Validation of ActiGraph and Fitbit in the assessment of energy expenditure in Huntington's disease.

BACKGROUND: Consumer and research activity monitors have become popular because of their ability to quantify energy expenditure (EE) in free-living conditions. However, the accuracy of activity trackers in determining EE in people with Huntington's Disease (HD) is unknown. RESEARCH QUESTION: Can the ActiGraph wGT3X-B or the Fitbit Charge 4 accurately measure energy expenditure during physical activity, in people with HD compared to Indirect Calorimetry (IC) (Medisoft Ergo Card)? METHODS: We conducted a cross-sectional, observational study with fourteen participants with mild-moderate HD (mean age 55.7 ± 11.4 years). All participants wore an ActiGraph and Fitbit during an incremental test, running on a treadmill at 3.2 km/h and 5.2 km/h for three minutes at each speed. We analysed and compared the accuracy of EE estimates obtained by Fitbit and ActiGraph against the EE estimates obtained by a metabolic cart, using with Intra-class correlation (ICC), Bland-Altman analysis and correlation tests. RESULTS: A significant correlation and a moderate reliability was found between ActiGraph and IC for the incremental test (r = 0.667)(ICC=0.633). There was a significant correlation between Fitbit and IC during the incremental test (r = 0.701), but the reliability was poor at all tested speeds in the treadmill walk. Fitbit significantly overestimated EE, and ActiGraph underestimated EE compared to IC, but ActiGraph estimates were more accurate than Fitbit in all tests. SIGNIFICANCE: Compared to IC, Fitbit Charge 4 and ActiGraph wGT3X-BT have reduced accuracy in estimating EE at slower walking speeds. These findings highlight the need for population-specific algorithms and validation of activity trackers.

Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington's Disease: A Cross-Sectional Multicentre Study.

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington's disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.

Caffeine Ingestion Improves Performance During Fitness Tests but Does Not Alter Activity During Simulated Games in Professional Basketball Players.

PURPOSE: To examine the effects of acute caffeine supplementation on physical performance during fitness testing and activity during simulated games in basketball players. METHODS: A double-blind, counterbalanced, randomized, crossover study design was followed. A total of 14 professional male basketball players ingested a placebo (sucrose) and caffeine (6 mg·kg-1 of body mass) in liquid form prior to completing 2 separate testing sessions. Each testing session involved completion of a standardized 15-minute warm-up followed by various fitness tests including 20-m sprints, countermovement jumps, Lane Agility Drill trials, and a repeated-sprint-ability test. Following a 20-minute recovery, players completed 3 × 7-minute 5-vs-5 simulated periods of full-court basketball games, each separated by 2 minutes of recovery. Local positioning system technology was used to measure player activity during games. Players completed a side-effects questionnaire 12 to 14 hours after testing. RESULTS: Players experienced significant (P < .05), moderate-very large (effect size = -2.19 to 0.89) improvements in 20-m sprint, countermovement jump, Lane Agility Drill, and repeated-sprint-ability performance with caffeine supplementation. However, external workloads completed during simulated games demonstrated nonsignificant, trivial-small (effect size = -0.23 to 0.12) changes between conditions. In addition, players reported greater (P < .05) insomnia and urine output after caffeine ingestion. CONCLUSIONS: Acute caffeine supplementation could be effective to improve physical performance during tests stressing fitness elements important in basketball. However, acute caffeine supplementation appears to exert no meaningful effects on the activity completed during simulated basketball games and may promote sleep disturbances and exert a diuretic effect when taken at 6 mg·kg-1 of body mass in professional players.

Comparison of multidirectional jump performance and lower limb passive range of motion profile between soccer and basketball young players.

