저자는 BIVA 소프트웨어를 제공해 주신 이탈리아 파도바 대학교 의학 및 외과 과학부의 Piccoli 교수와 Pastori 교수에게 감사의 뜻을 전합니다. 또한 Luis Llorente 박사와 Dra. 환자의 류마티스 평가를 위한 INCMNSZ 면역학 및 류마티스학과의 Andrea Hinojosa-Azaola. 이 연구는 Mariel Lozada Mellado의 박사 과정 연구와 연구 프로젝트 보조금 000000000261652를 통해 CVU 777701 장학금을 후원한 CONACyT의 지원을 받았습니다. 의뢰자는 연구 설계나 데이터 수집, 분석 또는 해석, 보고서 작성 및 출판을 위한 논문 제출 결정에 어떠한 역할도 하지 않았습니다.

The video discusses research on using vector impedance analysis to assess hydration changes in body cell mass in rheumatoid arthritis patients. It highlights the increased infection risk associated with low body cell mass and emphasizes the benefits of physical exercise in improving strength, quality of life, and inflammation in these patients.

류마티스 관절염 환자를 위한 운동 프로그램 개발

<ol>
	<li>Aletaha, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rheumatoid+arthritis+classification+criteria:+An+American+College+of+Rheumatology/European+League+Against+Rheumatism+collaborative+initiative.">Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative.</a> Annals of the Rheumatic Diseases. 62 (9), 1580-1588 (2010).</li><li>Gamal, R. M., Mahran, S. A., Abo El Fetoh, N., Janbi, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quality+of+life+assessment+in+Egyptian+rheumatoid+arthritis+patients:+Relation+to+clinical+features+and+disease+activity.">Quality of life assessment in Egyptian rheumatoid arthritis patients: Relation to clinical features and disease activity.</a> Egyptian Rheumatologist. 38 (2), 65-70 (2016).</li><li>Rall, L. C., Roubenoff, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rheumatoid+cachexia:+metabolic+abnormalities,+mechanisms,+and+interventions.">Rheumatoid cachexia: metabolic abnormalities, mechanisms, and interventions.</a> Rheumatology. 43 (10), 1219-1223 (2004).</li><li>Summers, G. D., Deighton, C. M., Rennie, M. J., Booth, A. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rheumatoid+cachexia:+A+clinical+perspective.">Rheumatoid cachexia: A clinical perspective.</a> Rheumatology. 47 (8), 1124-1131 (2008).</li><li>Elkan, A. C., Engvall, I. L., Cederholm, T., Hafstr&#246;m, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rheumatoid+cachexia,+central+obesity+and+malnutrition+in+patients+with+low-active+rheumatoid+arthritis:+Feasibility+of+anthropometry,+Mini+Nutritional+Assessment,+and+body+composition+techniques.">Rheumatoid cachexia, central obesity and malnutrition in patients with low-active rheumatoid arthritis: Feasibility of anthropometry, Mini Nutritional Assessment, and body composition techniques.</a> European Journal of Nutrition. 48 (5), 315-322 (2009).</li><li>Engvall, I. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cachexia+in+rheumatoid+arthritis+is+associated+with+inflammatory+activity,+physical+disability,+and+low+bioavailable+insulin-like+growth+factor.">Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor.</a> Scandinavian Journal of Rheumatology. 37 (5), 321-328 (2008).</li><li>Jacobs, D. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioelectrical+Impedance+Analysis:+Implications+for+Clinical+Practice.">Bioelectrical Impedance Analysis: Implications for Clinical Practice.</a> Nutrition in Clinical Practice. 12 (5), 204-210 (1997).</li><li>Santill&#225;n-D&#237;az, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence+of+rheumatoid+cachexia+assessed+by+bioelectrical+impedance+vector+analysis+and+its+relation+with+physical+function.">Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function.</a> Clinical Rheumatology. 37 (3), 607-614 (2018).</li><li>Piccoli, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bivariate+normal+values+of+the+bioelectrical+impedance+vector+in+adult+and+elderly+populations.">Bivariate normal values of the bioelectrical impedance vector in adult and elderly populations.</a> The American Journal of Clinical Nutrition. 61 (2), 269-270 (1995).