Francesca de Blasio

Evaluation of body composition in COPD patients using multifrequency bioelectrical impedance analysis

Background Multifrequency bioelectrical impedance analysis (MF-BIA) is a technique that measures body impedance (Z) at different frequencies (5, 10, 50, 100, and 250 kHz). Body composition may be estimated using empirical equations, which include BIA variables or, alternatively, raw BIA data may provide direct information on water distribution and muscle quality. Objectives To compare raw MF-BIA data between COPD patients and controls and to study their relationship with respiratory and functional parameters in COPD patients. Methods MF-BIA was performed (Human Im-Touch analyzer) in 212 COPD patients and 115 age- and BMI-matched controls. Fat-free mass (FFM) and fat mass were estimated from BIA data, and low- to high-frequency (5 kHz/250 kHz) impedance ratio was calculated. Physical fitness, lung function and respiratory muscle strength were also assessed in COPD patients. Results After adjusting for age, weight, and body mass index, FFM and the 5/250 impedance ratio were lower in COPD patients (P<0.001) and were negatively affected by disease severity. In both male and female patients, the 5/250 impedance ratio was significantly correlated mainly with age (r=−0.316 and r=−0.346, respectively). Patients with a 5/250 impedance ratio below median value had lower handgrip strength (P<0.001), 6-minute walk distance (P<0.005), respiratory muscle strength (P<0.005), forced expiratory volume in 1 second (P<0.05) and vital capacity (P<0.005). Finally, the 5/250 impedance ratio was reduced (P<0.05) in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) III and IV (compared to those with GOLD I and II) or a BODE index between 6 and 10 points (compared to those with BODE index between 1 and 5 points). Conclusion MF-BIA may be a useful tool for assessing body composition and nutritional status in COPD patients. In particular, the impedance ratio could give valuable information on cellular integrity and muscle quality.

O-32 Reliability of optojump system for the assessment of different protocols of jump and agreement with jump­and­reach test

Aim Vertical jump represents an important skill in many sports and its evaluation is proposed to assess lower limb strength. The Jumpand-Reach test is the most commonly used fieldtest. It measures, on a vertical surface, the difference between the heights reached by the fingers with the arm extended standing flatfooted and at the highest point of the flight phase. It is simple, no equipment is required, but unilateral swing of the arm, involvement of muscles beyond the lower limb and coordination are needed. The Squat Jump and the Countermovement Jump, with hands to the hips, are adopted to obtain a specific measure of lower limb strength. The Countermovement Jump with arm swing is proposed to assess a more natural jump performance. Unfortunately, it is impossible to measure the height of these jumps without devices, such as accelerometers, contact mats, force platforms and video-analysis. The Optojump (Microgate, Bolzano-Italy), an optical transmitting-receiving bars measurement system, is proposed to measure these jumps. The aim of this study is to assess the testretest reliability of Squat Jump, Countermovement Jump and Countermovement Jump with arm swing measured by Optojump system. Moreover, the reliability of JumpandReach test measured both by vertical surface and by Optojump and the agreement between these two methods are analysed. Methods 31 healthy volunteers were recruited (16 F15M). Inclusion criteria: age 2029 years, absence of painful conditions in the last three months. Subjects with orthopaedic, vascular, rheumatological and/or neurological diseases affecting lower limb were excluded. Each subject performed squat jump, countermovement jump and countermovement jump with arm swing using Optojump. Furthermore, each participant performed jumpandreach test and data were recorded by vertical surface (fieldtest) and by Optojump, simultaneously. Each jump was repeated three times during a single session (4 sessions in 2 days), with 20’’ rest between jumps and 5’ rest between different jumps’ test. The sequence of test was modified in each session. The interclass correlation coefficients and the standard error of measurement were calculated. The Bland-Altman method was used to assess the agreement between the two methods of measurement adopted for jumpandreach. Results Interclass correlation coefficients were Squat Jump = 0.969 (CI: 95% = 0.946–0.984, SEM = 1.91), Countermovement Jump = 0.969 (CI: 95% = 0.947–0.984, SEM = 1.7), Countermovement Jump with arm swing = 0.985 (CI: 95% = 0.973–0.992, SEM = 1.69), JumpandReach (Optojump) = 0.989 (CI: 95% = 0.981–0.994,SEM = 1.56), JumpandReach (vertical surface) = 0.982 (CI: 95% = 0.968–0.990, SEM = 2.91). JumpandReach scores obtained by vertical surface were significantly higher than scores recorded by Optojump (p < 0.001). The correlation coefficient was very high (r = 0.92) but BlandAltman analysis (Figure 1) showed a significant bias between two methods (mean = 12.36 cm, limits of agreement 2.6322.09 cm +42,04%, limits of agreement 17.46%, 66.62%). Conclusions The Optojump is a reliable device to measure Squat Jump, Countermovement Jump, Counter-movement Jump with arm swings and JumpandReach. Also the JumpandReach test measured by vertical surface showed a significant reliability but with scores higher than Optojump. A significative bias in the agreement between the two methods of JumpandReach measurement was detected. This difference is probably due to some biomechanical aspects that require further investigations to better understand the impact of upper body structures on jump performance. Abstract O-32 Figure 1 Bland-Altman Analysis