Biomedical musculoskeletal applications of infrared thermal imaging on arm and forearm: A systematic review.

Infrared thermal imaging (IRT) has been a target of research for biomedical musculoskeletal applications, due to the possible association of the physiological data that it provides, through skin temperature measurement, with pathological states. The aim of this systematic review is to acquaint the outcomes of the biomedical application of IRT in arm and forearm evaluation and its future perspectives of research. During the literature review, 926 articles were identified using the search engines PubMed and Scopus, and 10 articles were retrieved from other sources. After screening the abstracts and applying the eligibility criteria on those which were fully accessible, 33 articles were included in the review. It can be observed that IRT has the potential to provide physiological information on the arm and forearm, showing potential to serve as an aid in various pathologies and health situations. Future studies and challenges are identified and proposed, facilitating the improvement and acceptance of the application of IRT in the assessment of arm and forearm' health status.

Comparison of Jamar and Bodygrip Dynamometers for Handgrip Strength Measurement.

Guerra, RS, Amaral, TF, Sousa, AS, Fonseca, I, Pichel, F, and Restivo, MT. Comparison of Jamar and Bodygrip dynamometers for handgrip strength measurement. J Strength Cond Res 31(7): 1931-1940, 2017-Studies that compared the agreement between Jamar and other models of dynamometers for handgrip strength (HGS) measurement have exhibited variability in the provided results. The lack of comparability between dynamometers led to the development of the Bodygrip dynamometer. This study aims to examine the reliability of the Bodygrip for HGS measurement, to compare it with the Jamar, and to explore the HGS differences between instruments considering the ergonomic effect of using the Bodygrip with 2 different handles. A cross-sectional study was conducted in free-living (n = 114, 18-89 years) and inpatient (n = 50, 65-93 years) volunteers. Nondominant HGS was tested randomly with the Jamar and Bodygrip, the latter using 2 different handles-curved and straight types. Handgrip strength was obtained for each participant under the same conditions. Each individual performed 2 HGS measurements with each dynamometer, and the maximum HGS value was considered for dynamometers comparison. Differences in the maximum HGS value between the 2 devices (Jamar-Bodygrip), intraclass correlation coefficients (ICCs), Bland and Altman plots, and limits of agreement were obtained. Correlation between the highest HGS measurement obtained for the nondominant hand with the Jamar and with the Bodygrip using each handle was excellent (ICCs: 0.93-0.95). Mean differences of -0.5 (limits of agreement: -4.6; 3.5) kgf with the curved handle and of 1.0 (-7.7; 9.7) kgf with the straight handle for the free-living participants were obtained, whereas for inpatients these values were -1.0 (-3.8; 1.9) kgf and 2.1 (-3.3; 7.5) kgf, respectively, for the curved and straight handles. The Bodygrip is comparable to the Jamar in free-living adults and in hospitalized older adults, exhibiting excellent interinstrument reliability. The Bodygrip with the curved handle produces results closer to the Jamar when compared with Bodygrip with the straight handle, which emphasizes the importance of grip handle ergonomics to measurement reliability.

Usefulness of six diagnostic and screening measures for undernutrition in predicting length of hospital stay: a comparative analysis.