</li><li>Espinosa-Cuevas, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vectores+de+impedancia+bioel&#233;ctrica+para+la+composici&#243;n+corporal+en+poblaci&#243;n+mexicana+[Bioelectrical+impedance+vectors+for+body+composition+in+Mexican+population].">Vectores de impedancia bioel&#233;ctrica para la composici&#243;n corporal en poblaci&#243;n mexicana [Bioelectrical impedance vectors for body composition in Mexican population].</a> Revista de investigaci&#243;n cl&#237;nica [Clinical research journal]. 59 (1), 15-24 (2007).</li><li>Piccoli, A., Pillon, L., Dumler, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impedance+vector+distribution+by+sex,+race,+body+mass+index,+and+age+in+the+United+States:+standard+reference+intervals+as+bivariate+Z+scores.">Impedance vector distribution by sex, race, body mass index, and age in the United States: standard reference intervals as bivariate Z scores.</a> Nutrition. 18 (2), 153-167 (2002).</li><li>Maese, J., Garc&#237;a De Y&#233;benes, M. J., Carmona, L., Hern&#225;ndez-Garc&#237;a, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Estudio+sobre+el+manejo+de+la+artritis+reumatoide+en+Espa&#241;a+(emAR+II)+[Study+on+the+management+of+rheumatoid+arthritis+in+Spain+(emAR+II)].+Caracter&#237;sticas+cl&#237;nicas+de+los+pacientes+[Clinical+characteristic+of+patients].">Estudio sobre el manejo de la artritis reumatoide en Espa&#241;a (emAR II) [Study on the management of rheumatoid arthritis in Spain (emAR II)]. Caracter&#237;sticas cl&#237;nicas de los pacientes [Clinical characteristic of patients].</a> Reumatolog&#237;a Clinica. 8 (5), 236-242 (2012).</li><li>Hurkmans, E., Van der Giesen, F. J., Vlieland, T. P. M. V., Schoones, J., Van den Ende, E. C. H. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamic+exercise+programs+(aerobic+capacity+and/or+muscle+strength+training)+in+patients+with+rheumatoid+arthritis.">Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis.</a> Cochrane Database of Systematic Reviews. 4, CD006853 (2009).</li><li>Baillet, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+cardiorespiratory+aerobic+exercise+in+rheumatoid+arthritis:+Meta-analysis+of+randomized+controlled+trials.">Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta-analysis of randomized controlled trials.</a> Arthritis Care &amp; Research. 62 (7), 984-992 (2010).</li><li>De Jong, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+follow-up+of+a+high-intensity+exercise+program+in+patients+with+rheumatoid+arthritis.">Long-term follow-up of a high-intensity exercise program in patients with rheumatoid arthritis.</a> Clinical Rheumatology. 28 (6), 663-671 (2009).</li><li>Garc&#237;a-Morales, J. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+a+dynamic+exercise+program+in+combination+with+Mediterranean+diet+on+quality+of+life+in+women+with+rheumatoid+arthritis.">Effect of a dynamic exercise program in combination with Mediterranean diet on quality of life in women with rheumatoid arthritis.</a> Journal of Clinical Rheumatology. 26 (2), S116-S122 (2019).</li><li>Munneke, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+a+high-intensity+weight-bearing+exercise+program+on+radiologic+damage+progression+of+the+large+joints+in+subgroups+of+patients+with+rheumatoid+arthritis.">Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis.</a> Arthritis &amp; Rheumatism. 53, 410-417 (2005).</li><li>Hochberg, M., Chang, R., Dwosh, I., Lyndsey, S., Pincus, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+American+College+of+Rheumatology+1991+Revised+Criteria+for+the+Classification+of+Global+Functional+Status+in+Rheumatoid+Arthritis.">The American College of Rheumatology 1991 Revised Criteria for the Classification of Global Functional Status in Rheumatoid Arthritis.</a> Arthritis &amp; Rheumatism. 35, 498-502 (1991).</li><li>Nikiphorou, E., Konan, S., MacGregor, A. J., Haddad, F. S., Young, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+surgical+treatment+of+rheumatoid+arthritis.">The surgical treatment of rheumatoid arthritis.</a> Bone Joint Journal. 96 (10), 1287-1289 (2014).</li><li>Jacqueline, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rheumatoid+Arthritis:+A+Brief+Overview+of+the+Treatment.">Rheumatoid Arthritis: A Brief Overview of the Treatment.</a> Medical Principles and Practice. 27 (6), 501-507 (2019).</li><li>Piccoli, A., Rossi, B., Pillon, L., Bucciante, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+method+for+monitoring+body+fluid+variation+by+bioimpedance+analysis:+the+RXc+graph.">A new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph.</a> Kidney International. 46 (2), 534-539 (1994).</li><li>Benatti, F. B., Pedersen, B. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exercise+as+an+anti-inflammatory+therapy+for+rheumatic+diseases+-+Myokine+regulation.">Exercise as an anti-inflammatory therapy for rheumatic diseases - Myokine regulation.</a> Nature Reviews Rheumatology. 11 (2), 86-97 (2015).</li><li>Cooney, J. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Benefits+of+Exercise+in+Rheumatoid+Arthritis.">Benefits of Exercise in Rheumatoid Arthritis.</a> Journal of Aging Research. 6, 297-310 (2011).</li><li>Barbosa-Silva, M. C. G., Barros, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioelectrical+impedance+analysis+in+clinical+practice:+a+new+perspective+on+its+use+beyond+body+composition+equations.+Current+Opinion.">Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations. Current Opinion.</a> Clinical Nutrition and Metabolic Care. 8 (3), 311-317 (2005).</li><li>Mulasi, U., Kuchnia, A. J., Cole, A. J., Earthman, C. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioimpedance+at+the+bedside:+current+applications,limitations,+and+opportunities.">Bioimpedance at the bedside: current applications,limitations, and opportunities.</a> Nutrition in Clinical Practice. 30 (2), 180-193 (2015).</li><li>Steihaug, O. M., Bogen, B., Kristoffersen, M., Ranhoff, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bones,+blood+and+steel:+How+bioelectrical+impedance+analysis+is+affected+by+a+hip+fracture+and+surgical+implants.">Bones, blood and steel: How bioelectrical impedance analysis is affected by a hip fracture and surgical implants.</a> Journal of Electrical Bioimpedance. 8, 54-59 (2017).</li><li>Nwosu, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioelectrical+impedance+vector+analysis+(BIVA)+is+a+method+to+compare+body+composition+differences+according+to+cancer+stage+and+type.">Bioelectrical impedance vector analysis (BIVA) is a method to compare body composition differences according to cancer stage and type.</a> Clinical nutrition ESPEN. 30, 59-66 (2019).</li><li>Martins, P. C., Gobbo, L. A., Silva, D. A. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioelectrical+impedance+vector+analysis+(BIVA)+in+university+athletes.">Bioelectrical impedance vector analysis (BIVA) in university athletes.</a> Journal of the International Society of Sports Nutrition. 18 (7), 1-8 (2021).</li><li>Norman, K., Pirlich, M., Sorensen, J., Christensen, P., Kemps, M., Sch&#252;tz, T., Lochs, H., Kondrup, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bioimpedance+vector+analysis+as+a+measure+of+muscle+function.">Bioimpedance vector analysis as a measure of muscle function.</a> Clinical Nutrition. 28 (1), 78-82 (2009).</li><li>Stagi, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Usability+of+classic+and+specific+bioelectrical+impedance+vector+analysis+in+measuring+body+composition+of+children.">Usability of classic and specific bioelectrical impedance vector analysis in measuring body composition of children.</a> Clinical nutrition. 41 (3), 673-679 (2022).</li><li>Garber, C. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+College+of+Sports+Medicine.+American+College+of+Sports+Medicine+position+stand.+Quantity+and+quality+of+exercise+for+developing+and+maintaining+cardiorespiratory,+musculoskeletal,+and+neuromotor+fitness+in+apparently+healthy+adults:+guidance+for+prescribing+exercise.">American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.</a> Medicine &amp; Science in Sports &amp; Exercise. 43 (7), 1334-1359 (2011).</li></ol>

저자는 공개할 것이 없습니다.

류마티스 관절염에서는 염증 메커니즘으로 인한 관절의 구조적 변화를 의미하는 질병의 악순환이 설명되었습니다. 이러한 변화는 만성 염증 상태와 함께 관절의 구조적 변화와 그에 따른 기능 장애와 함께 환자에게 큰 통증과 염증 단계를 겪게 하여 대사 및 심혈관 질환 발병 위험과 류마티스 악액질과 같은 신체 구성의 변화를 증가시킨다22. 운동은 이 질병의 증상을 완화하고,...

류마티스 관절염(RA)은 급성 관절통, 근력 감소, 신체 기능 손상으로 인해 환자의 기능과 독립성에 영향을 미치는 장애 질환으로, 이 모든 것은 이 질병에 내재된 염증 과정과 관련이 있습니다 1,2. 진행된 단계에서 지속적인 염증은 기형, 관절 기능 장애 및 류마티스 악액질로 이어지는 구조적 변화를 유발하며, 이는 이러한 환자의 예후가 좋지 않습니다 3,4.
류마티스 악액질은 안정적인 체중과 체지방량 증가로 인한 근육 손실과 같은 신체 구성의 변화를 특징으로 하며, 이는 이러한 환자의 삶의 질에 상당한 영향을 미칠 수 있습니다 3,5,6. 체성분을 평가하기 위해 다양한 기술을 사용할 수 있으며, 가장 널리 사용되는 것은 생체 전기 임피던스 분석(BIA)입니다. 그러나, 종래의 BIA 분석이 변경된 체성분을 가진 피험자에 사용될 경우, 추정은 건강하거나 정상적으로 수분을 섭취한 인구에 대해 공식화된 예측 방정식을 기반으로 하기 때문에 제한될 수 있다 7,8.
BIVA(생체 전기 임피던스 벡터 분석)라고 하는 다른 접근 방식은 그래픽 RXc를 기반으로 하는 임피던스 벡터를 사용합니다. 높이에 대해 보정된 임피던스, 저항(R) 및 리액턴스(Xc) 데이터를 활용하여 세포 질량의 수화 상태 및 무결성에 대한 정보를 제공하는 벡터를 생성합니다. BIVA는 환자를 탈수, 과수, 정상, 운동선수, 마른 체형, 악액질, 비만과 같은 범주로 분류할 수 있어 RA 환자에게 유용한 도구입니다 8,9,10. 주축(타원의 왼쪽 또는 오른쪽 절반) 위 또는 아래에 위치한 벡터는 각각 연조직에서 더 높은 세포 질량과 더 낮은 세포 질량과 연관되어 있습니다. 장축에 평행한 벡터의 전방 및 후방 변위는 탈수 및 유체 과부하와 관련이 있습니다. 운동선수는 세포 질량이 더 높은 개인으로 정의되며 잠재적으로 탈수를 동반합니다. 마른 분류는 잠재적으로 탈수를 동반할 수 있는 낮은 세포 질량을 가진 사람들을 말하며, 비만 분류는 체액 과부하를 동반할 수 있는 높은 세포 질량을 가진 개인에게 적용됩니다. BIVA에 의한 악액질의 분류는 높은 저항과 낮은 리액턴스 값에 의해 결정되며, 이는 벡터가 그래프의 오른쪽으로 이동하는 것으로 표시되며, 이는 세포 질량의 감소를 나타내며, 잠재적으로 수화 상태11의 변화를 동반합니다(그림 1).
류마티스 관절염에 대한 기존의 약물 치료는 주로 통증, 염증 및 관절 손상 진행을 줄이는 데 초점을 맞추고 있으며, 체성분의 변화에는 제한적인 주의를 기울였다12. 이 인구에서 일반적으로 사용되는 비약물적 요법 중 운동 기반 중재는 기능, 피로, 통증, 관절 이동성, 유산소 능력, 근력, 지구력, 유연성 및 심리적 웰빙을 개선하는 데 긍정적인 결과를 보여주었습니다. 중요한 것은 이러한 중재가 증상을 악화시키거나 광범위한 기존 손상 없이 환자의 관절 손상을 유발하지 않으면서 이러한 이점을 달성하는 것으로 나타났다는 것입니다 13,14,15,16,17. 그러나 이 인구에서 운동 중재 후 수분 및 체세포 질량 상태의 변화를 구현하고 평가하는 것에 대한 지식은 제한적입니다. 이러한 환자는 종종 통증, 염증 및 관절 구조적 변화를 경험하여 참여할 수 있는 활동 유형을 제한하고 기존 접근 방식을 사용하여 체성분 평가를 더욱 복잡하게 만듭니다. 이 프로토콜은 류마티스 관절염 환자를 위한 동적 운동 프로그램을 구현한 후 생체 전기 임피던스 벡터 분석을 사용하여 수분 및 체세포 질량 상태의 변화를 평가하는 방법을 시연하는 것을 목표로 합니다. 또한 프로토콜은 심혈관 능력, 근력 및 조정 구성 요소뿐만 아니라 단계, 도구, 제한 사항 및 일반적인 고려 사항을 포함하여 동적 운동 프로그램에 대한 세부 정보를 제공합니다.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Alcohol 70% swabs</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>bicycle ergometer</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>BIVA&#160; tolerance software 2002</td>
			<td>NA</td>
			<td>NA</td>
			<td>Is a sofware created for academic use, can be download in http://www.renalgate.it/formule_calcolatori/bioimpedenza.htm in &#34;LE FORMULE DEL Prof. Piccoli&#34; section</td>
		</tr>
		<tr>
			<td>BIVA confidence software</td>
			<td>NA</td>
			<td>NA</td>
			<td>Is a sofware created for academic use, can be download in http://www.renalgate.it/formule_calcolatori/bioimpedenza.htm in &#34;LE FORMULE DEL Prof. Piccoli&#34; section</td>
		</tr>
		<tr>
			<td>Chair</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>Chlorhexidine</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used, 0.05%</td>
		</tr>
		<tr>
			<td>Examination table</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>Leadwires square socket</td>
			<td>BodyStat</td>
			<td>SQ-WIRES</td>
			<td></td>
		</tr>
		<tr>
			<td>Long Bodystat 0525 electrodes</td>
			<td>BodyStat</td>
			<td>BS-EL4000</td>
			<td></td>
		</tr>
		<tr>
			<td>Plastic ball</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used, 30 cm</td>
		</tr>
		<tr>
			<td>Pulse oximeter</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>Quadscan 4000&#160; equipment</td>
			<td>BodyStat</td>
			<td>BS-4000</td>
			<td>Impedance measuring range: 20 - 1300 &#937; ohms 
			Test Current: 620 &#956;A 
			Frequency: 5, 50, 100, 200 kHz 
			Accuracy: Impedance 5 kHz: +/- 2 &#937; 
			Impedance 50 kHz: +/- 2 &#937; 
			Impedance 100 kHz: +/- 3 &#937; 
			Impedance 200 kHz: +/- 3 &#937; 
			Resistance 50 kHz: +/- 2 &#937; 
			Reactance 50 kHz: +/- 1 &#937; 
			Phase Angle 50 kHz: +/- 0.2&#176; 
			Calibration: A resistor is supplied for independent verification from time to time. The impedance value should read between 496 and 503 &#937;.</td>
		</tr>
		<tr>
			<td>Resistence bands</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used, with resistence of 0.5 kg to 3.2 kg</td>
		</tr>
		<tr>
			<td>Stationary bicycle</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>Treadmill</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used</td>
		</tr>
		<tr>
			<td>Wooden stick</td>
			<td>NA</td>
			<td>NA</td>
			<td>Any brand can be used, 1.5m in large and &#60;1kg</td>
		</tr>
	</tbody>
</table>

evaluation of changes in hydration and body cell mass with bioelectrical impedance analysis after exercise program for rheumatoid arthritis patients

류마티스 관절염(RA)은 류마티스 악액질과 같은 합병증을 유발할 수 있는 쇠약해지는 질병입니다. 신체 운동은 류마티스 관절염 환자에게 도움이 되는 것으로 나타났지만, 수분 공급과 체세포 질량에 미치는 영향은 아직 불확실합니다. 통증, 염증 및 관절 변화의 존재는 종종 활동을 제한하고 수분 수준 변화로 인해 전통적인 체성분 평가를 신뢰할 수 없게 만듭니다. 생체전기임피던스는 체성분을 추정하기 위해 일반적으로 사용되는 방법이지만, 주로 일반인을 대상으로 개발되어 체성분의 변화를 고려하지 않기 때문에 한계가 있습니다. 반면에 생체 전기 임피던스 벡터 분석(BIVA)은 보다 포괄적인 접근 방식을 제공합니다. BIVA는 높이에 따라 조정된 저항(R)과 리액턴스(Xc)를 그래픽으로 해석하여 수화 상태와 세포 질량의 무결성에 대한 귀중한 정보를 제공합니다.
이 연구에는 류마티스 관절염을 앓고 있는 여성 12명이 포함되었다. 연구 초기에 BIVA 방법을 사용하여 수분 및 체세포 질량 측정을 수행했습니다. 그 후, 환자들은 심혈관 능력, 근력 및 협응력 훈련을 포함하는 6개월간의 역동적인 운동 프로그램에 참여했습니다. 수분 및 체세포 질량의 변화를 평가하기 위해 BIVA 신뢰도 소프트웨어를 사용하여 키에 맞게 조정된 R 및 Xc 매개변수의 차이를 비교했습니다. 그 결과 주목할 만한 변화가 나타났는데, 운동 프로그램 후 저항은 감소한 반면, 리액턴스는 증가했다. BIVA는 분류 방법으로 환자를 탈수, 과수, 정상, 운동선수, 마른 체형, 악액질 및 비만 범주로 효과적으로 분류할 수 있습니다. 따라서 체중이나 예측 방정식과 무관한 정보를 제공하기 때문에 RA 환자를 평가하는 데 유용한 도구입니다. 전반적으로, 이 연구에서 BIVA의 구현은 RA 환자의 수분 공급 및 체세포 질량에 대한 운동 프로그램의 효과를 밝혔습니다. 그 장점은 포괄적인 정보를 제공하고 전통적인 체성분 평가 방법의 한계를 극복할 수 있는 능력에 있습니다.

Rheumatoid arthritis (RA) is a disabling disease that affects patients&#39; functionality and independence due to acute joint pain, reduced muscle strength, and impaired physical function, all of which are associated with the inflammatory process inherent to the disease1,2. In advanced stages, persistent inflammation causes structural alterations leading to deformity, joint dysfunction, and rheumatoid cachexia, which is a poor prognostic factor for these patients3,4.
Rheumatoid cachexia is characterized by alterations in body composition, such as muscle loss with stable weight and increased fat mass, which can significantly impact the quality of life for these patients3,5,6. Various techniques are available to assess body composition, with the most widely used being bioelectrical impedance analysis (BIA). However, when conventional BIA analysis is used in subjects with altered body compositions, the estimations may be limited as they are based on prediction equations formulated for a healthy or normally hydrated population7,8.
A different approach, called bioelectrical impedance vector analysis (BIVA), utilizes the impedance vector based on graphical RXc. It utilizes impedance, resistance (R), and reactance (Xc) data corrected for height, resulting in a vector that provides information about the hydration state and integrity of the cell mass. BIVA is capable of classifying patients into categories such as dehydration, overhydration, normal, athlete, lean, cachectic, and obese, making it a valuable tool for RA patients8,9,10. Vectors located above or below the main axis (the left or right halves of the ellipses) have been associated with higher and lower cell mass&#160;in soft tissues, respectively. Forward and backward displacements of vectors parallel to the major axis are linked to dehydration and fluid overload. Athletes are defined as individuals with higher cell mass, potentially accompanied by dehydration. The lean classification refers to those with lower cell mass, potentially accompanied by dehydration, and the obese classification applies to individuals with higher cell mass, which may be accompanied by fluid overload. The classification of cachexia by BIVA is determined by high resistance and low reactance values, represented by the movement of the vector to the right of the graph, indicating a decrease in cell mass, potentially accompanied by an alteration in hydration status11 (Figure 1).
Conventional pharmacological treatments for RA primarily focus on reducing pain, inflammation, and joint damage progression, with limited attention given to alterations in body composition12. Among the non-pharmacological therapies commonly used in this population, exercise-based interventions have shown positive outcomes in improving functionality, fatigue, pain, joint mobility, aerobic capacity, muscle strength, endurance, flexibility, and psychological well-being. Importantly, these interventions have been shown to achieve these benefits without exacerbating symptoms or causing joint damage in patients without extensive pre-existing damage13,14,15,16,17. However, there is limited knowledge on implementing and evaluating changes in hydration and body cell mass status following exercise interventions in this population. These patients often experience pain, inflammation, and structural joint changes, limiting the types of activities they can engage in and further complicating body composition assessments using traditional approaches. This protocol aims to demonstrate how to evaluate changes in hydration and body cell mass status using bioelectrical impedance vectorial analysis after implementing a dynamic exercise program for patients with rheumatoid arthritis. Additionally, the protocol provides details of the dynamic exercise program, including cardiovascular capacity, strength, and coordination components, as well as the steps, instruments, limitations, and general considerations.

