The Appendicular Lean Mass Index Is a Suitable Surrogate for Muscle Mass in Children with Cerebral Palsy

ABSTRACT Background Densitometrically measured lean body mass (LBM) is often used to quantify skeletal muscle mass in children with cerebral palsy (CP). Since LBM depends on the individual's height, the evaluation of $\frac{{{\rm{LBM}}}}{{heigh{t^2}}}\ $ (lean BMI) is often recommended. However, LBM includes not only skeletal muscle mass but also the mass of skin, internal organs, tendons, and other components. This limitation applies to a far lesser extent to the appendicular lean mass index (LMIapp). Objectives The aim of the study was to evaluate skeletal muscle mass in children with CP using total lean BMI (LMItot) and LMIapp. Methods The present study was a monocentric retrospective analysis of prospectively collected data among children and adolescents with CP participating in a rehabilitation program. In total, 329 children with CP [148 females; Gross Motor Function Classification Scale (GMFCS) I, 32 children; GMFCS II, 73 children; GMFCS III, 133 children; GMFCS IV, 78 children; and GMFCS V, 13 children] were eligible for analysis. The mean age was 12.3 ± 2.75 y. Pediatric reference centiles for age-adjusted LMIapp were generated using data from NHANES 1999–2004. Low skeletal muscle mass was defined as a z score for DXA determined LMItot and LMIapp less than or equal to −2.0. Results The z scores for LMIapp were significantly lower than LMItot in children with CP, GMFCS levels II–V (P < 0.001), with the exception of GMFCS level I (P = 0.121), where no significant difference was found. The prevalence of low LMItot (16.1%; 95% CI: 16.1, 20.1%) was significantly lower (P < 0.001) than the prevalence of LMIapp (42.2%; 95% CI: 36.9, 47.9%) in the study population. Conclusions The prevalence of low skeletal muscle mass in children with CP might be underestimated by LMItot. LMIapp is more suitable for the evaluation of skeletal muscle mass in children with CP.

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Abstract 16239: Skeletal Muscle Mass Recovery Early After Left Ventricular Assist Device Implantation in Patients With Advanced Systolic Heart Failure

Circulation ◽

10.1161/circ.142.suppl_3.16239 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Amanda R Vest ◽

Joronia Chery ◽

Alexandra Coston ◽

Laura Telfer ◽

Matthew Lawrence ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Mass ◽

Lean Mass ◽

Skeletal Muscle Mass ◽

Muscle Wasting ◽

Systolic Heart Failure ◽

Left Ventricular ◽

Ventricular Assist ◽

Device Implantation ◽

Lvad Support

Introduction: Patients with advanced systolic heart failure (HF) are at risk of unintentional weight loss and muscle wasting. It has been observed that left ventricular assist device (LVAD) recipients gain weight after device implantation, although it is unknown whether this represents skeletal muscle or fat mass gains. Hypothesis: We hypothesized that LVAD recipients would gain skeletal muscle mass during the first 6 months of LVAD support. Methods: We prospectively recruited 28 adults with systolic HF ±21 days from LVAD implantation. Participants underwent whole-body dual X-ray absorptiometry (DXA) to calculate fat free mass (FFM, representing all lean mass), appendicular lean mass (ALM, lean mass in the arms and legs) and fat mass (FM). DXA was repeated at 3 and 6 months after LVAD implantation (±14 days), with study participation ending after either the 6 month visit or heart transplantation, whichever occurred first. Paired t-testing and mixed effects models were used to evaluate changes over time each for FFM, ALM and FM. Results: The cohort was 86% (24/28) male, with mean age 56 ±12 years and mean BMI 26.6 ±5.5 kg/m 2 at baseline. The median Intermacs class was 2 and duration of HF 50 months. Per European Working Group on Sarcopenia in Older People (EWGSOP) criteria, 41% of participants had muscle wasting at baseline. There was a significant increase from baseline to 3 months and then 6 months of LVAD support for FFM (Fig 1A; baseline: 56.6 ±11.8 kg, n=27; 3 months: 57.9 ±11.3 kg, n=23; 6 months: 62.7 ±11.1 kg, n=17; p-value for change=0.025) and for ALM (Fig 1B; 22.2 ±5.6 kg; 23.2 ±5.0 kg; 25.4 ± 4.5 kg; p<0.001). There was no increase in FM over the same period (p=0.36). Amongst 22 participants with comparison DXAs, 81% had a ≥5% ALM gain by either 3 or 6 months. Conclusions: Among patients with advanced systolic HF and a high baseline prevalence of muscle wasting, there was a significant gain in skeletal muscle mass, as represented by both FFM and ALM, over the first 6 months of LVAD support.

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Abstract P052: Less Appendicular Lean Mass Adjusted For Body Mass Index Is Associated With Higher Incident Diabetes In Middle-aged Adults In The CARDIA Study

Circulation ◽

10.1161/circ.143.suppl_1.p052 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Melanie S Haines ◽

Aaron Leong ◽

Bianca Porneala ◽

Victor W Zhong ◽

Cora E Lewis ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Mass Index ◽

Muscle Mass ◽

Lean Mass ◽

Skeletal Muscle Mass ◽

Middle Age ◽

Incident Diabetes ◽

Middle Aged ◽

Black And White ◽

White Adults

Although less muscle mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data in middle-aged Black and White adults are lacking. Middle age is a critical window as accelerated muscle loss is yet to occur, and preventing diabetes reduces lifelong morbidity and mortality. We hypothesized that lower appendicular lean mass adjusted for body mass index (ALM/BMI) is associated with higher incident diabetes in middle-aged Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. ALM/BMI was measured by dual x-ray energy absorptiometry (DXA) in 2005-06 among middle-aged US men (n=855) and women (n=1045) in CARDIA. Incident diabetes occurred if any of the following were met in 2010-11 or 2015-16 among persons without diabetes in 2005-06: fasting glucose ≥7 mmol/L (126 mg/dL), 2-hour glucose ≥11.1 mmol/L (200 mg/dL) on a 75-gram glucose tolerance test, HbA 1C ≥48 mmol/mol (6.5%), or use of glucose-lowering medications. We used logistic regression models with sex stratification given sex differences in ALM. In men, mean age was 45.0 ± 3.5 y, BMI 28.0 ± 4.3 kg/m 2 , and ALM/BMI 1.07 ± 0.14 m 2 . In women, mean age was 45.2 ± 3.6 years, BMI 28.4 ± 6.4 kg/m 2 , and ALM/BMI 0.73 ± 0.12 m 2 . Diabetes developed in 70 men (8.2%) and 72 women (6.9%). For each standard deviation increase in ALM/BMI (m 2 ), the risk of diabetes decreased by 22% in men and 29% in women (Table 1). After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association of ALM/BMI with diabetes incidence was no longer significant. Associations were similar between race-ethnic groups. In conclusion, less relative skeletal muscle mass is associated with a greater risk of developing diabetes in middle-aged men and women over 10 years, which is largely explained by the relationship of ALM/BMI to other metabolic risk factors. Low skeletal muscle mass in middle age is a marker for greater diabetes risk and may be a target for preventative interventions.

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Effects of marine oligomeric polyphenols on body composition and physical ability of elderly individuals with sarcopenia: a pilot study

Physical Activity and Nutrition ◽

10.20463/pan.2021.0014 ◽

2021 ◽

Vol 25 (3) ◽

pp. 1-7

Author(s):

Il-Su Kwon ◽

Deuk-Su Park ◽

Hyeon-Cheol Shin ◽

Myung-Gyu Seok ◽

Jae-Keun Oh

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Bone Density ◽

Muscle Mass ◽

Interaction Effect ◽

Skeletal Muscle Mass ◽

Elderly Individuals ◽

Significant Difference ◽

Post Test ◽

The One

[Purpose] We aimed to identify the effects of marine oligomeric polyphenol (MOP) intake in elderly individuals with sarcopenia.[Methods] Older adults (aged 65 years or older) were recruited based on the diagnostic criterion for sarcopenia and were randomly assigned to the MOP intake group (n=10) or the placebo (PBO) intake group (n=10). To determine the effect of MOP intake received for four weeks, the pre- and post-intake body composition (weight, skeletal muscle mass, and bone density) and senior fitness tests were assessed.[Results] Our results showed there were significant differences in the skeletal muscle mass (p =0.039), bone density (p =0.020), fat-free mass index (p =0.026), and 2.4 m up and go test (p =0.001) between pretest and post-test. There was a significant difference between the pre-test and post-test and an interaction effect for the one-leg stand test (p =0.010 and p =0.049, respectively). However, there were no significant differences in body fat percentage, calf circumference, grip strength, or the chair rise test.[Conclusion] Some variables exhibited significant differences in the pre- and post-assessments, and there was an interaction effect for the one-leg stand. However, this was insufficient to prove the effectiveness of MOP intake in improving sarcopenia. Therefore, additional studies are essential to examine the effects of MOP intake and exercise intervention on the body composition and fitness of patients over a longer period.

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Impact of Low Skeletal Muscle Mass on Complications and Survival for Gastric Cancer: A Propensity Score Matching Analysis

10.21203/rs.3.rs-614857/v1 ◽

2021 ◽

Author(s):

Zhen Fang ◽

Peijuan Li ◽

Jin Liu ◽

Wei Chong ◽

Fengying Du ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Postoperative Complications ◽

Propensity Score ◽

Propensity Score Matching ◽

Muscle Mass ◽

Laparoscopic Gastrectomy ◽

Skeletal Muscle Mass ◽

Significant Difference ◽

The Impact

Abstract Background: Increasing evidence has indicated that low skeletal muscle mass is linked with cancer prognosis, but existing have shown contrasting results. The purpose of the study is to determine the impact of preoperative low skeletal muscle mass (LSMM) on complications and survival of patients who undergo laparoscopic gastrectomy for gastric cancer (GC).Methods: Patients who undergo laparoscopic gastrectomy for GC were enrolled and third lumbar vertebra psoas muscles index (PMI) was assessed by computer tomography (CT). Using propensity score matching (1:1) to obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, comparing the postoperative complications and 3-year overall survival (OS) between LSMM group and non-LSMM group.Results: A total of 386 patients, 226 were matched for analyses. Compared with the non-LSMM group, the LSMM group manifested significantly shorter 3-year OS (58.14% vs 71.95%, P=0.034). However, the incidence of postoperative complications was no difference between two groups after matching. After stratification based on the pT stage of the tumor, statistically significant difference in the 3-year OS rates of the advance GC cohort between the two groups were observed.Conclusions: LSMM predicts a poor prognosis for patients with advance GC and it is not associated with postoperative complications.

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Effectiveness of Robot-Assisted Gait Training on Functional Skills in Children with Cerebral Palsy

Journal of Pediatric Neurology ◽

10.1055/s-0041-1725128 ◽

2021 ◽

Author(s):

Burak Yaşar ◽

Emine Atıcı ◽

Derya Azim Razaei ◽

Tülay Çevik Saldıran

Keyword(s):

Cerebral Palsy ◽

Functional Independence Measure ◽

Gait Training ◽

Functional Independence ◽

Rehabilitation Program ◽

Robot Assisted ◽

Timed Up And Go ◽

Motor Functions ◽

Significant Difference ◽

Children With Cerebral Palsy

AbstractThis study was aimed to investigate the effects of robot-assisted gait training (RAGT) on motor functions, spasticity status, balance, and functionality in children with cerebral palsy (CP). A total of 26 patients who were diagnosed with CP (diplegic, with gross motor function classification system [GMFCS] levels of 2–5) and who regularly participated in a rehabilitation program were recruited in the study after obtaining approval from their parents. The patients were randomly assigned to two groups. Group 1 (n = 13) received conventional physical therapy (65 minutes, 2 days/week × 8) and group 2 (n = 13) received 25 minutes of RAGT (RoboGait) in addition to conventional therapy (CT; 40 minutes, 2 days/week × 8). GMFCS was used to evaluate motor functions and the Modified Ashworth Scale was used to evaluate spasticity. The pediatric Berg balance scale, pediatric functional independence measure, and timed up and go tests were employed to assess balance and functional status. The evaluations were performed at baseline and after 8 weeks of therapy. Both rehabilitation methods led to a statistically significant decrease in spasticity (p < 0.05); however, there was no difference in this improvement of spasticity between the groups (p > 0.05). Both groups exhibited significant improvements in functional independence, balance, and performance at the end of therapy (p < 0.05), and there was no significant difference between the groups (p > 0.05). The results of this study show that addition of RAGT to CT for 8 weeks is not superior to CT alone in children with CP.

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Correlation between the Gait Deviation Index and skeletal muscle mass in children with spastic cerebral palsy

Journal of Physical Therapy Science ◽

10.1589/jpts.30.1176 ◽

2018 ◽

Vol 30 (9) ◽

pp. 1176-1179 ◽

Cited By ~ 4

Author(s):

Naomichi Matsunaga ◽

Tadashi Ito ◽

Koji Noritake ◽

Hiroshi Sugiura ◽

Yasunari Kamiya ◽

...

Keyword(s):

Skeletal Muscle ◽

Cerebral Palsy ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Spastic Cerebral Palsy ◽

Deviation Index ◽

Gait Deviation Index

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The impact of sarcopenia and decrease in skeletal muscle mass in patients with advanced pancreatic cancer during FOLFIRINOX therapy

British Journal Of Nutrition ◽

10.1017/s0007114520003463 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Shinya Uemura ◽

Takuji Iwashita ◽

Hironao Ichikawa ◽

Yuhei Iwasa ◽

Naoki Mita ◽

...

Keyword(s):

Skeletal Muscle ◽

Pancreatic Cancer ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Tumour Size ◽

Advanced Pancreatic Cancer ◽

Significant Risk ◽

Skeletal Muscle Index ◽

Significant Difference ◽

The Impact

Abstract Sarcopenia, defined as decrease in skeletal muscle mass (SMM) and strength, might be associated with reduced survival. We investigated the impact of sarcopenia and decrease in SMM in patients with advanced pancreatic cancer during FOLFIRINOX (FX) therapy. Consecutive sixty-nine patients who received FX were evaluated. Skeletal muscle index (SMI) (cm2/m2) was used to evaluate SMM. The cut-off value of sarcopenia was defined as SMI <42 for males and <38 for females, based on the Asian Working Group for sarcopenia criteria. Sarcopenia was diagnosed in thirty-three (48 %) subjects. Comparison of baseline characteristics of the two groups (sarcopenia group: non-sarcopenia group) showed a significant difference in sex, tumour size and BMI. There was no significant difference in the incidence of adverse events with grades 3–5 and progression-free survival (PFS) during FX between the two groups (PFS 8·1 and 8·8 months; P = 0·88). On the multivariate analysis, progressive disease at the first follow-up computed tomography (hazard ratio (HR) 3·87, 95 % CI 1·53, 9·67), decreased SMI ≥ 7·9 % in 2 months (HR 4·02, 95 % CI 1·87, 8·97) and carcinoembryonic antigen ≥ 4·6 (HR 2·52, 95 % CI 1·10, 6·11) were significant risk factors associated with poor overall survival (OS), but sarcopenia at diagnosis was not. OS in patients with decreased SMI of ≥7·9 % and <7·9 % were 10·9 and 21·0 months (P < 0·01), respectively. In conclusion, decrease in SMM within 2 months after the initiation of chemotherapy had significantly shorter OS, although sarcopenia at diagnosis did not affect OS. Therefore, it might be important to maintain SMM during chemotherapy for a better prognosis.

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Association between −308 G/A TNF-αPolymorphism and Appendicular Skeletal Muscle Mass Index as a Marker of Sarcopenia in Normal Weight Obese Syndrome

Disease Markers ◽

10.1155/2013/983424 ◽

2013 ◽

Vol 35 ◽

pp. 615-623 ◽

Cited By ~ 23

Author(s):

L. Di Renzo ◽

F. Sarlo ◽

L. Petramala ◽

L. Iacopino ◽

G. Monteleone ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Muscle Mass ◽

Lean Mass ◽

Skeletal Muscle Mass ◽

Normal Weight ◽

Sarcopenic Obesity ◽

Appendicular Skeletal Muscle ◽

Skeletal Muscle Mass Index ◽

Appendicular Skeletal Muscle Mass

Background and Aim. Normal weight obese (NWO) syndrome is characterized by normal body mass index (BMI), but high amount of fat mass and reduced lean mass. We evaluated allelic frequency of the G/A −308 TNF-αpolymorphism and prevalence of sarcopenia in NWO.Methods. We enrolled 120 Italian healthy women, distinguished into 3 groups: normal weight (NW); NWO, and preobese-obese (PreOB/OB) and evaluated anthropometric parameters, body composition by dual X-ray absorptiometry, blood tests, and genotyping of G/A −308 TNF-αpolymorphism.Results. We found a positive association between sarcopenic obesity and −308 TNF-αpolymorphism. All obese women were sarcopenic and were no carrier of mutation (G/G). Among all G/G, NWO showed significant differences in lean mass and total body lean mass (TBLean) with respect to NW and PreOB/OB (P<0.001). Regarding appendicular skeletal muscle mass index values, 4.21% of NW were sarcopenic (50% G/G and 50% G/A); the same percentage was observed in NWO subjects (100% G/G). Moreover, 2.10% of PreOB/OB were sarcopenic and all were G/G.Conclusion. Our study suggests that TNF-αpolymorphism contributes to sarcopenic obesity susceptibility, in association with body composition. This is the first study that shows the importance of TNF-αpolymorphism to determine TBLean variation in NWO syndrome.

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Skeletal Muscle Mass, Sarcopenia and Rehabilitation Outcomes in Post-Acute COVID-19 Patients

Journal of Clinical Medicine ◽

10.3390/jcm10235623 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5623

Author(s):

Michele Gobbi ◽

Emanuela Bezzoli ◽

Francesco Ismelli ◽

Giulia Trotti ◽

Stefano Cortellezzi ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Handgrip Strength ◽

Rehabilitation Program ◽

Rehabilitation Unit ◽

Functional Parameters ◽

Rehabilitation Outcomes ◽

The Impact

The relationship between skeletal muscle mass at the beginning of the post-acute rehabilitation phase and rehabilitation outcomes has been scarcely investigated. The aim of this study was to investigate the impact of the existence of sarcopenia upon admission to a post-acute COVID-19 patient rehabilitation unit on body composition and functional and respiratory capacity at discharge. Thirty-four post-acute COVID-19 patients were referred to our Rehabilitation Unit from different COVID Hospitals in northern Italy. Body weight loss, body composition, handgrip strength, functional parameters, oxygen saturation and related perception of dyspnea in several positions were measured before and after a 28-day multidisciplinary rehabilitation program. Spirometry was performed only upon admission. The intervention included psychiatric support, cognitive behavioral therapy, nutritional therapy and physiotherapy, including aerobic and resistance training. Training volume was 45 min/session, 6 sessions/week. Upon admission, the prevalence of sarcopenia among our patients was 58%. In all of the 34 patients, we observed a trend of improvement in all of the respiratory, body composition, muscle strength and functional parameters considered. Monitoring muscle mass and strength in post-acute COVID-19 patients appears to be a key predictor of rehabilitation outcomes. Early diagnosis of sarcopenia therefore appears to be of paramount importance in the management of post-acute COVID-19 patients.

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Six-minute Walk Test in Children with Cerebral Palsy: Comparing the Walking Distance between Different Level of Communication Function

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v7i02.140 ◽

2019 ◽

Vol 7 (02) ◽

pp. 18

Author(s):

Budiati Laksmitasari ◽

Luh Karunia Wahyuni ◽

Tirza Z Tamin

Keyword(s):

Cerebral Palsy ◽

Classification System ◽

Walking Distance ◽

Walk Test ◽

Six Minute Walk Test ◽

Significant Difference ◽

Communication Function ◽

Children With Cerebral Palsy ◽

Level I ◽

Minute Walk

Introduction: Children with cerebral palsy (CP), six-minute walk test (6MWT) is more difficult to perform because some children have communication impairment. The objective to study the distance of 6MWT among different level of communication in children with CP.Methods: This study was cross-sectional study , in a Rehabilitation Clinic, on Juli to December 2018. The subjects were children aged 7-18 years old with cerebral palsy with Gross Motor Function Classification System (GMFCS) I-III, Communication Function Classification System (CFCS) I-III, able to walkindependently with or without aid, and understand the instruction of 6MWT. All the subjects performed 6MWT. Level of communication function was evaluated by CFCS. The 6MWD between CFCS groups were compared.Results: There were 23 subjects mean aged 9 years old, consisted of 17(73.9%) male and 6(26.1%) female, with GMFCS level I-III in sequence were 3(13%), 11(47.8%), and 9(39.1%), also with CFCS level I-III in sequence were 5(21.7%), 7(30.4%), and 11(47.8%). Subjects with verbal communicationwere 14(60.9%) and nonverbal communication were 9(39.1%). The median of 6MWD in group with CFCS level I, II, and III respectively were 115 (60-282), 161 (17.5-281), and 135 (23-280) m. There was no significant difference in 6MWD between different groups of CFCS (p=0.960).Conclusion: There were no difference in walking distance on 6MWT among different level of communication function in children with CP.Keywords: Cerebral palsy, Six-minute walk-test, Six-minute walking-distance, Communication Function Classification System (CFCS)

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