A Prospective Study of Postoperative Lymphedema After Surgery for Cervical Cancer

2010 ◽  
Vol 20 (5) ◽  
pp. 900-904 ◽  
Author(s):  
Michael J. Halaska ◽  
Marta Novackova ◽  
Ivana Mala ◽  
Marek Pluta ◽  
Roman Chmel ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lower Limb ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Conservative Surgery ◽  
Cancer Surgery ◽  
Lower Limbs ◽  
Control Group ◽  
The Right ◽  
A Prospective Study

Objective:Lymphedema is a severe postoperative complication in oncological surgery. Multifrequency bioelectrical impedance analysis (MFBIA) is a new method for early lymphedema detection. The objective was to establish the methodology of MFBIA for lower-limb lymphedema and to detect a lymphedema in patients undergoing cervical cancer surgery.Methods:From a population of 60 patients undergoing cervical cancer surgery, 39 underwent radical hysterectomy Wertheim III (RAD group), and 21 underwent conservative surgery (laparoscopic lymphadenectomy plus simple trachelectomy/simple hysterectomy - CONS group). A control group of 29 patients (CONTR group) was used to determine the SD of impedance at zero frequency (R0). Patients were examined before surgery and at 3 and 6 months after surgery by MFBIA and by measuring the circumference of the lower limbs.Results:No differences were found between the CONS and RAD groups on age, height, weight, and histopathologic type of tumor. However, the number of dissected lymph nodes differed significantly between the groups (17.3 in the CONS group vs 25.8 in the RAD group,P= 0.0012). The SD ofR0in the CONTR group was 36.0 and 39.0 for the right and the left leg, respectively. No difference in prevalence of lymphedema based on circumference method was found (35.9% in the RAD and 47.6% in the CONS groups, not statistically significant).Conclusions:No difference in the prevalence of lymphedema was found between the CONS and RAD groups. A methodology for MFBIA for the detection of lower-limb lymphedema was described.

A Prospective Study in Detection of Lower-Limb Lymphedema and Evaluation of Quality of Life After Vulvar Cancer Surgery

2012 ◽  
Vol 22 (6) ◽  
pp. 1081-1088 ◽  
Author(s):  
Marta Novackova ◽  
Michael J. Halaska ◽  
Helena Robova ◽  
Ivana Mala ◽  
Marek Pluta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Bioelectrical Impedance Analysis ◽  
Vulvar Cancer ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Cancer Surgery ◽  
Control Group ◽  
Inguinofemoral Lymphadenectomy

BackgroundLower-limb lymphedema is one of the most disabling adverse effects of vulvar cancer surgery. Multifrequency Bioelectrical Impedance Analysis (MFBIA) is a modern noninvasive method to detect lymphedema. The first aim of this study was to prospectively determine the prevalence of secondary lower-limb lymphedema after surgical treatment for vulvar cancer using objective methods, circumference measurements and MFBIA technique. The second aim was to compare quality of life (QoL) before and 6 months after vulvar surgery.MethodsTwenty-nine patients underwent vulvar cancer surgery in our study: 17 underwent inguinofemoral lymphadenectomy (RAD), and 12 underwent sentinel lymph node biopsy (CONS). Patients were examined before and 6 months after vulvar surgery by measuring the circumference of the lower limbs and with MFBIA. A control group of 27 healthy women was also measured. To evaluate QoL, the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 months after surgery.ResultsUsing circumference measurement, 9 lymphedemas (31%) were diagnosed: 3 (25%) in the CONS and 6 (37.5%) in the RAD group (P= 0.69). After vulvar surgery, patients in the RAD group reported more fatigue and worsening of physical and role functioning. When comparing both groups, the RAD group had significantly worse parameters in social functioning, fatigue, and dyspnea.ConclusionsLower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.

scholarly journals Validity and Reliability of Micro-controller based BIA Instrument for Assessment of Upper and Lower limb in Male Subjects at Multi-Frequency

2021 ◽  
Vol 23 (08) ◽  
pp. 762-770
Author(s):  
Charu Pawar ◽  
◽  
Munna Khan ◽  
J.P. saini ◽  
◽  
...  
Keyword(s):  
Lower Limb ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Validity And Reliability ◽  
Standard Device ◽  
Left Limb ◽  
The Right ◽  
Result Analysis ◽  
Male Subjects ◽  
Error Percentage