저자 스포트라이트: 체세포량이 적은 환자의 질병 위험 요인을 분석하기 위한 BIVA 구현 

류마티스 관절염 환자를 위한 운동 프로그램 후 생체 전기 임피던스 분석을 통한 수분 공급 및 체세포 질량 변화 평가

The research aims to demonstrate the utility of the vector impedance analysis for assessing change in hydration in body cell mass in patients with rheumatoid arthritis, and to investigate the benefits of physical exercise for this population. Recent research has shown that patients classified with low body cell mass, using bioelectrical impedance vector analysis, have an increased risk of infections and service predictors for cardiovascular diseases. This findings indicate that patients with lower cellular mass as determined by vectorial bioelectrical impedance analysis have a high risk of infections.Additionally, we have observed that physical exercise improves strength and quality of life and reduces inflammation in patient with rheumatoid arthritis. Assessing body composition through vectorial analysis of bioelectrical impedance will enable informed decision in pharmacological treatment. Additionally, integrating physical exercise as part of the treatment aims to prevent or improve a specific alteration associated with changes in body composition.It is crucial to evaluate the long-term effects of body composition alterations in patients with rheumatoid arthritis and demonstrate the effectiveness of physical exercise in increasing cellular mass, which is the most metabolically active human body compartment, which provides a greater functional reserve associated with better prognosis.

결과는 48 세션 동적 운동 프로그램에 참여한 6 명의 여성 RA 환자에 대한 것입니다. 환자의 평균 연령은 52.7세± 13.1세였고, BMI는 26.8± 4.6이었다. 평균 질병 지속 기간은 15.5± 6.1년이었으며, 질병 활동 점수 28로 측정한 질병 활성도는 평균 1.9± 1로 낮은 활성도로 분류되었다. 장애와 관련하여, 건강 평가 설문지 장애는 평균 0.5점± 0.3점을 산출했다. 운동 프로그램을 받지 않은 참가자 6명의 평균 연령...

Watch this Scientific Journal Video about Implementation of BIVA for Analyzing Disease Risk Factors in Patients with Low Body Cell Mass at JoVE.com

이 프로토콜은 류마티스 관절염 환자를 위해 고안된 동적 운동 프로그램에 따라 생체 전기 임피던스 벡터 분석을 사용하여 수분 및 체세포 질량 상태의 변화를 평가합니다. 역동적인 운동 프로그램 자체는 심혈관 능력, 근력 및 조정에 중점을 둔 구성 요소를 강조하여 상세합니다. 프로토콜은 단계, 기기 및 제한 사항을 자세히 설명합니다.

Rheumatoid arthritis (RA) is a debilitating disease that can result in complications such as rheumatoid cachexia. While physical exercise has shown ...

