RationaleBij bio-elektrische impedantieanalyse (BIA)-metingen wordt doorgaans een paar elektroden dorsaal op de rechterhand geplaatst (positie A) en een paar op de voet. Bij patiënten met kwetsbare huid, littekens of wonden is deze dorsale handplaatsing niet altijd mogelijk. Deze studie vergelijkt de overeenstemming van BIA-metingen bij zeven alternatieve plaatsingen met positie A.MethodeBIA-metingen werden uitgevoerd met de Bodystat-500 met behulp van acht combinaties van handelektroden: op de dorsale zijde van de hand (positie A) of dorsale zijde hand-onderarm (positie B en C); op de palmaire zijde van de hand (positie D) of palmaire zijde hand-onderarm (positie E en F) of gemengd palmair-dorsale zijde van de hand (positie G en H). ICC's werden gebruikt om alle uitkomsten te vergelijken met positie A. Veranderingen in vetmassa ∆FM, vetvrije massa ∆FFM en appendiculaire skeletspiermassa ∆ASMM werden berekend met behulp van de formule van Kyle.ResultatenZeventig gezonde Kaukasische deelnemers werden gemeten: mediane leeftijd 22 jaar, IQR 21-23; gemiddelde BMI 22,8 ± 2,5 kg/m². Elektrodeposities D, G en H toonden een ICC van 0,99-1,00 voor ∆FM, ∆FFM en ∆ASMM, met minimale veranderingen in ∆FFM en ∆FM: 0,1–0,4 kg ± 0,3 kg en ∆ASMM: 0,0–0,2 kg ± 0,2 kg. Metingen op positie B, C, E en F toonden significante en klinisch relevante verschillen met ∆FM en ∆FFM: 3,8–4,0 kg ± 1,1 kg en ∆ASMM: 2,0–2,1 kg ± 0,6 kg, met ICC's van 0,96-0,97.ConclusieAls alternatief voor de typische elektrodeplaatsing op de dorsale zijde van de hand toont deze studie aan dat drie alternatieve plaatsingen uitstekende overeenstemming geven met slechts minimale veranderingen in FFM, FM en ASMM. In de praktijk dient het plaatsen van elektroden op meer proximale posities op de onderarm te worden vermeden. Alternatief bevelen we een gemengde of palmaire elektrodeplaatsing op de hand aan.
RationaleIn bioelectrical impedance analysis (BIA) measurements, one pair of electrodes is typically placed dorsal on the right hand (position A) and one pair on the foot. In patients with fragile skin, scars or wounds, this dorsal hand placement is not always possible. This study compares agreement of BIA measurements at seven alternative placements with position A. MethodsBIA measurements were performed with the Bodystat-500 using eight combinations of hand electrodes: at the dorsal side of the hand (position A) or dorsal side hand-forearm (position B and C); at the palmar side of the hand (position D) or palmar side hand-forearm (position E and F) or mixed palmar-dorsal side of the hand (position G and H). ICCs were used to compare alle outcomes to position A. Changes in fat mass ∆FM, fat-free mass ∆FFM and appendicular skeletal muscle mass ∆ASMM were calculated using Kyle’s formula.ResultsSeventy healthy Caucasian participants were measured: median age 22 years, IQR 21-23; mean BMI 22.8 ± 2.5 kg/m². Electrode positions D,G and H showed an ICC 0.99-1.00 for ∆FM, ∆FFM and ∆ASMM with minimal changes in ∆FFM and ∆FM: 0.1–0.4 kg ± 0.3 kg and ∆ASMM: 0.0–0.2 kg ± 0.2 kg. Measurements at position B, C, E, and F showed significant and clinically relevant differences with ∆FM and ∆FFM: 3.8–4.0 kg ± 1.1 kg and ∆ASMM: 2.0–2.1 kg ± 0.6 kg, with ICCs 0.96-0.97.ConclusionAlternatively to the typical electrode placement on the dorsal side of the hand, this study demonstrates that three alternative placements results in an excellent agreement with only minimal changes in FFM, FM and ASMM. In practice, placing electrodes at more proximal positions on the forearm should be avoided. Alternatively, we recommend a mixed or palmar electrode placement on the hand.
BackgroundThe Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP).ObjectiveThis study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list.MethodsConstruct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach’s alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14).ResultsAfter Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach’s alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming.ConclusionsThe OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.
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