Prediction of maximal oxygen uptake by bioelectrical impedance analysis in overweight adolescents.

AIM: Maximal oxygen uptake (VO(2max)), the gold standard for measurement of cardiorespiratory fitness, is frequently difficult to assess in overweight individuals due to physical limitations. Reactance and resistance measures obtained from bioelectrical impedance analysis (BIA) have been suggested as easily obtainable predictors of cardiorespiratory fitness, but the accuracy with which ht(2)/Z can predict VO(2max) has not previously been examined in overweight adolescents. METHODS: The impedance index was used as a predictor of VO(2max) in 87 overweight girls and 47 overweight boys ages 12 to 17 with mean BMI of 38.6 + or - 7.3 and 42.5 + or - 8.2 in girls and boys respectively. The Bland Altman procedure assessed agreement between predicted and actual VO(2max). RESULTS: Predicted VO(2max) was significantly correlated with measured VO(2max) (r(2)=0.48, P<0.0001). Using the Bland Altman procedure, there was significant magnitude bias (r(2)=0.10; P<0.002). The limits of agreement for predicted relative to actual VO(2max) were -589 to 574 mL O(2)/min. CONCLUSIONS: The impedance index was highly correlated with VO(2max) in overweight adolescents. However, using BIA data to predict maximal oxygen uptake over-predicted VO(2max) at low levels of oxygen consumption and under-predicted VO(2max) at high levels of oxygen consumption. This magnitude bias, along with the large limits of agreement of BIA-derived predicted VO(2max), limit its usefulness in the clinical setting for overweight adolescents.

Distal femoral fixation: a biomechanical comparison of the standard condylar buttress plate, a locked buttress plate, and the 95-degree blade plate.

OBJECTIVES: This biomechanical cadaver study was performed to compare the fixation stability of a standard lateral condylar buttress plate with a similar condylar buttress plate with the distal screws locked to the plate. Then the study was repeated with six additional matched femoral pairs to compare the locked plate with a standard 95-degree blade plate. DESIGN: Six matched pairs of mildly osteopenic femurs were selected, and each side was assigned randomly to fixation with either a standard lateral condylar buttress plate or a modified lateral condylar buttress plate with locked distal screws. The experiment was repeated with six additional matched pairs of femurs instrumented with either a modified lateral condylar buttress plate with locked distal screws or a standard 95-degree blade plate. INTERVENTION: The femurs were instrumented, and a gap osteotomy was created at the distal femoral metaphysis. The instrumented femurs were then mechanically tested in axial compression and bending/torsional loading to determine fixation stability; then they were loaded at 1,000 newtons for 10(5) cycles and retested for stability. MAIN OUTCOME MEASUREMENT: The displacement across the osteotomy gap at 100-newton and 1,000-newton axial loads was measured directly for each specimen before and after cycling. In addition, resistance to displacement in bending/torsional loading (newtons/centimeter) was determined from load/displacement curves, before and after cycling. RESULTS: The locked buttress plate provided significantly greater fixation stability than the standard plate both before and after cycling in axial loading. The locked buttress plate also proved significantly more stable in axial loading than the blade plate both before and after cycling. CONCLUSION: A condylar buttress plate with locked screws is a valid concept for improving fixation stability.