This study was performed aimed at comparing multidirectional bilateral and unilateral jump performance and passive range of motion (ROM) of lower limbs between soccer and basketball young players and evaluating associations between inter-limb ROM asymmetry and bilateral jump performance. A total of 67 young male athletes participated in this study, who were classified as soccer (n = 40; 15.55 ± 1.5 y; 1.76 ± 0.12 m; 58.15 ± 10.82 kg; 19.84 ± 2.98 kg·m2) and basketball (n = 27; 15.7 ± 1.66 y; 1.76 ± 0.12 m; 62.33 ± 16.57 kg; 19.84 ± 2.98 kg·m2) players. Participants were asked to perform bilateral and unilateral multidirectional jumps, and passive ROM of hip (flexion, extension and abduction), knee (flexion) and ankle (dorsiflexion) joints was also assessed. Significant between-group differences were observed for hip extension with flexed knee ROM in dominant (soccer: 142.43 ± 7.74°; basketball: 148.63 ± 8.10°) and non-dominant (soccer: 144.38 ± 8.36°; basketball: 148.63 ± 6.45°) legs; hip flexion with flexed knee ROM in dominant (soccer: 13.26 ± 4.71°; basketball: 9.96 ± 3.42°) and non-dominant (soccer: 12.86 ± 4.55°; basketball: 9.70 ± 3.62°) legs; and for the ratio of hip abduction (soccer: 1.02 ± 0.08; basketball: 0.97 ± 0.11). However, no significant between-group differences were observed for bilateral and unilateral jump capacity, or for inter-limb asymmetries (dominant vs. non-dominant leg). Finally, no associations were observed between ROM ratio (dominant vs. non-dominant leg) and bilateral jump performance. These findings lead to the suggestion that differences on passive ROM values in young male athletes may be sport-specific. Additionally, there seems to be need for the implementation of training strategies specifically aimed at improving bilateral or unilateral jump ability, or at diminishing inter limb passive ROM differences in order to improve multidirectional jump performance for neither soccer nor basketball youth male players.

Is adductor pollicis skinfold an accurate tool when checking local muscle improvement in malnourished patients with anorexia nervosa?

OBJECTIVES: Anorexia nervosa (AN) is a complex disease that involves malnutrition and a profound depletion in muscle mass. The thickness of the adductor pollicis muscle (APM) has been proposed as a new anthropometric technique to estimate muscle mass, check early changes, and assess its evaluation. This study aimed to evaluate the accuracy and validity of the APM thickness in a cohort of malnourished patients with AN when checking local mass gain. The Doppler ultrasound maybe an affordable and useful method to discriminate all tissues around the APM area. METHODS: A prospective cohort study was conducted of 31 malnourished patients with AN who were admitted to the Regional Eating Disorders Unit for treatment, including re-alimentation. Anthropometric measurements were taken, including arm circumference, triceps skinfold thickness, arm muscle circumference, body mass index, and APM thickness of both hands. Simultaneously, a Doppler ultrasound was performed in the same area, measuring and discriminating fat, skin, and muscle tissues around the APM. RESULTS: Nutritional improvement is accompanied by fat, but not muscle gain in the hand in the adductor pollicis area of patients with AN. A Doppler ultrasound can accurately discriminate between tissues around the APM. CONCLUSIONS: APM thickness reflects the addition of two different muscles plus fat and skin; therefore, this tool is not reliable to assess APM mass.

[Associated metabolic and nutritional side effects to biological cancer therapy]. / Efectos adversos metabólicos y nutricionales asociados a la terapia biológica del cáncer.

INTRODUCTION: The different types of cancer represent one of the main causes of morbimortality worldwide. Classical anti-tumor therapy (surgery, chemotherapy, radiotherapy) has notably increased the survival rate. Biological therapies, with selective and frequently specific mechanisms of action, are a relatively recent acquisition in oncologic therapy; among the most commonly used ones are: cytokines, monoclonal antibodies, tyrosine kinase inhibitors, and mTOR inhibitors. The nutritional and metabolic adverse effects of classical therapy are well documented in the literature and the clinical guidelines, which is not the case for biological therapy. OBJECTIVE: To review the literature in this field and to detail in an organized manner the results obtained. METHODS: Indexed literature and the technical data sheets of the drugs included in the different families were revised through the Spanish Agency of Medicines and Health Care Products until July of 2013. The symptoms and clinical signs of a theoretical action on the nutritional and metabolic status were recorded. RESULTS: The specific action of each family is described. The possible adverse effects of each one of them on the nutritional and metabolic status are grouped, detailing and differentiating them in tables for easier and more friendly-user consultation. The most prevalent possible side effects observed are those related with the appetite, the gastrointestinal tract, and electrolytic impairments. CONCLUSIONS: the possible side effects associated to biological therapies are plenty and occur with different frequency and severity. It is important to know the nutritional and metabolic impact when using these therapies for preventing and managing them.