The purpose of this study was to validate the resultant data for assessment of upper and lower limb for male subjects, using developed microcontroller based bioelectrical impedance analysis (BIA) instrument with standard device (Microprocessor based 4 channel auto mode T.E.N.S unit) at multi-frequency. Twenty-two male subjects of age 21-45 years were taken under the examination. Data measured by developed BIA instrument is validated with data recorded by standard device. The recorded data represent that the measured data varies with frequencies. The frequencies used for the measurement were 5 KHz, 50 KHz, 100 KHz, 250 KHz, and 500 KHz. The results indicates that impedance of upper and lower limb change according to the frequency variations, and reduces with the increment of the different frequencies. A result also indicates that impedance of the left limb is greater than the impedance of the right limb. The results analysis of upper limb shows that error percentage between developed BIA instrument and standard device is less than 1.93Ω for left arm and less than 1.50Ω for the right arm at the same frequencies. The result analysis of lower limb shows that mean error percentage between both instruments, for left leg is less than 3.37Ω and less than 2.78Ω for right leg.

scholarly journals Asymmetry of Musculature and Hand Grip Strength in Bodybuilders and Martial Artists

2020 ◽  
Vol 17 (13) ◽  
pp. 4695
Author(s):  
Anna Burdukiewicz ◽  
Jadwiga Pietraszewska ◽  
Justyna Andrzejewska ◽  
Krystyna Chromik ◽  
Aleksandra Stachoń
Keyword(s):  
Grip Strength ◽  
Physical Exertion ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Hand Grip Strength ◽  
The Body ◽  
Control Group ◽  
Body Structure ◽  
Hand Grip ◽  
The Right

The functional preference for the upper limb influences the occurrence of bilateral differences in other segments of the human body. The aim of the study is to assess the influence of the applied fighting technique and targeted physical effort on the occurrence of asymmetry in body musculature and isometric strength in bodybuilders and competitors of selected martial arts. Academic athletes practicing judo (J), jiu-jitsu (JJ), and bodybuilding (BB) were examined. The control group (C) consisted of students who do not practice any sports. The assessment of the body structure was conducted through segmental bioelectrical impedance analysis. Moreover, the study took into account the measurements of left- and right-hand grip strength. In judo, the uneven physical exertion of the right and left sides of the body further increases both directional and absolute asymmetry. Bilateral asymmetry of musculature in jiu-jitsu competitors and bodybuilders occurs to a lesser extent. The control group was characterized by cross-asymmetry. So as to avoid the risk of injury of sportsmen, it is important to consistently supervise and correct their body structure, which also includes the symmetrical participation of the active muscle mass in particular segments. The symmetrisation process should be individualized since each particular sportsman has their own side-to-side body morphology.

scholarly journals Motor disability in patients with multiple sclerosis: transcranial magnetic stimulation study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Anssam Bassem Mohy ◽  
Aqeel Kareem Hatem ◽  
Hussein Ghani Kadoori ◽  
Farqad Bader Hamdan
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Lower Limb ◽  
Magnetic Stimulation ◽  
Motor Evoked Potential ◽  
Invasive Procedure ◽  
Single Pulse ◽  
Lower Limbs ◽  
Control Group ◽  
Conduction Time ◽  
Motor Disability

Abstract Background Transcranial magnetic stimulation (TMS) is a non-invasive procedure used in a small targeted region of the brain via electromagnetic induction and used diagnostically to measure the connection between the central nervous system (CNS) and skeletal muscle to evaluate the damage that occurs in MS. Objectives The study aims to investigate whether single-pulse TMS measures differ between patients with MS and healthy controls and to consider if these measures are associated with clinical disability. Patients and methods Single-pulse TMS was performed in 26 patients with MS who hand an Expanded Disability Status Scale (EDSS) score between 0 and 9.5 and in 26 normal subjects. Different TMS parameters from upper and lower limbs were investigated. Results TMS disclosed no difference in all MEP parameters between the right and left side of the upper and lower limbs in patients with MS and controls. In all patients, TMS parameters were different from the control group. Upper limb central motor conduction time (CMCT) was prolonged in MS patients with pyramidal signs. Upper and lower limb CMCT and CMCT-f wave (CMCT-f) were prolonged in patients with ataxia. Moreover, CMCT and CMCT-f were prolonged in MS patients with EDSS of 5–9.5 as compared to those with a score of 0–4.5. EDSS correlated with upper and lower limb cortical latency (CL), CMCT, and CMCT-f whereas motor evoked potential (MEP) amplitude not. Conclusion TMS yields objective data to evaluate clinical disability and its parameters correlated well with EDSS.

Predicting composition of leg sections with anthropometry and bioelectrical impedance analysis, using magnetic resonance imaging as reference

1999 ◽  
Vol 96 (6) ◽  
pp. 647-657 ◽  
Author(s):  
N. J. FULLER ◽  
C. R. HARDINGHAM ◽  
M. GRAVES ◽  
N. SCREATON ◽  
A. K. DIXON ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Adipose Tissue ◽  
Magnetic Resonance ◽  
Coefficient Of Variation ◽  
Lower Limb ◽  
Bioelectrical Impedance Analysis ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Tissue Composition ◽  
Resonance Imaging

Magnetic resonance imaging (MRI) was used to evaluate and compare with anthropometry a fundamental bioelectrical impedance analysis (BIA) method for predicting muscle and adipose tissue composition in the lower limb. Healthy volunteers (eight men and eight women), aged 41 to 62 years, with mean (S.D.) body mass indices of 28.6 (5.4) kg/m2 and 25.1 (5.4) kg/m2 respectively, were subjected to MRI leg scans, from which 20-cm sections of thigh and 10-cm sections of lower leg (calf) were analysed for muscle and adipose tissue content, using specifically developed software. Muscle and adipose tissue were also predicted from anthropometric measurements of circumferences and skinfold thicknesses, and by use of fundamental BIA equations involving section impedance at 50 kHz and tissue-specific resistivities. Anthropometric assessments of circumferences, cross-sectional areas and volumes for total constituent tissues matched closely MRI estimates. Muscle volume was substantially overestimated (bias: thigh, -40%; calf, -18%) and adipose tissue underestimated (bias: thigh, 43%; calf, 8%) by anthropometry, in contrast to generally better predictions by the fundamental BIA approach for muscle (bias: thigh, -12%; calf, 5%) and adipose tissue (bias: thigh, 17%; calf, -28%). However, both methods demonstrated considerable individual variability (95% limits of agreement 20–77%). In general, there was similar reproducibility for anthropometric and fundamental BIA methods in the thigh (inter-observer residual coefficient of variation for muscle 3.5% versus 3.8%), but the latter was better in the calf (inter-observer residual coefficient of variation for muscle 8.2% versus 4.5%). This study suggests that the fundamental BIA method has advantages over anthropometry for measuring lower limb tissue composition in healthy individuals.

Deficits in anticipatory inhibition of postural muscle activity associated with load release while standing in individuals with spastic diplegic cerebral palsy

2013 ◽  
Vol 109 (8) ◽  
pp. 1996-2006 ◽  
Author(s):  
Hidehito Tomita ◽  
Yoshiki Fukaya ◽  
Kenji Totsuka ◽  
Yuri Tsukahara
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Muscle Activity ◽  
Erector Spinae ◽  
Lower Limbs ◽  
Control Group ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Postural Muscle ◽  
Load Release

This study aimed to determine whether individuals with spastic diplegic cerebral palsy (SDCP) have deficits in anticipatory inhibition of postural muscle activity. Nine individuals with SDCP (SDCP group, 3 female and 6 male, 13–24 yr of age) and nine age- and sex-matched individuals without disability (control group) participated in this study. Participants stood on a force platform, which was used to measure the position of the center of pressure (CoP), while holding a light or heavy load in front of their bodies. They then released the load by abducting both shoulders. Surface electromyograms were recorded from the rectus abdominis, erector spinae (ES), rectus femoris (RF), medial hamstring (MH), tibialis anterior (TA), and gastrocnemius (GcM) muscles. In the control group, anticipatory inhibition before load release and load-related modulation of the inhibition were observed in all the dorsal muscles recorded (ES, MH, and GcM). In the SDCP group, similar results were obtained in the trunk muscle (ES) but not in the lower limb muscles (MH and GcM), although individual differences were seen, especially in MH. Anticipatory activation of the ventral lower limb muscles (RF and TA) and load-related modulation of the activation were observed in both participant groups. CoP path length during load release was longer in the SDCP group than in the control group. The present findings suggest that individuals with SDCP exhibit deficits in anticipatory inhibition of postural muscles at the dorsal part of the lower limbs, which is likely to result in a larger disturbance of postural equilibrium.

Bioelectrical Impedance Analysis of Water Reduction in Lower-Limb Lymphedema by Lymphaticovenular Anastomosis

2018 ◽  
Vol 35 (04) ◽  
pp. 306-314 ◽  
Author(s):  
Yoshichika Yasunaga ◽  
Daisuke Yanagisawa ◽  
Erika Ohata ◽  
Kiyoshi Matsuo ◽  
Shunsuke Yuzuriha
Keyword(s):  
Lower Limb ◽  
Bioelectrical Impedance Analysis ◽  
Linear Regression Analysis ◽  
Reduction Rate ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Body Water ◽  
Volume Reduction ◽  
Water Volume ◽  
The Mean

Background Although lymphedema is fundamentally abnormal accumulation of excess water in the extracellular space, previous studies have evaluated the efficacy of physiological bypass surgery (lymphaticovenular anastomosis [LVA]) for lymphedema without measuring water volume. This study clarified the water reductive effect of LVA using bioelectrical impedance analysis (BIA). Methods The efficacy of LVA for unilateral lower-limb lymphedema was evaluated using BIA in a retrospective cohort. The water volume of affected and unaffected legs was measured using multifrequency BIA before and after LVA. Preoperative measurements were undertaken after compression therapy for at least 3 months. The follow-up period after LVA was a minimum of 6 months. Results Thirty consecutive patients with unilateral lower-limb lymphedema were enrolled. The mean water volume reduction of the affected leg by LVA (ΔLBW) was 0.86 L (standard deviation [SD]: 0.86, median: 0.65) with a mean number of 3.3 anastomoses (SD: 1.7). The mean reduction rate of edema was 45.1% (SD: 36.3). Multiple linear regression analysis revealed water volume difference between the affected and unaffected legs before LVA (excess LBW) as the strongest predictor of ΔLBW (R 2 = 0.759, p < 0.01; β = 0.500, p < 0.01). Conclusion The LVA reduces the volume of accumulated body water in lower-limb lymphedema. As excess LBW most strongly predicted the amount of water volume reduction by LVA, body water volume measurement by BIA before LVA might identify patients with low excess LBW not expected to benefit from LVA, regardless of apparent differences in limb circumference.

scholarly journals Body composition and lung function in adults with Cystic Fibrosis

2020 ◽  
Vol 83 (3) ◽  
pp. 239-250
Author(s):  
Aleksandra John ◽  
Joanna Goździk-Spychalska ◽  
Magdalena Durda-Masny ◽  
Wojciech Czaiński ◽  
Marta Gębala ◽  
...  
Keyword(s):  
Body Composition ◽  
Lung Function ◽  
Nutritional Status ◽  
Reference Group ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Control Group ◽  
Body Components ◽  
Group 2 ◽  
The Relationship

AbstractThe study aimed to assess: (1) differences in nutritional status and lung function between CF patients and the control group; (2) differences in body composition and lung function between groups of patients with CF designated by type of mutation; (3) the relationship between lung function and body composition in CF patients.We studied 37 CF patients aged 19 to 51 years, and 41 healthy non-CF volunteers. Nutritional status was evaluated based on the BMI and the bioelectrical impedance analysis. The lung function was described by FEV1%. CF patients were classified according to the CFTR genotype based on five classes of mutations. BMI were lower in CF patients compared to reference group (women: Z = 3.76, p <0.001, men: Z = 3.06, p = 0.002). CF patients had a lower mean content of particular body components, as well as FEV1% values. BMI differed significantly depending on the type of mutation in females (H = 10.33, p = 0.006) and males (H = 8.26, p = 0.016). The lowest values of BMI were observed in the group of patients with severe types of mutations. Also, variables describing body composition were statistically significantly lower in patients with a severe type of mutations. The CFTR gene mutation type statistically significantly differentiated FEV1% (H = 23.22, p <0.000). The results of the logistic regression analysis showed that the likelihood of dropping FEV1% below the norm was twice as high in undernourished females and males. To assess the nutritional status of CF patients, more informative methods describing the proportions of body components are required.

scholarly journals Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Wang ◽  
Hui Wei ◽  
Runxiu Shi ◽  
Leitong Lin ◽  
Lechi Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Gait Cycle ◽  
Lumbar Disc ◽  
Lower Limbs ◽  
Heel Strike ◽  
Control Group ◽  
Double Support ◽  
Support Phase

AbstractThis study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.

scholarly journals Pre- and Postoperative Body Composition and Metabolic Characteristics in Patients with Acromegaly: A Prospective Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Xiaopeng Guo ◽  
Lu Gao ◽  
Xiaodong Shi ◽  
Hailong Li ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Skinfold Thickness ◽  
Metabolic Characteristics ◽  
Postoperative Changes ◽  
Gender And Age ◽  
And Gender ◽  
A Prospective Study

Objective. To investigate the preoperative body composition, metabolic characteristics, and postoperative changes in patients with active acromegaly and analyze the effects of gender and age. Methods. We included 36 patients with untreated acromegaly and 37 patients with nonfunctional pituitary adenomas. Adipose tissue (AT), the visceral fat index (VFI), sclerotin, protein, skeletal muscle, total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were measured using bioelectrical impedance analysis (BIA). Total energy expenditure (TEE) and basal metabolism (BM) were measured with a cardiopulmonary and metabolic analyzer (CMA). Tricep skinfold thickness (TST), bicep circumference, waistline, hipline, and calf circumference were measured with a skinfold caliper and tape. These indices were measured before surgery and 3 months and 1 year after surgery. Results. Overall, AT, VFI, and TST were lower, whereas sclerotin, protein, skeletal muscle, TBW, ICW, ECW, TEE, and BM were higher in acromegaly patients. Postoperatively, TST rose initially and then decreased, the waistline increased, and sclerotin, skeletal muscle, TEE, and BM decreased. Changes in these indices differed with gender and age in unique patterns. Conclusions. Body composition and metabolism in acromegaly patients changed after surgery, and gender and age influenced these changes.

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