BACKGROUND: Undernutrition has been associated with longer length of hospital stay (LOS). However, an analysis that investigates the association of recommended undernutrition diagnostic and screening indicators with LOS conducted in patients with a varied spectrum of pathologies and considering confounders would help to clarify their clinical value. OBJECTIVE: We aimed to quantify the association of being undernourished as evaluated by different methodologies with LOS and their validity in predicting inpatient LOS. DESIGN: A prospective observational study was conducted. Undernutrition was evaluated by the Academy of Nutrition and Dietetics-American Society for Parental and Enteral Nutrition recommended clinical characteristics of malnutrition (AA-CCM) tool, the Patient-Generated Subjective Global Assessment (PG-SGA), the Nutritional Risk Screening (NRS-2002) tool, and the Malnutrition Universal Screening tool (MUST). Handgrip strength (HGS) quartiles by sex and phase angle (PA) categories were also used as indicators of undernutrition. PARTICIPANTS AND SETTING: Six hundred eighty-two inpatients from a Portuguese university hospital participated between 2011 and 2013. MAIN OUTCOME MEASURES: LOS was determined between the date of hospital admission and discharge. STATISTICAL ANALYSES PERFORMED: Kaplan-Meier and adjusted Cox proportional hazard ratio (HR) methods were applied. RESULTS: Moderate or severe undernutrition by AA-CCM (HR 0.58, 95% CI 0.49 to 0.69), by PG-SGA (moderate or suspected: HR 0.60, 95% CI 0.49 to 0.73 and severe: HR 0.52, 95% CI 0.42 to 0.64), risk of undernutrition assessed by NRS-2002 (HR 0.61, 95% CI 0.52 to 0.73), by MUST (medium: HR 0.75, 95% CI 0.60 to 0.95 and high: HR 0.67, 95% CI 0.55 to 0.81), HGS quartile (second: HR 0.64, 95% CI 0.50 to 0.80 and first [lowest]: HR 0.50, 95% CI 0.39 to 0.64) and nutritional risk defined by low PA (HR 0.62, 95% CI 0.48 to 0.81) were all independently associated with lower probability of being discharged from the hospital. CONCLUSIONS: Despite assessing different dimensions of nutritional status, undernutrition by AA-CCM and PG-SGA, risk of undernutrition assessed by NRS-2002 and MUST, and low HGS and PA independently predict longer LOS in hospitalized patients. All these methodologies share a similar validity in predicting LOS.

Handgrip strength and associated factors in hospitalized patients.

BACKGROUND: Handgrip strength (HGS) is a marker of nutrition status. Many factors are associated with HGS. Age, height, body mass index, number of diagnoses, and number and type of drugs have been shown to modify the association between undernutrition and HGS. Nevertheless, other patient characteristics that could modify this association and its joint modifier effect have not been studied yet. OBJECTIVE: To evaluate the association of inpatients' HGS and undernutrition considering the potential modifier effect of cognitive status, functional activity, disease severity, anthropometrics, and other patient characteristics on HGS. METHODS: A cross-sectional study was conducted in a university hospital. Sex, age, abbreviated mental test score, functional activity score, Charlson index, number of drugs, Patient-Generated Subjective Global Assessment (PG-SGA) score, body weight, mid-arm muscle circumference, adductor pollicis muscle thickness, body height, wrist circumference, hand length, and palm width were included in a linear regression model to identify independent factors associated with HGS (dependent variable). RESULTS: The study sample was composed of 688 inpatients (18-91 years old). All variables included in the model were associated with HGS (ß, -0.16 to 0.38; P ≤ .049) and explained 68.5% of HGS. Age, functional activity decline, Charlson index, number of drugs, PG-SGA score, body weight, and wrist circumference had a negative association with HGS. All other studied variables were positively associated with HGS. CONCLUSION: Nutrition status evaluated by PG-SGA was still associated with HGS after considering the joint effect of other patient characteristics, which reinforces the value of HGS as an indicator of undernutrition.

A digital calliper for training and study purposes.

A quick and valid method for evaluating percentage body fat is based on the use of skinfold callipers. However, limitations associated to their use and characteristics led the authors to improve a traditional calliper (Harpenden) and to integrate it with a software application. Such a measuring system, LipoTool, is meant to have better accuracy and reliability, including data processing and digital recording at a very low cost. At first, a sample of 49 older adults was used to evaluate the performance of LipoTool by comparing its results to those obtained with the traditional Harpenden calliper. A strong positive association in %BF was achieved. This digital sensing system was later improved by incorporating wireless communication between the calliper and the software application, adding other functionalities. The software application works in any computer and is flexible to incorporate new coming models, linear regressions or new algorithms. This new system was validated against the standard Dual-Energy X-Ray Absorptiometry system, using a sample of 40 adults with positive results. This solution is a valid and reliable alternative to traditional reference callipers, simplifying the percentage of body fat evaluation and providing a more effective use in daily practice with less expenditure of time and resources. Its implemented guided procedure turns it into a precious training tool based on a non-invasive, portable device, and not requiring special individual preparation. Ongoing activities are focused on the design of a new mechanical structure, with novel functionalities and for exploring other studies.