Introducción: Los diferentes tipos de cáncer constituyen una de las principales causas de morbi-mortalidad en el mundo. La terapia clásica antitumoral (cirugía, quimioterapia, radioterapia) ha incrementado notoriamente la supervivencia. Las terapias biológicas, con mecanismos de acción selectivos y frecuentemente específicos, constituyen una incorporación relativamente reciente al tratamiento oncológico; entre las más utilizadas se incluyen: citoquinas, anticuerpos monoclonales e inhibidores de tirosin kinasa y de mTOR. Si bien están adecuadamente documentados los efectos adversos nutricionales y metabólicos asociados a la terapia clásica, tanto en literatura como en guías clínicas, no ocurre igual con la terapia biológica. Objetivo: Revisar la literatura al respecto y detallar de modo organizado los resultados obtenidos. Métodos: Se revisó la literatura indizada así como todas las fichas técnicas de los fármacos incluidos en las distintas familias mediante la Agencia Española del Medicamento y Productos Sanitarios a Julio de 2013. Se registran los síntomas y signos clínicos con teórica acción sobre el estado nutricional o metabólico. Resultados: Se describe la acción específica de cada familia. Se agrupan los posibles efectos adversos de cada una sobre el estado nutricional y metabolismo, detallando y diferenciándolos en tablas para una más fácil y cómoda revisión y consulta. Se observan como posibles efectos secundarios más prevalentes los relacionados con el apetito, aparato digestivo y alteraciones electrolíticas. Conclusiones: Los posibles efectos secundarios asociados a terapias biológicas son múltiples y aparecen con diferente frecuencia y gravedad. Es importante al utilizarlas conocer el impacto nutricional y metabólico que pueden presentar, para su prevención y tratamiento.

[Effect of refeeding on the body composition of females with restrictive anorexia nervosa; anthropometry versus bioelectrical impedance]. / Efecto de la realimentación en la composición corporal de mujeres con anorexia nerviosa restrictiva; antropometría frente a impedancia bioeléctrica.

OBJECTIVE: To assess the body composition in a group of malnourished patients with anorexia nervosa as compared to healthy controls, before and after nutritional support, by means of anthropometry and bioimpedance. METHODS: Prospective observational study. Complete anthropometry was performed as well as bioimpedance analysis in 12 women (24.5 years) with restrictive anorexia nervosa at hospital admission and weekly thereafter during re-feeding. The control group was formed by 24 healthy women (21 years). The Student's t test, the Mann-Whitney U test, the Student's t test for repeated measurements, and the Wilcoxon's test were applied. The level of agreement between anthropometry and BIA was calculated by the interclass correlation coefficient and the Bland-Altman s test. RESULTS: The patients had significant improvements in all indexes of body composition throughout their hospital staying although their values at discharge still were lower than those of the control subjects. The average weight gain was 5.22 kg (SD: 1.42), of which 51.4% was fat mass, preferentially centrally distributed. In the control subjects, the BIA equation that correlated the best with anthropometrics was Sun s equation (CCI = 0.896); in the patients, the level of agreement was weaker, both at hospital admission and at hospital discharge. CONCLUSIONS: Re-feeding produces weight gain, essentially at the expense of fat mass, which is centrally distributed; the nutritional status is not reestablished. The level of agreement between anthropometry and bioimpedance for studying body composition is acceptable, especially in healthy subjects. In those cases with severe changes in body composition and/or water balance, anthropometry is recommended when vectorial BIA or some other gold standard method are not available for the analysis of body composition.

Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años) al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años). Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42), de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896); en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico.