damage following maximal versus submaximal lengthening contractions of the elbow flexors.

Effect of BCAA supplement timing on exercise-induced muscle soreness and damage: a pilot placebo-controlled double-blind study.

PubMed

Ra, Song-Gyu; Miyazaki, Teruo; Kojima, Ryo; Komine, Shoichi; Ishikura, Keisuke; Kawanaka, Kentaro; Honda, Akira; Matsuzaki, Yasushi; Ohmori, Hajime

2017-09-22

The aim of present study was to compare the effects of branched-chain amino acid (BCAA) supplementation taken before or after exercise on delayed onset muscle soreness (DOMS) and exercise-induced muscle damage (EIMD). Fifteen young men (aged 21.5 ± 0.4 years) were given either BCAA (9.6 g·day-1) or placebo before and after exercise (and for 3 days prior to and following the exercise day) in three independent groups: the Control group (placebo before and after exercise), the PRE group (BCAA before exercise and placebo after exercise), and the POST group (placebo before exercise and BCAA after exercise). Participants performed 30 repetitions of eccentric exercise with the non-dominant arm. DOMS, upper arm circumference (CIR), elbow range of motion (ROM), serum creatine kinase (CK), lactate dehydrogenase (LDH), and aldolase, BCAA, and Beta-hydroxy-Beta-methylbutyrate (3HMB) were measured immediately before and after the exercise and on the following 4 days. Serum BCAA and 3HMB concentrations increased significantly in the PRE group immediately after the exercise, recovering to baseline over the following days. In the days following the exercise day, DOMS, CIR, and ROM were significantly improved in the PRE group compared to the Control group, with weaker effects in the POST group. Serum activities of CK, LDH, and aldolase in the days following the exercise day were significantly suppressed in the PRE group compared to Control group. Present study confirmed that repeated BCAA supplementation before exercise had a more beneficial effect in attenuating DOMS and EIMD induced by eccentric exercise than repeated supplementation after exercise.

76 FR 40905 - Turnagain Arm Tidal Electric Energy Project; Notice of Intent To File License Application, Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 13509-001] Turnagain Arm Tidal Electric Energy Project; Notice of Intent To File License Application, Filing of Pre-Application.... Name of Project: Turnagain Arm Tidal Electric Energy Project. f. Location: Of the Upper Cook Inlet off...

Characterization of Upper-Troposphere Water Vapor Measurements during AFWEX Using LASE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferrare, Richard; Browell, E. V.; Ismail, S.

Water vapor profiles from NASA's Lidar Atmospheric Sensing Experiment (LASE) system acquired during the ARM/FIRE Water Vapor Experiment (AFWEX) are used to characterize upper troposphere water vapor (UTWV) measured by ground-based Raman lidars, radiosondes, and in situ aircraft sensors over the Department of Energy Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site in northern Oklahoma. LASE was deployed from the NASA DC-8 aircraft and measured water vapor over the ARM SGP Central Facility (CF) site during seven flights between November 27 and December 10, 2000. Initially, the DOE ARM SGP Cloud and Radiation Testbed (CART) Raman lidar (CARL) UTWVmore » profiles were about 5-7% wetter than LASE in the upper troposphere, and the Vaisala RS80-H radiosonde profiles were about 10% drier than LASE between 8-12 km. Scaling the Vaisala water vapor profiles to match the precipitable water vapor (PWV) measured by the ARM SGP microwave radiometer (MWR) did not change these results significantly. By accounting for an overlap correction of the CARL water vapor profiles and by employing schemes designed to correct the Vaisala RS80-H calibration method and account for the time response of the Vaisala RS80H water vapor sensor, the average differences between the CARL and Vaisala radiosonde upper troposphere water vapor profiles are reduced to about 5%, which is within the ARM goal of mean differences of less than 10%. The LASE and DC-8 in situ Diode Laser Hygrometer (DLH) UTWV measurements generally agreed to within about 3 to 4%. The DC-8 in situ frost point cryogenic hygrometer and Snow White chilled mirror measurements were drier than the LASE, Raman lidars, and corrected Vaisala RS80H measurements by about 10-25% and 10-15%, respectively. Sippican (formerly VIZ manufacturing) carbon hygristor radiosondes exhibited large variabilities and poor agreement with the other measurements. PWV derived from the LASE profiles agreed to within about 3% on average with PWV derived from the ARM SGP microwave radiometer. The agreement between the LASE and MWR PWV and the LASE and CARL UTWV measurements supports the hypotheses that MWR measurements of the 22 GHz water vapor line can accurately constrain the total water vapor amount and that the CART Raman lidar, when calibrated using the MWR PWV, can provide an accurate, stable reference for characterizing upper troposphere water vapor.« less

Mechanical energy and power flow of the upper extremity in manual wheelchair propulsion.

PubMed

Guo, Lan-Yuen; Su, Fong-Chin; Wu, Hong-Wen; An, Kai-Nan

2003-02-01

To investigate the characteristics of mechanical energy and power flow of the upper limb during wheelchair propulsion. Mechanical energy and power flow of segments were calculated. Very few studies have taken into account the mechanical energy and power flow of the musculoskeletal system during wheelchair propulsion. Mechanical energy and power flow have proven to be useful tools for investigating locomotion disorders during human gait. Twelve healthy male adults (mean age, 23.5 years) were recruited for this study. Three-dimensional kinematic and kinetic data of the upper extremity were collected during wheelchair propulsion using a Hi-Res Expert Vision system and an instrumented wheel, respectively. During the initiation of the propulsion phase, joint power is generated in the upper arm or is transferred from the trunk downward to the forearm and hand to propel the wheel forward. During terminal propulsion, joint power is transferred upward to the trunk from the forearm and upper arm. The rate of change of mechanical energy and power flow for the forearm and hand have similar patterns, but the upper arm values differ. Joint power plays an important role in energy transfer as well as the energy generated and absorbed by muscles spanning the joints during wheelchair propulsion. Energy and power flow information during wheelchair propulsion allows us to gain a better understanding of the coordination of the movement by the musculoskeletal system.

Integrative rehabilitation of elderly stroke survivors: the design and evaluation of the BrightArm™.

PubMed

Rabin, Bryan A; Burdea, Grigore C; Roll, Doru T; Hundal, Jasdeep S; Damiani, Frank; Pollack, Simcha

2012-07-01

To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations.

Integrative rehabilitation of elderly stroke survivors: The design and evaluation of the BrightArm™

PubMed Central

Rabin, Bryan A.; Burdea, Grigore C.; Roll, Doru T.; Hundal, Jasdeep S.; Damiani, Frank; Pollack, Simcha

2011-01-01

Purpose To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. Method The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Results Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Conclusions Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations. PMID:22107353

Effects of a multicomponent exercise program in institutionalized elders with Alzheimer's disease.

PubMed

Sampaio, Arnaldina; Marques, Elisa A; Mota, Jorge; Carvalho, Joana

2016-10-18

This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients. © The Author(s) 2016.

Validation of the A&D UM-211 device for office blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Fania, Claudio; Albertini, Federica; Palatini, Paolo

2017-10-01

The aim of this study was to define the accuracy of UM-211, an automated oscillometric device for office use coupled to several cuffs for different arm sizes, according to the International Protocol of the European Society of Hypertension. The validation was performed in 33 individuals. Their mean age was 59.6±12.9 years, systolic blood pressure (BP) was 144.3±21.5 mmHg (range: 96-184 mmHg), diastolic BP was 86.8±18.5 mmHg (range: 48-124 mmHg), and arm circumference was 30.2±4.3 cm (range: 23-39 cm). Four sequential readings were taken by observers 1 and 2 using a double-headed stethoscope and a mercury sphygmomanometer, whereas three BP readings were taken by the supervisor using the test instrument. The differences between the readings provided by the device and the mean observer measurements were calculated. Therefore, each device measurement was compared with the previous and the next mean observer measurement. The validation results fulfilled all the 2010 European Society of Hypertension revision Protocol criteria for the general population and passed all validation grades. On average, the device overestimated systolic BP by 1.7±2.4 mmHg and diastolic BP by 1.7±2.5 mmHg. These data show that the UM-211 device coupled to several cuffs for different ranges of arm circumference met the requirements for validation according to the International Protocol and can be recommended for clinical use in the adult population. However, these results mainly apply to the use of the 22-32 and the 31-45 cm cuffs.

Upper-normal waist circumference is a risk marker for metabolic syndrome in normal-weight subjects.

PubMed

Okada, R; Yasuda, Y; Tsushita, K; Wakai, K; Hamajima, N; Matsuo, S

2016-01-01

To elucidate implication of upper-normal waist circumference (WC), we examined whether the normal range of WC still represents a risk of metabolic syndrome (MetS) or non-adipose MetS components among normal-weight subjects. A total of 173,510 persons (100,386 men and 73,124 women) with normal WC (<90/80 cm in men/women) and body mass index (BMI) of 18.5-24.9 were included. Subjects were categorized as having low, moderate, and upper-normal WC for those with WC < 80, 80-84, and 85-89 cm in men and <70, 70-74, and 75-79 cm in women, respectively. The prevalence of all the non-adipose MetS components (e.g. prediabetes and borderline dyslipidemia) was significantly higher in subjects with upper-normal WC on comparison with those with low WC. Overall, the prevalence of MetS (having three or more of four non-adipose MetS components) gradually increased with increasing WC (12%, 21%, and 27% in men and 11%, 14%, and 19% in women for low, moderate, and upper-normal WC, respectively). Moreover, the risk of having a greater number of MetS components increased in subjects with upper-normal WC compared with those with low WC (odds ratios for the number of one, two, three, and four MetS components: 1.29, 1.81, 2.53, and 2.47 in men and 1.16, 1.55, 1.49, and 2.20 in women, respectively). Upper-normal WC represents a risk for acquiring a greater number of MetS components and the early stage of MetS components (prediabetes and borderline dyslipidemia), after adjusting for BMI, in a large general population with normal WC and BMI. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

A novel upper limb rehabilitation system with self-driven virtual arm illusion.

PubMed

Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

2014-01-01

This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

Radial nerve dysfunction (image)

MedlinePlus

The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson's disease.

PubMed

He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

2015-12-01

Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson's disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during tremor in PD patients. 11 idiopathic, tremor dominant PD subjects participated in this study. Joint kinematics during tremor in the upper extremity was recorded along with EMGs of six upper arm muscles using a novel experimental apparatus. The apparatus provided support for the upper extremity on a horizontal surface with reduced friction, so that resting tremor in the arm can be recorded with a MotionMonitor II system. In each subject, the frequencies of rhythmic firings in upper arm muscles were determined using spectral analysis. Paired and pool-averaged coherence analyses of EMGs for the group of muscles were performed to correlate the level of inter-muscular synchronization to tremor amplitudes at shoulder and elbow. The phase shift between synchronized antagonistic muscle pairs was calculated to aid coherence analysis in the muscle pool. Recorded EMG revealed that rhythmic firings were present in most recorded muscles, which were either synchronized to form phase-locked bursting cycles at a subject specific frequency, or unsynchronized with a random phase distribution. Paired coherence showed a stronger synchronization among a subset of recorded arm muscles at tremor frequency than that at double tremor frequency. Furthermore, the number of synchronized muscles in the arm was positively correlated to tremor amplitudes at elbow and shoulder. Pool-averaged coherence at tremor frequency also showed a better correlation with the amplitude of resting tremor than that of double tremor frequency, indicating that the neuromechanical coupling in peripheral neuromuscular system was stronger at tremor frequency. Both paired and pool-averaged coherences are more consistent indexes to correlate to tremor intensity in a group of upper extremity muscles of PD patients. The central drive at tremor frequency contributes mainly to synchronize peripheral muscles in the modulation of tremor intensity.

Deodorants: a clinical provocation study in fragrance-sensitive individuals.

PubMed

Johansen, J D; Rastogi, S C; Bruze, M; Andersen, K E; Frosch, P; Dreier, B; Lepoittevin, J P; White, I; Menné, T

1998-10-01

Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance-sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance-mix-sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in those deodorants. 14 eczema patients performed a 7-day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 applications per day were made in the axilla and simultaneously on a 25 cm2 area on the upper arm. A total of 20 deodorants were tested among the 14 patients. Afterwards, the deodorants were subjected to quantitative chemical analysis identifying constituents of the fragrance mix. 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both in the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis revealed that 18/19 deodorants contained between 1 and 6 of the fragrance-mix constituents, on average 3 being found. The mean concentration of fragrance-mix constituents was generally higher in the deodorants causing a positive use test, as compared with those giving a negative reaction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use test on the upper arm and a strong clinical suspicion.

Reliability, Validity, and Responsiveness of the QuickDASH in Patients With Upper Limb Amputation.

PubMed

Resnik, Linda; Borgia, Matthew

2015-09-01

To examine the internal consistency, test-retest reliability, validity, and responsiveness of the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in persons with upper limb amputation. Cross-sectional and longitudinal. Three sites participating in the U.S. Department of Veterans Affairs Home Study of the DEKA Arm. A convenience sample of upper limb amputees (N=44). Training with a multifunction upper limb prosthesis. Multiple outcome measures including the QuickDASH were administered twice within 1 week, and for a subset of 20 persons, after completion of in-laboratory training with the DEKA Arm. Scale alphas and intraclass correlation coefficient type 3,1 (ICC3,1) were used to examine reliability. Minimum detectable change (MDC) scores were calculated. Analyses of variance, comparing QuickDASH scores by the amount of prosthetic use and amputation level, were used for known-group validity analyses with alpha set at .05. Pairwise correlations between QuickDASH and other measures were used to examine concurrent validity. Responsiveness was measured by effect size (ES) and standardized response mean (SRM). QuickDASH alpha was .83, and ICC was .87 (95% confidence interval, .77-.93). MDC at the 95% confidence level (MDC95%) was 17.4. Full- or part-time prosthesis users had better QuickDASH scores compared with nonprosthesis users (P=.021), as did those with more distal amputations at both baseline (P=.042) and with the DEKA Arm (P=.024). The QuickDASH was correlated with concurrent measures of activity limitation as expected. The ES and SRM after training with the DEKA Arm were 0.6. This study provides evidence of reliability and validity of the QuickDASH in persons with upper limb amputation. Results provide preliminary evidence of responsiveness to prosthetic device type/training. Further research with a larger sample is needed to confirm results. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Movement analysis of upper limb during resistance training using general purpose robot arm "PA10"

NASA Astrophysics Data System (ADS)

Morita, Yoshifumi; Yamamoto, Takashi; Suzuki, Takahiro; Hirose, Akinori; Ukai, Hiroyuki; Matsui, Nobuyuki

2005-12-01

In this paper we perform movement analysis of an upper limb during resistance training. We selected sanding training, which is one type of resistance training for upper limbs widely performed in occupational therapy. Our final aims in the future are to quantitatively evaluate the therapeutic effect of upper limb motor function during training and to develop a new rehabilitation training support system. For these purposes, first of all we perform movement analysis using a conventional training tool. By measuring upper limb motion during the sanding training we perform feature abstraction. Next we perform movement analysis using the simulated sanding training system. This system is constructed using the general purpose robot arm "PA10". This system enables us to measure the force/torque exerted by subjects and to easily change the load of resistance. The control algorithm is based on impedance control. We found these features of the upper limb motion during the sanding training.

The relationship between consistency of propulsive cycles and maximum angular velocity during wheelchair racing.

PubMed

Wang, Yong Tai; Vrongistinos, Konstantinos Dino; Xu, Dali

2008-08-01

The purposes of this study were to examine the consistency of wheelchair athletes' upper-limb kinematics in consecutive propulsive cycles and to investigate the relationship between the maximum angular velocities of the upper arm and forearm and the consistency of the upper-limb kinematical pattern. Eleven elite international wheelchair racers propelled their own chairs on a roller while performing maximum speeds during wheelchair propulsion. A Qualisys motion analysis system was used to film the wheelchair propulsive cycles. Six reflective markers placed on the right shoulder, elbow, wrist joints, metacarpal, wheel axis, and wheel were automatically digitized. The deviations in cycle time, upper-arm and forearm angles, and angular velocities among these propulsive cycles were analyzed. The results demonstrated that in the consecutive cycles of wheelchair propulsion the increased maximum angular velocity may lead to increased variability in the upper-limb angular kinematics. It is speculated that this increased variability may be important for the distribution of load on different upper-extremity muscles to avoid the fatigue during wheelchair racing.

Exposure to Upper Arm Elevation During Work Compared to Leisure Among 12 Different Occupations Measured with Triaxial Accelerometers.

PubMed

Palm, Peter; Gupta, Nidhi; Forsman, Mikael; Skotte, Jørgen; Nordquist, Tobias; Holtermann, Andreas

2018-06-26

Regarding prevention of neck and shoulder pain (NSP), unsupported arm elevation is one factor that should be taken into account when performing work risk assessment. Triaxial accelerometers can be used to measure arm elevation over several days but it is not possible to differentiate between supported and unsupported arm elevation from accelerometers only. Supported arm elevation is more likely to exist during sitting than standing. The aim of the study was to evaluate the use of whole workday measurements of arm elevation with accelerometers to assess potentially harmful work exposure of arm elevation, by comparing arm elevation at work with arm elevation during leisure, in a population with diverse work tasks, and to assess how the exposure parameters were modified when upper arm elevation during sitting time was excluded. The participants, 197 workers belonging to 12 occupational groups with diverse work tasks, wore triaxial accelerometers on the dominant arm, hip, and back for 1-4 days to measure arm elevation and periods of sitting. None of the groups were found to have higher exposure to arm elevation during work compared to leisure. Even though some occupations where known to have work tasks that forced them to work with elevated arms to a large extent. A high proportion of arm elevation derived from sitting time, especially so during leisure. When arm elevation during sitting time was excluded from the analysis, arm elevation was significantly higher at work than during leisure among construction workers, garbage collectors, manufacturing workers, and domestic cleaners. Together this illustrates that it is not suitable to use whole workday measurments of arm elevation with accelerometer as a sole information source when assessing the risk for NSP due to arm elevation. Information on body posture can provide relevant contextual information in exposure assessments when it is known that the potential harmful exposure is performed in standing or walking.

Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities.

PubMed

Takamura, Toshinari; Kita, Yuki; Nakagen, Masatoshi; Sakurai, Masaru; Isobe, Yuki; Takeshita, Yumie; Kawai, Kohzo; Urabe, Takeshi; Kaneko, Shuichi

2017-07-01

To test the hypothesis that preserved muscle mass is protective against obesity-associated insulin resistance and metabolic abnormalities, we analyzed the relationship of lean body mass and computed tomography-assessed sectional areas of specific skeletal muscles with insulin resistance and metabolic abnormalities in a healthy cohort. A total of 195 subjects without diabetes who had completed a medical examination were included in this study. Various anthropometric indices such as circumferences of the arm, waist, hip, thigh, and calf were measured. Body composition (fat and lean body mass) was determined by bioelectrical impedance analysis. Sectional areas of specific skeletal muscles (iliopsoas, erector spinae, gluteus, femoris, and rectus abdominis muscles) were measured using computed tomography. Fat and lean body mass were significantly correlated with metabolic abnormalities and insulin resistance indices. When adjusted by weight, relationships of fat and lean body mass with metabolic parameters were mirror images of each other. The weight-adjusted lean body mass negatively correlated with systolic and diastolic blood pressures; fasting plasma glucose, HbA1c, alanine aminotransferase, and triglyceride, and insulin levels; and hepatic insulin resistance indices, and positively correlated with HDL-cholesterol levels and muscle insulin sensitivity indices. Compared with weight-adjusted lean body mass, weight-adjusted sectional areas of specific skeletal muscles showed similar, but not as strong, correlations with metabolic parameters. Among anthropometric measures, the calf circumference best reflected lean body mass, and weight-adjusted calf circumference negatively correlated with metabolic abnormalities and insulin resistance indices. Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective marker against obesity-associated metabolic abnormalities.

Gravity compensation of an upper extremity exoskeleton.

PubMed

Moubarak, S; Pham, M T; Moreau, R; Redarce, T

2010-01-01

This paper presents a new gravity compensation method for an upper extremity exoskeleton mounted on a wheel chair. This new device is dedicated to regular and efficient rehabilitation training for post-stroke and injured people without the continuous presence of a therapist. The exoskeleton is a wearable robotic device attached to the human arm. The user provides information signals to the controller by means of the force sensors around the wrist and the arm, and the robot controller generates the appropriate control signals for different training strategies and paradigms. This upper extremity exoskeleton covers four basic degrees of freedom of the shoulder and the elbow joints with three additional adaptability degrees of freedom in order to match the arm anatomy of different users. For comfortable and efficient rehabilitation, a new heuristic method have been studied and applied on our prototype in order to calculate the gravity compensation model without the need to identify the mass parameters. It is based on the geometric model of the robot and accurate torque measurements of the prototype's actuators in a set of specifically chosen joint positions. The weight effect has been successfully compensated so that the user can move his arm freely while wearing the exoskeleton without feeling its mass.

Military Personnel: Army Needs to Focus on Cost-Effective Use of Financial Incentives and Quality Standards in Managing Force Growth

DTIC Science & Technology

2009-05-01

diplomas and who score in the upper half on the Armed Forces Qualification Test. The Army implemented some new programs to increase the market of...quality of its enlisted personnel, we analyzed data from OSD on educational credentials and aptitude test scores for these personnel, and we collected...recruits to have high-school diplomas and at least 60 percent to have scores in the upper half on the Armed Forces Qualification Test (AFQT). In fiscal

Validation of the OMRON M7 (HEM-780-E) blood pressure measuring device in a population requiring large cuff use according to the International Protocol of the European Society of Hypertension.

PubMed

El Feghali, Ramzi N; Topouchian, Jirar A; Pannier, Bruno M; El Assaad, Hiba A; Asmar, Roland G

2007-06-01

A high percentage of hypertensive patients present an arm circumference of over 32 cm; the use of a large cuff is therefore recommended. Validation studies are usually performed in the general population using a standard-size cuff. The aim of this study was to assess the accuracy of the Omron M7 device in a population with an arm circumference ranging from 32 to 42 cm. A validation study was performed according to the International Protocol of the European Society of Hypertension. This protocol is divided into two phases: the first phase is performed on 15 selected participants (45 pairs of blood-pressure measurements); if the device passes this phase, 18 supplementary participants are included (54 pairs of blood-pressure measurements), making a total number of 33 participants (99 pairs of blood-pressure measurements), on whom the analysis is performed. For each participant, four blood-pressure measurements were performed simultaneously by two trained observers, using mercury sphygmomanometers fitted with a Y tube; the measurements alternated with three by the test device. The difference between the blood-pressure value given by the device and that obtained by the two observers (mean of the two observations) was calculated for each measure. The 99 pairs of blood-pressure differences were classified into three categories (

Zinc as an adjunct therapy in the management of severe pneumonia among Gambian children: randomized controlled trial.

PubMed

Howie, Stephen; Bottomley, Christian; Chimah, Osaretin; Ideh, Readon; Ebruke, Bernard; Okomo, Uduak; Onyeama, Charles; Donkor, Simon; Rodrigues, Onike; Tapgun, Mary; Janneh, Marie; Oluwalana, Claire; Kuti, Bankole; Enwere, Godwin; Esangbedo, Pamela; Doherty, Conor; Mackenzie, Grant; Greenwood, Brian; Corrah, Tumani; Prentice, Andrew; Adegbola, Richard; Zaman, Syed

2018-06-01

The benefit of zinc as an adjunct therapy for severe pneumonia is not established. We assessed the benefit of adjunct zinc therapy for severe pneumonia in children and determined whether the study children were zinc deficient. This was a randomized, parallel group, double-blind, placebo-controlled trial with an allocation ratio of 1:1 conducted in children with severe pneumonia to evaluate the efficacy of daily zinc as an adjunct treatment in preventing 'treatment failure' (presence of any sign of severe pneumonia) on day-5 and day-10 and in reducing the time to resolution of signs of severe pneumonia. Six hundred and four children 2-59 months of age presenting with severe pneumonia at six urban and rural health care facilities in The Gambia were individually randomised to receive placebo (n = 301) or zinc (n = 303) for seven days. To determine if the study children were zinc deficient, supplementation was continued in a randomly selected subgroup of 121 children from each arm for six months post-enrolment, and height-gain, nutritional status, plasma zinc concentrations, and immune competence were compared. Percentage of treatment failure were similar in placebo and zinc arms both on day 5 (14.0% vs 14.1%) and day 10 (5.2% vs 5.9%). The time to recovery from lower chest wall indrawing and sternal retraction was longer in the placebo compared to zinc arm (24.4 vs 23.0 hours; P  = 0.011 and 18.7 vs 11.0 hours; P  = 0.006 respectively). The time to resolution for all respiratory symptoms of severity was not significantly different between placebo and zinc arms (42.3 vs 30.9 hours respectively; P  = 0.242). In the six months follow-up sub-group, there was no significant difference in height gain, height-for-age and weight-for-height Z-scores, mid upper arm circumference, plasma zinc concentrations, and anergy at six months post-enrolment. In this population, zinc given as an adjunct treatment for severe pneumonia showed no benefit in treatment failure rates, or clinically important benefit in time to recovery from respiratory symptoms and showed marginal benefit in rapidity of resolution of some signs of severity. This finding does not support routine use of zinc as an adjunct treatment in severe pneumonia in generally zinc replete children. ISRCTN33548493.

Electrically Stimulated Antagonist Muscle Contraction Increased Muscle Mass and Bone Mineral Density of One Astronaut - Initial Verification on the International Space Station

PubMed Central

Takano, Yoshio; Yoshimitsu, Kazuhiro; Omoto, Masayuki; Hashida, Ryuki; Tagawa, Yoshihiko; Inada, Tomohisa; Yamada, Shin; Ohshima, Hiroshi

2015-01-01

Background Musculoskeletal atrophy is one of the major problems of extended periods of exposure to weightlessness such as on the International Space Station (ISS). We developed the Hybrid Training System (HTS) to maintain an astronaut’s musculoskeletal system using an electrically stimulated antagonist to resist the volitional contraction of the agonist instead of gravity. The present study assessed the system’s orbital operation capability and utility, as well as its preventative effect on an astronaut’s musculoskeletal atrophy. Methods HTS was attached to the non-dominant arm of an astronaut staying on the ISS, and his dominant arm without HTS was established as the control (CTR). 10 sets of 10 reciprocal elbow curls were one training session, and 12 total sessions of training (3 times per week for 4 weeks) were performed. Pre and post flight ground based evaluations were performed by Biodex (muscle performance), MRI (muscle volume), and DXA (BMD, lean [muscle] mass, fat mass). Pre and post training inflight evaluations were performed by a hand held dynamometer (muscle force) and a measuring tape (upper arm circumference). Results The experiment was completed on schedule, and HTS functioned well without problems. Isokinetic elbow extension torque (Nm) changed -19.4% in HTS, and -21.7% in CTR. Isokinetic elbow flexion torque changed -23.7% in HTS, and there was no change in CTR. Total Work (Joule) of elbow extension changed -8.3% in HTS, and +0.3% in CTR. For elbow flexion it changed -23.3% in HTS and -32.6% in CTR. Average Power (Watts) of elbow extension changed +22.1% in HTS and -8.0% in CTR. For elbow flexion it changed -6.5% in HTS and -4.8% in CTR. Triceps muscle volume according to MRI changed +11.7% and that of biceps was +2.1% using HTS, however -0.1% and -0.4% respectively for CTR. BMD changed +4.6% in the HTS arm and -1.2% for CTR. Lean (muscle) mass of the arm changed only +10.6% in HTS. Fat mass changed -12.6% in HTS and -6.4% in CTR. Conclusions These results showed the orbital operation capability and utility, and the preventive effect of HTS for an astronaut’s musculoskeletal atrophy. The initial flight data together with the ground data obtained so far will be utilized in the future planning of human space exploration. PMID:26296204

User Evaluation of a Dynamic Arm Orthosis for People With Neuromuscular Disorders.

PubMed

Gunn, Margaret; Shank, Tracy M; Eppes, Marissa; Hossain, Jobayer; Rahman, Tariq

2016-12-01

This paper presents the results of an online survey conducted with users of a functional upper extremity orthosis called the Wilmington Robotic EXoskeleton (WREX). The WREX is a passive anti-gravity arm orthosis that allows people with neuromuscular disabilities to move their arms in three dimensions. The paper also describes the design of a novel lightweight 3-D printed WREX used for ambulatory children. Three different versions of the WREX are now offered to patients. Two can be mounted on a wheelchair and one to a body jacket for ambulatory patients. An online user survey with 55 patients was conducted to determine the benefits of the various WREXs. The survey asked ten questions related to upper extremity function with and without the WREX as well as subjective impressions of the device. Results show a statistically significant improvement in arm function for everyday tasks with the WREX.

Mechanical Impedance Modeling of Human Arm: A survey

NASA Astrophysics Data System (ADS)

Puzi, A. Ahmad; Sidek, S. N.; Sado, F.

2017-03-01

Human arm mechanical impedance plays a vital role in describing motion ability of the upper limb. One of the impedance parameters is stiffness which is defined as the ratio of an applied force to the measured deformation of the muscle. The arm mechanical impedance modeling is useful in order to develop a better controller for system that interacts with human as such an automated robot-assisted platform for automated rehabilitation training. The aim of the survey is to summarize the existing mechanical impedance models of human upper limb so to justify the need to have an improved version of the arm model in order to facilitate the development of better controller of such systems with ever increase in complexity. In particular, the paper will address the following issue: Human motor control and motor learning, constant and variable impedance models, methods for measuring mechanical impedance and mechanical impedance modeling techniques.

Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

PubMed

Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

2018-02-01

Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

Effects of preoperative and postoperative enteral nutrition on postoperative nutritional status and immune function of gastric cancer patients.

PubMed

Ding, Dayong; Feng, Ye; Song, Bin; Gao, Shuohui; Zhao, Jisheng

2015-03-01

Effects of preoperative one week enteral nutrition (EN) support on the postoperative nutritional status, immune function and inflammatory response of gastric cancer patients were investigated. 106 cases of gastric cancer patients were randomly divided into preoperative one week EN group (trial group) and early postoperative EN group (control group), which were continuously treated with EN support until the postoperative 9th day according to different treatment protocols. All the patients were checked for their body weight, skinfold thickness, upper arm circumference, white blood cell count (WBC), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), humoral immunity (IgA, IgG), T cell subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), etc. on the preoperative and the postoperative 1st and 10th day, respectively. PA and IgG levels of the experimental group were higher than those of the control group on the postoperative 10th day, whereas IL-6 level of the experimental group was lower than that of the control group. EN support for preoperative gastric cancer patients will improve the postoperative nutritional status and immune function, alleviate inflammatory response, and facilitate the recovery of patients.

A case of brachyolmia.

PubMed

Karabiyik, N; Oğuz, F; Sidal, M; Hekim, N; Kayserili, H

1997-01-01

Brachyolmia refers to a form of skeletal dysplasia characterized by general platyspondyly without significant epiphyseal, metaphyseal or diaphyseal changes in long bones. Three, possibly four, types of brachyolmia have been defined: Type I-Hobaeck-Toledo type. Type II-Maroteaux and Type III. We report a patient with brachyolmia and present the clinical and radiological findings. A 15-year-old boy presented to our Outpatient Department because of his short stature. His height, weight, head circumference and arm span were 127 cm (< 3rd percentile), (3rd percentile) 39 kg, 55 cm (50th-75th percentile), and 142 cm respectively, and his upper segment/lower segment ratio was 0.91. His neck and trunk were short. He had severe kyphoscoliosis. Slit-lamp examination was normal. Radiologic features included platyspondyly in cervical, thoracic and lumbar vertebrae as well as kyphoscoliosis. Bilateral coxa valga and mild acetabular irregularities were noticed on pelvic radiographies. Levels of chondroitin and heparan sulphate as well as the glycosaminoglycan/creatinine ratio were elevated in the 24-hour urine specimen. The activities of N-acetylgalactosamine-6-sulphatase, beta-galactosidase and beta-hexosaminosidase were all normal in fibroblast culture. Although the x-ray findings of this patient are consistent with both Types I and III, recessive inheritance and glycosaminoglycan anomalies point to Type I brachyolmia.

Eccentric resistance training intensity may affect the severity of exercise induced muscle damage.

PubMed

Hasenoehrl, Timothy; Wessner, Barbara; Tschan, Harald; Vidotto, Claudia; Crevenna, Richard; Csapo, Robert

2017-09-01

The aim of the present study was to assess the role of eccentric exercise intensity in the development of and recovery from delayed onset muscle soreness (DOMS). Using a cross-over study design, 15 healthy, male college students were tested on two occasions. The training stimulus consisted of an exhaustive series of eccentric muscle contractions of the elbow flexors at either 100% (high intensity) or 50% (low intensity) of the individual concentric one-repetition maximum. Blood samples were taken at baseline as well as 24, 48, 72 and 96 hours postexercise, and analyzed for creatine kinase, myoglobin, interleukin-6 and prostaglandin-2. Additionally, upper arm circumference (CIRC) and DOMS-related sensation of pain (PAIN) were measured. Following high intensity training, CIRC was significantly greater (P=0.007). Further, creatine kinase, myoglobin and interleukin-6 tended to be higher, although the main effect of the factor "intensity" just failed to reach significance (creatine kinase: P=0.056, myoglobin: P=0.064, interleukin-6: P=0.091). No differences were found for prostaglandin-2 (P=0.783) and PAIN (P=0.147). When performed at greater intensity, fatiguing eccentric resistance exercise of the elbow flexors leads to greater muscle swelling and, potentially, increases in serum markers reflecting lesions in the muscle's cellular membrane.

Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition.

PubMed

LaCourse, Sylvia M; Chester, Frances M; Preidis, Geoffrey; McCrary, Leah M; Maliwichi, Madalitso; McCollum, Eric D; Hosseinipour, Mina C

2015-02-01

Strategies to effectively identify and refer children with severe acute malnutrition (SAM) to Nutritional Rehabilitation units (NRU) can reduce morbidity and mortality. From December 2011 to May 2012, we conducted a prospective study task-shifting inpatient malnutrition screening of Malawian children 6-60 months to lay-screeners and evaluated World Health Organization (WHO) criteria vs. the National Center for Health Statistics (NCHS) guidelines for SAM. Lay-screeners evaluated 3116 children, identifying 368 (11.8%) with SAM by WHO criteria, including 210 (6.7%) who met NCHS criteria initially missed by standard clinician NRU referrals. Overall case finding increased by 56.7%. Mid-upper arm circumference (MUAC) and bipedal edema captured 86% (181/210) NCHS/NRU-eligible children and 89% of those who died (17/19) meeting WHO criteria. Mortality of NCHS/NRU-eligible children was 10 times greater than those without SAM (odds ratio 10.5, 95% confidence interval 5.4-20.6). Ward-based lay-screeners and WHO guidelines identified high-risk children with SAM missed by standard NRU referral. MUAC and edema detected the majority of NRU-eligible children. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

More training and awareness are needed to improve the recognition of undernutrition in hospitalised children.

PubMed

Huysentruyt, Koen; Goyens, Philippe; Alliet, Philippe; Bontems, Patrick; Van Hautem, Hilde; Philippet, Pierre; Vandenplas, Yvan; De Schepper, Jean

2015-08-01

Reports suggest that 10% of hospitalised children in Europe are undernourished. We investigated whether nutritional screening tools (NST) were used in Belgian secondary-level hospitals, examined strategies for detecting undernutrition and identified barriers preventing the systematic management of undernutrition. A nationwide questionnaire-based survey of paediatric departments in Belgian secondary-level hospitals was carried out from September 2013 to February 2014. Respondents were dived into French-speaking (Walloon + Brussels) and Dutch-speaking (Flemish) departments. We received replies from 71 of the 97 (73.2%) departments. Half of the departments - 39.5% Flemish speaking and 71.4% Walloon speaking - carried out nutritional screening. Undernutrition was identified by measuring weight and length or height (92.7% of cases), clinical appraisal (74.7%), mid-upper arm circumference and/or skin fold thickness (19.7%). There was no protocol for undernutrition in many Flemish (60.5%)- and Walloon (28.6%)-speaking departments. Reasons given for not screening were as follows: lack of training (46.9%), ignorance of NST (42.2%) and lack of time (29.7%). Half of the paediatric departments in Belgian secondary-level hospitals did not carry out nutritional screening, and differences in current practices and attitudes may be due to cultural and/or educational differences. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Home environment, nutritional status and maternal intelligence as determinants of intellectual development in rural Philippine preschool children.

PubMed

Church, A T; Katigbak, M S

1991-01-01

Psychologists used 7 subtests based on Western intelligence tests but developed for rural preschoolers in Tagalog-speaking regions of the Philippines to estimate intelligence of 177 5-6 year old children in 4 agricultural villages in the provinces of Batangas and Oriental Mindoro. They also assessed the height for age, weight for age, and mid upper arm circumference of the children to determine nutritional status. They used 2 subtests from the Philippine Aptitude Classification Test to estimate the intelligence of 181 mothers and asked the mothers questions from the Environmental Interview Questionnaire to determine the status of the home environment. The psychologists hoped to examine the association between home environment, nutritional status, and intellectual development in these preschool children. A moderate association existed between home environment and intellectual development. It contributed more to child intellectual performance than did socioeconomic status and maternal intelligence. The physical and psychosocial environment also contributed to intellectual development. Maternal intelligence, a partial index of genetic influence, could not altogether explain the association between home environment and intellectual development. These results may identify environment experiences concerning environmental specificity such as exploration of the surrounding environment and spatial ability. Intellectual development was not significantly related to nutritional status in normal to moderately malnourished children.

Culture appropriate indicators for monitoring growth and development of urban and rural children below 6 years.

PubMed

Dixit, A; Govil, S; Patel, N V

1992-03-01

In this cross sectional study, 2000 apparently normal children aged 0-6 years (1200 urban and 800 rural), were nutritionally and developmentally assessed and their environment scrutinized for possible risk factors. Measurement of mid upper arm circumference (MUAC) using standard techniques revealed malnutrition in 44% of the rural and 24% of the urban children especially in the 2-6 years of age group. Culture appropriate indicators of psycho-social development picked up gross delays in gross motor (GM), vision and fine motor (V&FM) and language skills. Self help, concept hearing (SHCH) skills were recorded as normal while social skills were advanced particularly in the 0-2 years old urban group. By the use of the family protocols, low socio-economic status, malnutrition and 9 other risks factors have been generated for the urban group. No risk factor could be identified for the rural group. Better income emerged as the only real protective factor for the sample showing a direct positive relationship with the 45 skills tested, especially in the 2-6 years age group. Nineteen developmental skills were identified as powerful predictors of development. A prototype home based screening record was constructed for monitoring of growth and development which can be even used by minimally trained primary care worker.

[Analysis of elderly outpatients in relation to nutritional status, sarcopenia, renal function, and bone density].

PubMed

Salmaso, Franciany Viana; Vigário, Patrícia dos Santos; Mendonça, Laura Maria Carvalho de; Madeira, Miguel; Vieira Netto, Leonardo; Guimarães, Marcela Rodrigues Moreira; Farias, Maria Lucia Fleiuss de

2014-04-01

To evaluate relationships between nutritional status, sarcopenia and osteoporosis in older women. We studied 44 women, 67-94 years, by mini-nutritional assessment (MAN), glomerular filtration corr. 1.73 m(2), body mass index (BMI), arm circumference and calf (CP and CB), bone mineral density and body composition, DXA (fat mass MG; lean MM). We gauge sarcopenia: IMM MM = MSS + MIS/height(2). We used the Pearson correlation coefficient, p < 0.05 as significant. MNA and IMM were positively correlated with BMI, CP, CB and MG. Age influenced negatively FG corr., BMI, FM, IMM and CP. Fourteen had a history of osteoporotic fractures. The lowest T-score was directly related to MAN and MG. CONCLUSIONS The aging caused the decline of FG, fat mass and muscle; the calf circumference, and brachial reflected nutritional status and body composition; and major influences on BMD were nutritional status and fat mass.

Nutritional status, cachexia, and anorexia in women with peritoneal metastasis and intraperitoneal chemotherapy: a longitudinal analysis.

PubMed

Hilal, Ziad; Rezniczek, Günther A; Klenke, Robert; Dogan, Askin; Tempfer, Clemens B

2017-11-01

To describe the nutritional status of women with peritoneal metastasis (PM) from recurrent ovarian, fallopian, or peritoneal cancer and to assess longitudinal variations of the cachexia-anorexia syndrome (CAS) during palliative pressurized intraperitoneal aerosol chemotherapy (PIPAC). Nutritional assessment included body mass index (BMI), bioelectrical impedance analysis (BIA), and blood chemistry. CAS presence/absence was recorded before and during repeated cycles (1-11) of PIPAC. Eighty-four patients with peritoneal cancer (n=5) or PM from recurrent ovarian (n=77) or fallopian tube (n=2) cancer were included. At baseline, resting metabolism (RM) (1,432±172 kcal/day), visceral fat level (7.5±3.2), skeletal muscle mass (27.2%±4.6%), upper arm circumference (27.9±4.6 cm), lower leg circumference (35.1±3.9 cm), serum parameters (albumin [3.5±0.7 g/dL], total protein [6.3±0.9 g/dL], and transferrin [202±60 mg/dL]) were below normal limits. C-reactive protein (CRP) (4.3±6.8 mg/dL), caliper body fat (35.7%±6.3%), and total body fat mass (35.6%±8.5%) were above normal limits. Nineteen/84 (23%) patients had CAS at baseline. Deterioration or stabilization/improvement of CAS was observed in 9/55 (16.4%) and 46/55 (83.6%) patients with follow-up data, respectively. Baseline body fat mass, visceral fat level, skeletal muscle mass, caliper body fat, BMI, ascites, Karnofsky index, RM, and CRP, as well as tumor response were not predictive of CAS deterioration. Nutritional decline and onset or deterioration of CAS are difficult to predict. Careful measuring and monitoring of nutritional parameters and CAS in all patients seems to be necessary in order to identify those patients in need of enteral/parenteral nutrition support. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

The effect of oxandrolone on body proportions and body composition in growth hormone-treated girls with Turner syndrome.

PubMed

Menke, Leonie A; Sas, Theo C J; Zandwijken, Gladys R J; de Ridder, Maria A J; Stijnen, Theo; de Muinck Keizer-Schrama, Sabine M P F; Otten, Barto J; Wit, Jan M

2010-08-01

Untreated girls with Turner syndrome (TS) have short stature, relatively broad shoulders, a broad pelvis, short legs, a high fat mass and low muscle mass. Our objective was to assess the effect of the weak androgen oxandrolone (Ox) on body proportions and composition in growth hormone (GH)-treated girls with TS. 133 patients were included in a randomized, placebo-controlled, double-blind study. Patients were treated with GH (1.33 mg/m(2) per day) from baseline, combined with placebo (Pl) or Ox in a low (0.03 mg/kg per day) or previously conventional (0.06 mg/kg per day) dose from the age of eight, and oestrogens from the age of twelve. Sitting height, biacromial and biiliacal distances compared with height (i.e. shape values), BMI, waist circumference, sum of 4 skinfolds (sum4skin) and upper arm muscle area (UAMA) SD scores (SDS) were assessed half-yearly. Compared with GH + Pl, adult shape values on GH + Ox tended to be higher for sitting height (Ox 0.03, P = 0.2; Ox 0.06, P = 0.02) and biacromial distance (Ox 0.03, P = 0.2; Ox 0.06, P = 0.07) and lower for biiliacal distance (Ox 0.03, P = 0.004; Ox 0.06, P = 0.08). Sum4skin SDS tended to decrease more (Ox 0.03, P = 0.2; Ox 0.06, P = 0.005) while UAMA SDS increased more (Ox 0.03, P < 0.001; Ox 0.06, P < 0.001) than on GH + Pl. The increase in BMI and waist circumference SDS was comparable between the dosage groups. In GH-treated girls with TS, Ox 0.06 increases sitting height and tends to increase biacromial distance and decrease biiliacal distance, while Ox 0.03 significantly decreases biiliacal distance compared with height. Furthermore, Ox 0.06 reduces subcutaneous fat mass, and both Ox dosages increase muscle mass.

The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya: A cohort study

PubMed Central

Thitiri, Johnstone; Mwalekwa, Laura; Timbwa, Molline; Iversen, Per Ole; Fegan, Greg W.; Berkley, James A.

2017-01-01

Abstract The effects of rickets on children recovery from severe acute malnutrition (SAM) are unknown. Rickets may affect both growth and susceptibility to infectious diseases. We investigated the associations of clinically diagnosed rickets with life‐threatening events and anthropometric recovery during 1 year following inpatient treatment for complicated SAM. This was a secondary analysis of clinical trial data among non‐human immunodeficiency virus‐infected Kenyan children with complicated SAM (2–59 months) followed for 1 year posthospital discharge (ClinicalTrials.gov ID NCT00934492). The outcomes were mortality, hospital readmissions, and growth during 12 months. The main exposure was clinically diagnosed rickets at baseline. Of 1,778 children recruited, 230 (12.9%, 95% CI [11.4, 14 .6]) had clinical signs of rickets at baseline. Enrolment at an urban site, height‐for‐age and head circumference‐for‐age z scores were associated with rickets. Rickets at study enrolment was associated with increased mortality (adjusted Hazard Ratio [aHR] 1.61, 95% CI [1.14, 2.27]), any readmission (aHR 1.37, 95% CI [1.09, 1.72]), readmission for severe pneumonia (aHR 1.37, 95% CI [1.05, 1.79]), but not readmission with diarrhoea (aHR 1.05, 95% CI [0.73, 1.51]). Rickets was associated with increased height gain (centimetres), adjusted regression coefficient 0.19 (95% CI [0.10, 0.28]), but not changes in head circumference, mid‐upper arm circumference, or weight. Rickets was common among children with SAM at urban sites and associated with increased risks of severe pneumonia and death. Increased height gain may have resulted from vitamin D and calcium treatment. Future work should explore possibility of other concurrent micronutrient deficiencies and optimal treatment of rickets in this high‐risk population. PMID:29178404

Double burden of undernutrition and overnutrition in Vietnam in 2011: results of the SEANUTS study in 0·5-11-year-old children.

PubMed

Le Nguyen, Bao Khanh; Le Thi, Hop; Nguyen Do, Van Anh; Tran Thuy, Nga; Nguyen Huu, Chinh; Thanh Do, Tran; Deurenberg, Paul; Khouw, Ilse

2013-09-01

The Vietnamese South East Asian Nutrition Survey (SEANUTS), a cross-sectional study, was undertaken to assess the nutritional status in a nationally representative sample of children aged 0·5-11·9 years. A multi-stage cluster-randomised sampling method was used to recruit 2872 children. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemistry involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using a 24 h recall questionnaire, and nutrient intakes were compared with the Vietnamese RDA. In children aged < 5 years, approximately 14% were stunted, 8·6% underweight and 4·4% thin. A higher prevalence of stunting (15·6%) and underweight (22·2%) was observed in school-aged children. Undernutrition was more prevalent in rural areas than in urban areas. In contrast, almost 29% of the urban children were either overweight or obese when compared with 4% of the overweight children and 1·6% of the obese children in rural areas. A higher percentage of children in the age group 0·5-1·9 years and residing in rural areas had low Hb levels than those in the age group 2·0-5·9 years and residing in urban areas. In children aged 6-11 years, a small percentage had low Hb (11-14%) and vitamin A (5-10%) levels, but almost half the children (48-53%) had vitamin D insufficiency. Food consumption data indicated that the children did not meet the RDA for energy, protein, Fe, vitamin A, vitamin B1 and vitamin C. Results from the SEANUTS highlight the double burden of malnutrition in Vietnam. Information from the SEANUTS can serve as an input for targeted policy development, planning and development of nutrition programmes.

Perception and action in swimming: Effects of aquatic environment on upper limb inter-segmental coordination.

PubMed

Guignard, Brice; Rouard, Annie; Chollet, Didier; Ayad, Omar; Bonifazi, Marco; Dalla Vedova, Dario; Seifert, Ludovic

2017-10-01

This study assessed perception-action coupling in expert swimmers by focusing on their upper limb inter-segmental coordination in front crawl. To characterize this coupling, we manipulated the fluid flow and compared trials performed in a swimming pool and a swimming flume, both at a speed of 1.35ms -1 . The temporal structure of the stroke cycle and the spatial coordination and its variability for both hand/lower arm and lower arm/upper arm couplings of the right body side were analyzed as a function of fluid flow using inertial sensors positioned on the corresponding segments. Swimmers' perceptions in both environments were assessed using the Borg rating of perceived exertion scale. Results showed that manipulating the swimming environment impacts low-order (e.g., temporal, position, velocity or acceleration parameters) and high-order (i.e., spatial-temporal coordination) variables. The average stroke cycle duration and the relative duration of the catch and glide phases were reduced in the flume trial, which was perceived as very intense, whereas the pull and push phases were longer. Of the four coordination patterns (in-phase, anti-phase, proximal and distal: when the appropriate segment is leading the coordination of the other), flume swimming demonstrated more in-phase coordination for the catch and glide (between hand and lower arm) and recovery (hand/lower arm and lower arm/upper arm couplings). Conversely, the variability of the spatial coordination was not significantly different between the two environments, implying that expert swimmers maintain consistent and stable coordination despite constraints and whatever the swimming resistances. Investigations over a wider range of velocities are needed to better understand coordination dynamics when the aquatic environment is modified by a swimming flume. Since the design of flumes impacts significantly the hydrodynamics and turbulences of the fluid flow, previous results are mainly related to the characteristics of the flume used in the present study (or a similar one), and generalization is subject to additional investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

Short term health impact of a yoga and diet change program on obesity.

PubMed

Telles, Shirley; Naveen, Visweswaraiah K; Balkrishna, Acharya; Kumar, Sanjay

2010-01-01

Obese persons often find physical activity difficult. The effects of a yoga and diet change program, emphasizing breathing techniques practiced while seated, was assessed in obese persons. A single group of 47 persons were assessed on the first and last day of a yoga and diet change program, with 6 days of the intervention between assessments. The assessments were: body mass index (BMI), waist and hip circumferences, mid-arm circumference, body composition, hand grip strength, postural stability, serum lipid profile and fasting serum leptin levels. Participants practiced yoga for 5 hours every day and had a low fat, high fiber, vegetarian diet. Last and first day data were compared using a t-test for paired data. Following the 6-day residential program, participants showed a decrease in BMI (1.6 percent), waist and hip circumferences, fat-free mass, total cholesterol (7.7 percent decrease), high density lipoprotein (HDL) cholesterol (8.7 percent decrease), fasting serum leptin levels (44.2 percent decrease) and an increase in postural stability and hand grip strength (p<0.05, all comparisons). A 6-day yoga and diet change program decreased the BMI and the fat-free mass. Total cholesterol also decreased due to reduced HDL levels. This suggests that a brief, intensive yoga program with a change in diet can pose certain risks. Benefits seen were better postural stability, grip strength (though a 'practice effect' was not ruled out), reduced waist and hip circumferences and a decrease in serum leptin levels.

Serum Leptin Is a Biomarker of Malnutrition in Decompensated Cirrhosis

PubMed Central

Rachakonda, Vikrant; Borhani, Amir A.; Dunn, Michael A.; Andrzejewski, Margaret; Martin, Kelly; Behari, Jaideep

2016-01-01

Background and Aims Malnutrition is a leading cause of morbidity and mortality in cirrhosis. There is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. The aim of this study was to measure biochemical, serologic, hormonal, radiographic, and anthropometric features in a cohort of hospitalized cirrhotic patients to characterize biomarkers for identification of malnutrition. Design In this prospective observational cohort study, 52 hospitalized cirrhotic patients were classified as malnourished (42.3%) or nourished (57.7%) based on mid-arm muscle circumference < 23 cm and dominant handgrip strength < 30 kg. Anthropometric measurements were obtained. Appetite was assessed using the Simplified Nutrition Appetite Questionnaire (SNAQ) score. Fasting levels of serum adipokines, cytokines, and hormones were determined using Luminex assays. Logistic regression analysis was used to determine features independently associated with malnutrition. Results Subjects with and without malnutrition differed in several key features of metabolic phenotype including wet and dry BMI, skeletal muscle index, visceral fat index and HOMA-IR. Serum leptin levels were lower and INR was higher in malnourished subjects. Serum leptin was significantly correlated with HOMA-IR, wet and dry BMI, mid-arm muscle circumference, skeletal muscle index, and visceral fat index. Logistic regression analysis revealed that INR and log-transformed leptin were independently associated with malnutrition. Conclusions Low serum leptin and elevated INR are associated with malnutrition in hospitalized patients with end-stage liver disease. PMID:27583675

Physiological and anthropometric determinants of rhythmic gymnastics performance.

PubMed

Douda, Helen T; Toubekis, Argyris G; Avloniti, Alexandra A; Tokmakidis, Savvas P

2008-03-01

To identify the physiological and anthropometric predictors of rhythmic gymnastics performance, which was defined from the total ranking score of each athlete in a national competition. Thirty-four rhythmic gymnasts were divided into 2 groups, elite (n = 15) and nonelite (n = 19), and they underwent a battery of anthropometric, physical fitness, and physiological measurements. The principal-components analysis extracted 6 components: anthropometric, flexibility, explosive strength, aerobic capacity, body dimensions, and anaerobic metabolism. These were used in a simultaneous multiple-regression procedure to determine which best explain the variance in rhythmic gymnastics performance. Based on the principal-component analysis, the anthropometric component explained 45% of the total variance, flexibility 12.1%, explosive strength 9.2%, aerobic capacity 7.4%, body dimensions 6.8%, and anaerobic metabolism 4.6%. Components of anthropometric (r = .50) and aerobic capacity (r = .49) were significantly correlated with performance (P < .01). When the multiple-regression model-y = 10.708 + (0.0005121 x VO2max) + (0.157 x arm span) + (0.814 x midthigh circumference) - (0.293 x body mass)-was applied to elite gymnasts, 92.5% of the variation was explained by VO2max (58.9%), arm span (12%), midthigh circumference (13.1%), and body mass (8.5%). Selected anthropometric characteristics, aerobic power, flexibility, and explosive strength are important determinants of successful performance. These findings might have practical implications for both training and talent identification in rhythmic gymnastics.

Control of the seven-degree-of-freedom upper limb exoskeleton for an improved human-robot interface

NASA Astrophysics Data System (ADS)

Kim, Hyunchul; Kim, Jungsuk

2017-04-01

This study analyzes a practical scheme for controlling an exoskeleton robot with seven degrees of freedom (DOFs) that supports natural movements of the human arm. A redundant upper limb exoskeleton robot with seven DOFs is mechanically coupled to the human body such that it becomes a natural extension of the body. If the exoskeleton robot follows the movement of the human body synchronously, the energy exchange between the human and the robot will be reduced significantly. In order to achieve this, the redundancy of the human arm, which is represented by the swivel angle, should be resolved using appropriate constraints and applied to the robot. In a redundant 7-DOF upper limb exoskeleton, the pseudoinverse of the Jacobian with secondary objective functions is widely used to resolve the redundancy that defines the desired joint angles. A secondary objective function requires the desired joint angles for the movement of the human arm, and the angles are estimated by maximizing the projection of the longest principle axis of the manipulability ellipsoid for the human arm onto the virtual destination toward the head region. Then, they are fed into the muscle model with a relative damping to achieve more realistic robot-arm movements. Various natural arm movements are recorded using a motion capture system, and the actual swivel-angle is compared to that estimated using the proposed swivel angle estimation algorithm. The results indicate that the proposed algorithm provides a precise reference for estimating the desired joint angle with an error less than 5°.

CRUX: A compliant robotic upper-extremity exosuit for lightweight, portable, multi-joint muscular augmentation.

PubMed

Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Trombadore, James M; Teodorescu, Mircea; Agogino, Adrian; Kurniawan, Sri

2017-07-01

Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the user's movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the underlying complexity of the human body. In this paper, we present a compliant, robotic exosuit for upper extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible multi-joint design for portable augmentation. We also illustrate how CRUX maintains the full range of motion of the upper-extremities for its users while providing multi-DoF strength amplification to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

Cylindrical surface profile and diameter measuring tool and method

NASA Technical Reports Server (NTRS)

Currie, James R. (Inventor); Kissel, Ralph R. (Inventor); Smith, Earnest C. (Inventor); Oliver, Charles E. (Inventor); Redmon, John W., Sr. (Inventor); Wallace, Charles C. (Inventor); Swanson, Charles P. (Inventor)

1987-01-01

A tool is shown having a cross beam assembly made of beams joined by a center box structure. The assembly is adapted to be mounted by brackets to the outer end of a cylindrical case. The center box structure has a vertical shaft rotatably mounted therein and extending beneath the assembly. Secured to the vertical shaft is a radius arm which is adapted to rotate with the shaft. On the longer end of the radius arm is a measuring tip which contacts the cylindrical surface to be measured and which provides an electric signal representing the radius of the cylindrical surface from the center of rotation of the radius arm. An electric servomotor rotates the vertical shaft and an electronic resolver provides an electric signal representing the angle of rotation of the shaft. The electric signals are provided to a computer station which has software for its computer to calculate and print out the continuous circumference profile of the cylindrical surface, and give its true diameter and the deviations from the ideal circle.

Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders--A case-control ultrasound speckle tracking analysis.

PubMed

Landén Ludvigsson, Maria; Peterson, Gunnel; Jull, Gwendolen; Trygg, Johan; Peolsson, Anneli

2016-02-01

Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep). The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01). This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. Clinical Trials.gov, Number: NCT01547624. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intra-Cyclic Phases of Arm-Leg Movement and Index of Coordination in Relation to Sprint Breaststroke Swimming in Young Swimmers

PubMed Central

Strzala, Marek; Krezalek, Piotr; Glab, Grzegorz; Kaca, Marcin; Ostrowski, Andrzej; Stanula, Arkadiusz; Tyka, Anna K.

2013-01-01

Despite the limitations set by FINA regulations, execution technique in breaststroke swimming is being improved thanks to more and more advanced analyses of the efficiency of the swimmer’s movements. The aim of this study was to detect the parameters of the time structure of the cycle correlated with the maximal swimming speed at the of 50 meters distance, in order to focus to specific technical aspects in the breaststroke training. In the group of 23 participants, between the age of 15.0 ± 1.17, the breaststroke cycle movement of the arms and legs was divided into two phases: propulsive or non-propulsive. In addition, indices characterizing the temporal coordination of movements of the upper limbs in relation to the lower limbs were distinguished: 1) Arm-Leg Lag - determines the interval between the phases of propulsion generated by upper and lower limbs; 2) Glide or Overlap - the inter-cyclic glide or overlap of the propulsive movement of the upper on lower limbs. Significant dependence was noted between the swim speed (V50surface breast) and the percentage of time of the arm propulsive in-sweep phase 0.64, p < 0.01. A significant correlation was observed between the V50surface breast with the percentage of partially surfaced hand phase of arm recovery 0.54, p < 0.01. Correlation between total leg propulsion and non-propulsion phases with V50surface breast was 0.49 and -0.49 respectively, both p < 0.01. The Glide or Overlap index was significantly related to the swimming speed V50surface breast 0.48, p < 0.05. This type of analysis suggests how to refine the swimming technique, with the goal to improve the current speed capabilities; furthermore the results also indicate the direction of its development in the future swimmers of the group studied. Key Points This study investigated the influence of the inter- and intra-cyclic time structure of the movements in sprint breaststroke swimming. The distinction of the operations phases of the upper limbs in the propulsive movement shows significant correlation 0.64, p <0.01 between the swimming speed V50surface breast and the execution time of the in-sweep phase in the movement cycle. Significant relationship was noted between minimizing the first non-propulsive phase of arm recovery with higher contribution of the next, partially immersed sliding phase of arm recovery. The specification of the inter-cyclic coordination index of the upper and lower limbs during the movement cycle shows influence of the overlap of the propulsive movement of the upper limbs on the propulsive movement of the lower limbs on V50surface breast with correlation 0.48, p <0.05 for young swimmers. PMID:24421728

Protocol of the Low Birth Weight South Asia Trial (LBWSAT), a cluster-randomised controlled trial testing impact on birth weight and infant nutrition of Participatory Learning and Action through women's groups, with and without unconditional transfers of fortified food or cash during pregnancy in Nepal.

PubMed

Saville, Naomi M; Shrestha, Bhim P; Style, Sarah; Harris-Fry, Helen; Beard, B James; Sengupta, Aman; Jha, Sonali; Rai, Anjana; Paudel, Vikas; Pulkki-Brannstrom, Anni-Maria; Copas, Andrew; Skordis-Worrall, Jolene; Bhandari, Bishnu; Neupane, Rishi; Morrison, Joanna; Gram, Lu; Sah, Raghbendra; Basnet, Machhindra; Harthan, Jayne; Manandhar, Dharma S; Osrin, David; Costello, Anthony

2016-10-21

Low birth weight (LBW, < 2500 g) affects one third of newborn infants in rural south Asia and compromises child survival, infant growth, educational performance and economic prospects. We aimed to assess the impact on birth weight and weight-for-age Z-score in children aged 0-16 months of a nutrition Participatory Learning and Action behaviour change strategy (PLA) for pregnant women through women's groups, with or without unconditional transfers of food or cash to pregnant women in two districts of southern Nepal. The study is a cluster randomised controlled trial (non-blinded). PLA comprises women's groups that discuss, and form strategies about, nutrition in pregnancy, low birth weight and hygiene. Women receive up to 7 monthly transfers per pregnancy: cash is NPR 750 (~US$7) and food is 10 kg of fortified sweetened wheat-soya Super Cereal per month. The unit of randomisation is a rural village development committee (VDC) cluster (population 4000-9200, mean 6150) in southern Dhanusha or Mahottari districts. 80 VDCs are randomised to four arms using a participatory 'tombola' method. Twenty clusters each receive: PLA; PLA plus food; PLA plus cash; and standard care (control). Participants are (mostly Maithili-speaking) pregnant women identified from 8 weeks' gestation onwards, and their infants (target sample size 8880 birth weights). After pregnancy verification, mothers may be followed up in early and late pregnancy, within 72 h, after 42 days and within 22 months of birth. Outcomes pertain to the individual level. Primary outcomes include birth weight within 72 h of birth and infant weight-for-age Z-score measured cross-sectionally on children born of the study. Secondary outcomes include prevalence of LBW, eating behaviour and weight during pregnancy, maternal and newborn illness, preterm delivery, miscarriage, stillbirth or neonatal mortality, infant Z-scores for length-for-age and weight-for-length, head circumference, and postnatal maternal BMI and mid-upper arm circumference. Exposure to women's groups, food or cash transfers, home visits, and group interventions are measured. Determining the relative importance to birth weight and early childhood nutrition of adding food or cash transfers to PLA women's groups will inform design of nutrition interventions in pregnancy. ISRCTN75964374 , 12 Jul 2013.

A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery

PubMed Central

House, Gregory; Burdea, Grigore; Grampurohit, Namrata; Polistico, Kevin; Roll, Doru; Damiani, Frank; Hundal, Jasdeep; Demesmin, Didier

2016-01-01

Background: Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. Objectives: The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. Methods: BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20–50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. Results: Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). Conclusion: This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression. PMID:27867508

A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery.

PubMed

House, Gregory; Burdea, Grigore; Grampurohit, Namrata; Polistico, Kevin; Roll, Doru; Damiani, Frank; Hundal, Jasdeep; Demesmin, Didier

2016-11-01

Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20-50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression.

Physiologically Relevant Prosthetic Limb Movement Feedback for Upper and Lower Extremity Amputees

DTIC Science & Technology

2016-10-01

upper arm (elbow movement), Upper leg (knee movement) and lower leg ( ankle movement) to provide a physiologically relevant sense of limb movement...Additionally a BOA cable tensioning system is passed through these plates and anchored to the external surface of the socket. When tension is applied the

Age Differences in Energy Absorption in the Upper Extremity During a Descent Movement: Implications for Arresting a Fall

PubMed Central

Stotz, Paula J.; Normandin, Sarah C.; Robinovitch, Stephen N.

2010-01-01

Background Falls are the number one cause of unintentional injury in older adults. The protective response of “breaking the fall” with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Methods Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15° to 90°. Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. Results On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 ± 0.5% vs 3.1 ± 0.4% of their body weight × body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. Conclusions During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall. PMID:19861641

Age differences in energy absorption in the upper extremity during a descent movement: implications for arresting a fall.

PubMed

Sran, Meena M; Stotz, Paula J; Normandin, Sarah C; Robinovitch, Stephen N

2010-03-01

Falls are the number one cause of unintentional injury in older adults. The protective response of "breaking the fall" with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15 degrees to 90 degrees . Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 +/- 0.5% vs 3.1 +/- 0.4% of their body weight x body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall.

Intermanual transfer in training with an upper-limb myoelectric prosthesis simulator: a mechanistic, randomized, pretest-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2013-01-01

Intermanual transfer may improve prosthetic handling and acceptance if used in training soon after an amputation. The purpose of this study was to determine whether intermanual transfer effects can be detected after training with a myoelectric upper-limb prosthesis simulator. A mechanistic, randomized, pretest-posttest design was used. A total of 48 right-handed participants (25 women, 23 men) who were able-bodied were randomly assigned to an experimental group or a control group. The experimental group performed a training program of 5 days' duration using the prosthesis simulator. To determine the improvement in skill, a test was administered before, immediately after, and 6 days after training. The control group only performed the tests. Training was performed with the unaffected arm, and tests were performed with the affected arm (the affected arm simulating an amputated limb). Half of the participants were tested with the dominant arm and half with the nondominant arm. Initiation time was defined as the time from starting signal until start of the movement, movement time was defined as the time from the beginning of the movement until completion of the task, and force control was defined as the maximal applied force on a deformable object. The movement time decreased significantly more in the experimental group (F₂,₉₂=7.42, P=.001, η²(G)=.028) when compared with the control group. This finding is indicative of faster handling of the prosthesis. No statistically significant differences were found between groups with regard to initiation time and force control. We did not find a difference in intermanual transfer between the dominant and nondominant arms. The training utilized participants who were able-bodied in a laboratory setting and focused only on transradial amputations. Intermanual transfer was present in the affected arm after training the unaffected arm with a myoelectric prosthesis simulator, and this effect did not depend on laterality. This effect may improve rehabilitation of patients with an upper-limb amputation.

Deficits in Upper Limb Position Sense of Children with Spastic Hemiparetic Cerebral Palsy Are Distance-Dependent

ERIC Educational Resources Information Center

Smorenburg, Ana R. P.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

2012-01-01

This study examined the arm position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and typically developing children (TD) by means of a contralateral matching task. This task required participants to match the position of one arm with the position of the other arm for different target distances and from different starting…

The clinical aspects of the upper extremity exoskeleton "EXAR" use

NASA Astrophysics Data System (ADS)

Vorobiev, A. A.; Krivonozhkina, P. S.; Andryushchenko, F. A.; Zasypkina, O. A.

2015-11-01

The article considers some of indications and contraindications for the use of the exoskeleton "EXAR". Our experience with the present construction use shows that the exoskeleton "EXAR" is able to make up the following lost or disturbed muscle functions:- an arm raise; a drawing of the arm aside from the trunk;- a bending of the arm in shoulder or elbow joints.

Anthropometric and Laboratory Variables Related to Weight Loss-Comparison of Heart Failure Patients with Tumor Patients and Control Population.

PubMed

Letilovic, Tomislav; Vrhovac, Radovan; Krznarić, Željko

2017-01-01

Body weight loss is an important feature of heart failure (HF) and tumors. It is related to both reduced survival and adverse reactions to therapy in both of these conditions. The mechanisms of body weight loss in patients with HF and tumors are considered to be similar. Yet, studies comparing those two populations are generally lacking. The aim of this study was to compare anthropometric and laboratory data, related to weight loss, between patients with chronic HF and patients with different tumors as well as control population. Laboratory and anthropometric data on 143 consecutive patients with chronic HF and malignant diseases as well as data for 20 controls were collected. Patients with HF had lower levels of C-reactive protein (CRP) and albumin compared to controls. Anthropometric measurements revealed lower body mass index (BMI), muscle strength, mid-arm circumference, and waist circumference in patients with HF compared to controls. Measurements of biceps, triceps, subscapular, and suprailiac skinfolds were also lower in HF group. Compared to solid tumor group, HF patients had lower levels of CRP and higher levels of hemoglobin. Solid tumor patients had lower values of BMI and subscapular skinfold thickness, as well as higher muscle strength compared to HF group. Finally, compared to patients with solid hematological tumors, HF group had lower levels of albumin, lower muscle strength, as well as lower mid-arm circumference. We found differences in anthropometric and laboratory features, related to weight loss, in patients with HF compared to control population that were expected. On the other hand, observed differences in HF group compared to patients with various tumors could imply different pathophysiological mechanisms of weight loss between those groups. Such data could serve as a cornerstone for studies with larger numbers of patients and deeper pathophysiological insight.

Accuracy of non-paralytic anthropometric data for nutritional screening in older patients with stroke and hemiplegia.

PubMed

Nishioka, S; Wakabayashi, H; Yoshida, T

2017-02-01

Although malnutrition commonly affects stroke patients, there are no validated screening tools. We verified the usefulness of non-paralytic anthropometric measurements for the nutritional screening of stroke. A cross-sectional study was conducted in consecutive stroke patients with hemiplegia aged ⩾65 years, with Mini Nutritional Assessment Short Form score ⩽11. Diagnostic malnutrition criteria from the European Society for Clinical Nutrition and Metabolism were the reference standards: body mass index (BMI) <18.5 kg/m 2 or weight loss >10%+BMI <22 or 20 kg/m 2 . Non-paralytic anthropometric measurements (calf circumference (CC), arm circumference (AC), triceps skinfold (TSF) and arm muscle circumference (AMC)) and serum albumin concentration (Alb) at admission were the index tests. Cutoffs were determined by receiver operation curve and Youden index, and accuracy by area under the curve (AUC) and kappa value. Functional independence measures at discharge and discharge destination were collected. We included 488 patients (224 men and 264 women) with a mean age of 78.8 years and mean BMI of 22.0 and 21.1 kg/m 2 , respectively. Eighty-one men and 124 women had malnutrition. The AUC for CC, AC, TSF, AMC and Alb was 0.859, 0.825, 0.764, 0.745 and 0.670 for men, and 0.881, 0.843, 0.796, 0.742 and 0.658 for women, respectively. In both sexes, CC had the highest kappa (0.533, 0.608; both P<0.001) with cutoff values ⩽31 and ⩽30 cm. Patients with lower CC showed significantly worse functional outcomes and lower proportion of return to home (P<0.001). Non-paralytic CC indicated malnutrition with sufficient accuracy and good correlation with functional capacity; it may be a useful nutritional screening tool for stroke.

Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease.

PubMed

Ho, Shu-Chuan; Wang, Jiun-Yi; Kuo, Han-Pin; Huang, Chien-Da; Lee, Kang-Yun; Chuang, Hsiao-Chi; Feng, Po-Hao; Chen, Tzu-Tao; Hsu, Min-Fang

2016-01-01

Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death in the world. Patients with COPD experience airflow obstruction, weight loss, skeletal muscle dysfunction, and comorbidities. Anthropometric indicators are risk factors for mortality in geriatric assessment. This study examined and compared the associations of anthropometric indicators, such as low body mass index (BMI), low mid-arm circumference (MAC), and low calf circumference (CC), with the prediction of a 3-year follow-up mortality risk in patients with COPD. We recruited nonhospitalized patients with COPD without acute conditions from a general hospital in Taiwan. The BMI, MAC, and CC of all patients were measured, and they were followed for 3 years through telephone interviews and chart reviews. The Kaplan-Meier survival curves stratified by BMI, MAC, and CC were analyzed. Variables univariately associated with survival were entered into a multivariate Cox regression model. The Bayesian information criterion was used to compare the predictive ability of the three anthropometric indicators to predict mortality rate. In total, 104 patients were included (mean ± standard deviation age, 74.2±6.9 years; forced expiratory volume in 1 second [%], 58.4±20.4 predicted; males, 94.2%); 22 patients (21.2%) died during the 36-month follow-up. During this long-term follow-up, the three anthropometric indicators could predict mortality risk in patients with COPD (low BMI [<21 kg/m(2)], hazard ratio [HR] =2.78, 95% confidence interval [CI] =1.10-7.10; low MAC [<23.5 cm], HR =3.09, 95% CI =1.30-7.38; low CC [<30 cm], HR =4.40, 95% CI =1.82-10.63). CC showed the strongest potential in predicting the mortality risk, followed by MAC and BMI. Among the three anthropometric variables examined, CC can be considered a strong predictor of mortality risk in patients with COPD.

A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.

PubMed

Mramba, Lazarus; Ngari, Moses; Mwangome, Martha; Muchai, Lilian; Bauni, Evasius; Walker, A Sarah; Gibb, Diana M; Fegan, Gregory; Berkley, James A

2017-08-03

Objectives  To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality. Design  Growth curve construction and longitudinal cohort study. Setting  United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe. Participants  The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year. Main outcome measures  Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores. Results  The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of -2 to -3 and less than-3, compared with -2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval -0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002). Conclusions  The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Head circumference at birth and childhood developmental disorders in a nationwide cohort in Denmark.

PubMed

Aagaard, Kristina; Bach, Cathrine Carlsen; Henriksen, Tine Brink; Larsen, René Tidemand; Matthiesen, Niels Bjerregård

2018-06-08

Early markers of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) may improve the understanding and early recognition of these disorders. We aimed to estimate the association between head circumference at birth, a measure of cerebral size at birth, and the risk of ADHD and ASD. We present a register-based cohort study of all Danish singletons born alive between 1997 and 2013. Cox proportional hazards regression was used for the statistical analyses. Sibling-matched analyses were performed to account for unmeasured confounding shared by siblings. The analyses included 986 909 new-borns. Compared to normocephalic children, microcephaly was associated with an increased risk of ADHD (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12, 1.32). Macrocephaly was associated with a decreased risk of ADHD (HR 0.90, 95% CI 0.82, 0.99). Neither microcephaly nor macrocephaly were associated with ASD (HR 1.06, 95% CI 0.94, 1.19 and 1.03, 95% CI 0.90, 1.19). The largest difference was found within the normocephalic children. A head circumference at the lower limit of normocephaly compared to a head circumference at the upper limit was associated with an increased risk of ADHD (HR 1.52, 95% CI 1.43, 1.63). The sibling analyses confirmed the increased risk of ADHD with decreasing head circumference in the normocephalic children. No other clear associations were present in the sibling analyses. Within normocephalic children, smaller head circumference at birth was associated with a higher risk of ADHD. Restricted foetal brain growth may be a risk factor for the development of ADHD but not ASD. © 2018 John Wiley & Sons Ltd.

Upper airway sleep-disordered breathing in women.

PubMed

Guilleminault, C; Stoohs, R; Kim, Y D; Chervin, R; Black, J; Clerk, A

1995-04-01

To investigate the various clinical presentations of sleep-disordered breathing in women. A retrospective case-control study. A sleep disorders clinic. 334 women, aged 18 years and older, seen between 1988 and 1993, who were diagnosed with upper airway sleep-disordered breathing. Controls were 60 women with insomnia and 100 men with sleep-disordered breathing. Clinical, anatomic, and polygraphic information. The mean lag time (+/- SD) in women between the appearance of symptoms and a positive diagnosis was 9.7 +/- 3.1 years; among participants 30 to 60 years of age, the duration of untreated symptoms differed (P < 0.001) between women and men. Sleep-disordered breathing was blamed for divorce or social isolation by 40% of the case patients. Abnormal maxillomandibular features were noted in 45% of the women with disordered breathing. Dysmenorrhea and amenorrhea (which disappeared after treatment with nasal continuous positive airway pressure) were reported in 43% of premenopausal women compared with 13% of persons in the control group of women with insomnia. Thirty-eight women (11.4%) with upper airway sleep-disordered breathing had a respiratory disturbance index of less than 5 and were significantly younger, had a smaller neck circumference, and had a lower body mass index than women with a respiratory disturbance index of 5 or more. Physicians should revise their understanding of upper airway sleep-disordered breathing so that they notice women with certain craniofacial features, a low body mass index, a small neck circumference, and a respiratory disturbance index of less than 5. These revisions may enable more rapid diagnosis and treatment of women with sleep-disordered breathing.

Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity.

PubMed

Demark-Wahnefried, Wendy; Cases, Mallory G; Cantor, Alan B; Frugé, Andrew D; Smith, Kerry P; Locher, Julie; Cohen, Harvey J; Tsuruta, Yuko; Daniel, Michael; Kala, Rishabh; De Los Santos, Jennifer F

2018-04-01

Holistic approaches are sought to improve lifestyle behaviors and health of cancer survivors long term. Our aim was to explore whether a home-based vegetable gardening intervention is feasible and whether it improves diet and other health-related outcomes among older cancer survivors. We conducted a feasibility trial in which cancer survivors were randomized to receive a year-long gardening intervention immediately or to a wait-list control arm. Home visits at baseline and 1 year assessed physical performance, anthropometric indices, behavioral and psychosocial outcomes, and biomarkers. Participants included 46 older (aged 60+ years) survivors of locoregionally staged cancers across Alabama from 2014 to 2016. Forty-two completed 1-year follow-up. Cooperative extension master gardeners delivered guidance to establish three seasonal vegetable gardens at survivors' homes. Plants, seeds, and gardening supplies were provided. Primary outcomes were feasibility targets of 80% accrual and retention, and an absence of serious adverse events; other outcomes were secondary and explored potential benefits. Baseline to follow-up changes were assessed within and between arms using paired t, McNemar's, and χ 2 tests. This trial proved to be safe and demonstrated 91.3% retention; 70% of intervention participants rated their experience as "excellent," and 85% would "do it again." Data suggest significantly increased reassurance of worth (+0.49 vs -0.45) and attenuated increases in waist circumference (+2.30 cm vs +7.96 cm) in the gardening vs control arms (P=0.02). Vegetable and fruit consumption increased by approximately 1 serving/day within the gardening arm from baseline to follow-up (mean [standard error]=1.34 [1.2] to 2.25 [1.9] servings/day; P=0.02)] compared to controls (1.22 [1.1] to 1.12 [0.7]; P=0.77; between-arm P=0.06). The home vegetable gardening intervention among older cancer survivors was feasible and suggested improvements in vegetable and fruit consumption and reassurance of worth; data also suggest attenuated increases in waist circumference. Continued study of vegetable gardening interventions is warranted to improve health, health behaviors, and well-being of older cancer survivors. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Limb suction evoked during arterial occlusion causes systemic sympathetic activity in humans

PubMed Central

Cui, Jian; Blaha, Cheryl; Herr, Michael D.; Drew, Rachel C.; Muller, Matthew D.

2015-01-01

Venous saline infusions in an arterially occluded forearm evokes reflex increases in muscle sympathetic nerve activity (MSNA) and blood pressure (BP). We hypothesized that the application of suction to the human limbs would activate this venous distension reflex and raise sympathetic outflow. We placed airtight pressure tanks and applied 100 mmHg negative pressure to an arterially occluded limb (occlusion and suction, O&S) to induce tissue deformation without fluid translocation. BP, heart rate (HR), and MSNA were assessed in 19 healthy subjects during 2 min of arm or leg O&S. Occlusion without suction served as a control. During a separate visit, saline (5% forearm volume) was infused into veins of the arterially occluded arm (n = 13). The O&S increased limb circumference, MSNA burst rate (arm: Δ6.7 ± 0.7; leg: Δ6.8 ± 0.7 bursts/min), and total activity (arm: Δ199 ± 14; leg: Δ172 ± 22 units/min) and BP (arm: Δ4.3 ± 0.3; leg: Δ9.4 ± 1.4 mmHg) from the baseline. The MSNA and BP responses during arm O&S correlated with those during leg O&S. Occlusion alone had no effect on MSNA and BP. MSNA (r = 0.607) responses during arm O&S correlated with those evoked by the saline infusion into the arm. These correlations suggest that sympathetic activation during limb O&S is likely, at least partially, to be evoked via the venous distension reflex. These data suggest that suction of an occluded limb evokes sympathetic activation and that the limb venous distension reflex exists in arms and legs of normal humans. PMID:26136530

Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury.

PubMed

Kankipati, Padmaja; Boninger, Michael L; Gagnon, Dany; Cooper, Rory A; Koontz, Alicia M

2015-07-01

Repeated measures design. This study compared the upper extremity (UE) joint kinetics between three transfer techniques. Research laboratory. Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers. Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique. Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement.

Effect of torso flexion on the lumbar torso extensor muscle sagittal plane moment arms.

PubMed

Jorgensen, Michael J; Marras, William S; Gupta, Purnendu; Waters, Thomas R

2003-01-01

Accurate anatomical inputs for biomechanical models are necessary for valid estimates of internal loading. The magnitude of the moment arm of the lumbar erector muscle group is known to vary as a function of such variables as gender. Anatomical evidence indicates that the moment arms decrease during torso flexion. However, moment arm estimates in biomechanical models that account for individual variability have been derived from imaging studies from supine postures. Quantify the sagittal plane moment arms of the lumbar erector muscle group as a function of torso flexion, and identify individual characteristics that are associated with the magnitude of the moment arms as a function of torso flexion. Utilization of a 0.3 Tesla Open magnetic resonance image (MRI) to image and quantify the moment arm of the right erector muscle group as a function of gender and torso flexion. Axial MRI images through and parallel to each of the lumbar intervertebral discs at four torso flexion angles were obtained from 12 male and 12 female subjects in a lateral recumbent posture. Multivariate analysis of variance was used to investigate the differences in the moment arms at different torso flexion angles, whereas hierarchical linear regression was used to investigate associations with individual anthropometric characteristics and spinal posture. The largest decrease in the lumbar erector muscle group moment arm from neutral to 45-degree flexion occurred at the L5-S1 level (9.7% and 8.9% for men and women, respectively). Measures of spinal curvature (L1-S1 lordosis), body mass and trunk characteristics (depth or circumference) were associated with the varying moment arm at most lumbar levels. The sagittal plane moment arms of the lumbar erector muscle mass decrease as the torso flexes forward. The change in moment arms as a function of torso flexion may have an impact on prediction of spinal loading in biomechanical models.

The Arm is Not the Leg: Pathophysiology, Diagnosis, and Management of Upper Extremity Deep Vein Thrombosis.

PubMed

Noyes, Adam M; Dickey, John

2017-05-01

Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT. Thus, education on recognition, classification and management is critical to avoid long-term sequelae and mortality from UEDVT. [Full article available at http://rimed.org/rimedicaljournal-2017-05.asp].

Dynamic upper airway changes during sleep in patients with obstructive sleep apnea syndrome.

PubMed

Chuang, Li-Pang; Chen, Ning-Hung; Li, Hsueh-Yu; Lin, Shih-Wei; Chou, Yu-Ting; Wang, Chao-Jan; Liao, Yu-Fang; Tsai, Ying-Huang

2009-12-01

The narrowing pattern of the upper airway in obstructive sleep apnea patients may be different in sleep as compared with awake. Three different types of obstruction were observed in these subjects during drug-induced sleep. The different obstruction pattern during drug-induced sleep suggests that different strategies should be selected in upper airway management. To identify the sites of narrowing and evaluate dynamic upper airway movement in patients with obstructive sleep apnea syndrome (OSAS) while awake and asleep. This study included 10 patients treated for OSAS between August 2003 and June 2004. Overnight polysomnography was performed on all patients. Parameters including gender, age, neck circumference, and body mass index were recorded. Ultra-fast MRI during awake and drug-induced sleep was arranged to evaluate the dynamic motion of the upper airway. The narrowing pattern of the upper airway during awake differed from the narrowing pattern during drug-induced sleep in 3 of 10 subjects. Three different types, palatal obstruction, combined upper and lower pharyngeal obstruction, and circumferential obstruction of the upper airway, were observed in these patients during drug-induced sleep.

Accessory superficial ulnar artery: a case report.

PubMed

Solan, Shweta

2013-12-01

Variations in the arterial system of the upper limb have been well documented. A thorough knowledge on variations of arteries of upper extremity is necessary during performance of vascular and reconstructive surgeries and also, during evaluation of angiographic images. A case of accessory superficial ulnar artery was reported. The ulnar artery had a high origin from the brachial artery, in the upper third of the arm and it proceeded superficially and lateral to ulnar nerve in forearm, but it had a normal termination in the hand. The brachial artery had a usual course in the arm, but in the cubital fossa, it divided into the radial and deep ulnar arteries. This deep ulnar artery ended by dividing into ulnar recurrent and common interosseous arteries. Knowledge on this variation is important for the radiologists, orthopaedic and plastic surgeons, for appropriate planning of operative procedures involving the arteries of the upper limb.

Accessory Superficial Ulnar Artery: A Case Report

PubMed Central

Solan, Shweta

2013-01-01

Variations in the arterial system of the upper limb have been well documented. A thorough knowledge on variations of arteries of upper extremity is necessary during performance of vascular and reconstructive surgeries and also, during evaluation of angiographic images. A case of accessory superficial ulnar artery was reported. The ulnar artery had a high origin from the brachial artery, in the upper third of the arm and it proceeded superficially and lateral to ulnar nerve in forearm, but it had a normal termination in the hand. The brachial artery had a usual course in the arm, but in the cubital fossa, it divided into the radial and deep ulnar arteries. This deep ulnar artery ended by dividing into ulnar recurrent and common interosseous arteries. Knowledge on this variation is important for the radiologists, orthopaedic and plastic surgeons, for appropriate planning of operative procedures involving the arteries of the upper limb. PMID:24551682

Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: study rationale, development and design.

PubMed

Cho, Alex H; Killeya-Jones, Ley A; O'Daniel, Julianne M; Kawamoto, Kensaku; Gallagher, Patrick; Haga, Susanne; Lucas, Joseph E; Trujillo, Gloria M; Joy, Scott V; Ginsburg, Geoffrey S

2012-01-18

Type 2 diabetes is a prevalent chronic condition globally that results in extensive morbidity, decreased quality of life, and increased health services utilization. Lifestyle changes can prevent the development of diabetes, but require patient engagement. Genetic risk testing might represent a new tool to increase patients' motivation for lifestyle changes. Here we describe the rationale, development, and design of a randomized controlled trial (RCT) assessing the clinical and personal utility of incorporating type 2 diabetes genetic risk testing into comprehensive diabetes risk assessments performed in a primary care setting. Patients are recruited in the laboratory waiting areas of two primary care clinics and enrolled into one of three study arms. Those interested in genetic risk testing are randomized to receive either a standard risk assessment (SRA) for type 2 diabetes incorporating conventional risk factors plus upfront disclosure of the results of genetic risk testing ("SRA+G" arm), or the SRA alone ("SRA" arm). Participants not interested in genetic risk testing will not receive the test, but will receive SRA (forming a third, "no-test" arm). Risk counseling is provided by clinic staff (not study staff external to the clinic). Fasting plasma glucose, insulin levels, body mass index (BMI), and waist circumference are measured at baseline and 12 months, as are patients' self-reported behavioral and emotional responses to diabetes risk information. Primary outcomes are changes in insulin resistance and BMI after 12 months; secondary outcomes include changes in diet patterns, physical activity, waist circumference, and perceived risk of developing diabetes. The utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk information in a primary care setting can help improve patients' clinical outcomes, risk perceptions, and/or their engagement in healthy behavior change. In addition, study design features such as the use of existing clinic personnel for risk counseling could inform the future development and implementation of care models for the use of individual genetic risk information in primary care. ClinicalTrials.gov: NCT00849563.

Quantifying anti-gravity torques in the design of a powered exoskeleton.

PubMed

Ragonesi, Daniel; Agrawal, Sunil; Sample, Whitney; Rahman, Tariq

2011-01-01

Designing an upper extremity exoskeleton for people with arm weakness requires knowledge of the passive and active residual force capabilities of users. This paper experimentally measures the passive gravitational torques of 3 groups of subjects: able-bodied adults, able bodied children, and children with neurological disabilities. The experiment involves moving the arm to various positions in the sagittal plane and measuring the gravitational force at the wrist. This force is then converted to static gravitational torques at the elbow and shoulder. Data are compared between look-up table data based on anthropometry and empirical data. Results show that the look-up torques deviate from experimentally measured torques as the arm reaches up and down. This experiment informs designers of Upper Limb orthoses on the contribution of passive human joint torques.

New Exoskeleton Arm Concept Design And Actuation For Haptic Interaction With Virtual Objects

NASA Astrophysics Data System (ADS)

Chakarov, D.; Veneva, I.; Tsveov, M.; Tiankov, T.

2014-12-01

In the work presented in this paper the conceptual design and actuation of one new exoskeleton of the upper limb is presented. The device is designed for application where both motion tracking and force feedback are required, such as human interaction with virtual environment or rehabilitation tasks. The choice is presented of mechanical structure kinematical equivalent to the structure of the human arm. An actuation system is selected based on braided pneumatic muscle actuators. Antagonistic drive system for each joint is shown, using pulley and cable transmissions. Force/displacement diagrams are presented of two antagonistic acting muscles. Kinematics and dynamic estimations are performed of the system exoskeleton and upper limb. Selected parameters ensure in the antagonistic scheme joint torque regulation and human arm range of motion.

Design and pilot validation of A-gear: a novel wearable dynamic arm support.

PubMed

Kooren, Peter N; Dunning, Alje G; Janssen, Mariska M H P; Lobo-Prat, Joan; Koopman, Bart F J M; Paalman, Micha I; de Groot, Imelda J M; Herder, Just L

2015-09-18

Persons suffering from progressive muscular weakness, like those with Duchenne muscular dystrophy (DMD), gradually lose the ability to stand, walk and to use their arms. This hinders them from performing daily activities, social participation and being independent. Wheelchairs are used to overcome the loss of walking. However, there are currently few efficient functional substitutes to support the arms. Arm supports or robotic arms can be mounted to wheelchairs to aid in arm motion, but they are quite visible (stigmatizing), and limited in their possibilities due to their fixation to the wheelchair. The users prefer inconspicuous arm supports that are comfortable to wear and easy to control. In this paper the design, characterization, and pilot validation of a passive arm support prototype, which is worn on the body, is presented. The A-gear runs along the body from the contact surface between seat and upper legs via torso and upper arm to the forearm. Freedom of motion is accomplished by mechanical joints, which are nearly aligned with the human joints. The system compensates for the arm weight, using elastic bands for static balance, in every position of the arm. As opposed to existing devices, the proposed kinematic structure allows trunk motion and requires fewer links and less joint space without compromising balancing precision. The functional prototype has been validated in three DMD patients, using 3D motion analysis. Measurements have shown increased arm performance when the subjects were wearing the prototype. Upward and forward movements were easier to perform. The arm support is easy to put on and remove. Moreover, the device felt comfortable for the subjects. However, downward movements were more difficult, and the patients would prefer the device to be even more inconspicuous. The A-gear prototype is a step towards inconspicuousness and therefore well-received dynamic arm supports for people with muscular weakness.