이 연구는 류마티스 관절염 환자의 체세포 질량 변화를 평가하기 위한 벡터 임피던스 분석의 유용성을 입증하고 이 인구에 대한 신체 운동의 이점을 조사하는 것을 목표로 합니다. 최근 연구에 따르면 생체 전기 임피던스 벡터 분석을 사용하여 체세포 질량이 낮은 환자로 분류된 환자는 감염 위험이 증가하고 심혈관 질환에 대한 예측 인자를 제공하는 것으로 나타났습니다. 이 결과는 벡터 생체 전기 임피던스 분석에 의해 결정된 낮은 세포 질량을 가진 환자가 감염 위험이 높다는 것을 나타냅니다.또한 신체 운동은 류마티스 관절염 환자의 근력과 삶의 질을 향상시키고 염증을 감소시키는 것을 관찰했습니다. 생체 전기 임피던스의 벡터 분석을 통해 체성분을 평가하면 약물 치료에서 정보에 입각한 결정을 내릴 수 있습니다. 또한 치료의 일부로 신체 운동을 통합하는 것은 신체 구성의 변화와 관련된 특정 변화를 예방하거나 개선하는 것을 목표로 합니다.류마티스 관절염 환자에서 체성분 변화의 장기적인 영향을 평가하고 더 나은 예후와 관련된 더 큰 기능 예비를 제공하는 가장 신진대사가 활발한 인체 구획인 세포 질량을 증가시키는 신체 운동의 효과를 입증하는 것이 중요합니다.

evaluation-changes-hydration-body-cell-mass-with-bioelectrical

Research

JoVE Journal

Medicine

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients

809 조회수.  National Autonomous University of Mexico. 이 연구는 류마티스 관절염 환자의 체세포 질량 변화를 평가하기 위한 벡터 임피던스 분석의 유용성을 입증하고 이 인구에 대한 신체 운동의 이점을 조사하는 것을 목표로 합니다. 최근 연구에 따르면 생체 전기 임피던스 벡터 분석을 사용하여 체세포 질량이 낮은 환자로 분류된 환자는 감염 위험이 증가하고 심혈관 질환에 대한 예측 인자를 제공하는 것으로 나타났습니다. ...

비디오: 저자 스포트라이트: 체세포량이 적은 환자의 질병 위험 요인을 분석하기 위한 BIVA 구현 

Rheumatoid arthritis (RA) is a debilitating disease that can result in complications such as rheumatoid cachexia. While physical exercise has shown benefits for RA patients, its impact on hydration and body cell mass remains uncertain. The presence of pain, inflammation, and joint changes often restrict activity and make traditional body composition assessments unreliable due to altered hydration levels. Bioelectrical impedance is a commonly used method for estimating body composition, but it has limitations since it was primarily developed for the general population and does not consider changes in body composition. On the other hand, bioelectrical impedance vectorial analysis (BIVA) offers a more comprehensive approach. BIVA involves graphically interpreting resistance (R) and reactance (Xc), adjusted for height, to provide valuable information about hydration status and the integrity of the cell mass.
Twelve women with RA were included in this study. At the beginning of the study, hydration and body cell mass measurements were obtained using the BIVA method. Subsequently, the patients participated in a six-month dynamic exercise program encompassing cardiovascular capacity, strength, and coordination training. To evaluate changes in hydration and body cell mass, the differences in the R and Xc parameters, adjusted for height, were compared using BIVA confidence software. The results showed notable changes: resistance decreased after the exercise program, while reactance increased. BIVA, as a classification method, can effectively categorize patients into dehydration, overhydration, normal, athlete, thin, cachectic, and obese categories. This makes it a valuable tool for assessing RA patients, as it provides information independent of body weight or prediction equations. Overall, the implementation of BIVA in this study shed light on the effects of the exercise program on hydration and body cell mass in RA patients. Its advantages lie in its ability to provide comprehensive information and overcome the limitations of traditional body composition assessment methods.

This protocol assesses alterations in hydration and body cell mass status using bioelectrical impedance vectorial analysis following a dynamic exercise program designed for patients with rheumatoid arthritis. The dynamic exercise program itself is detailed, highlighting its components focused on cardiovascular capacity, strength, and coordination. The protocol details steps, instruments, and limitations.

연구

의학

Pre-Test and Bioelectrical Impedance Analysis Measurement for Participant Classification in Cachexia Study

To begin, ask the patient to remove both shoes, the right sock, and any metal objects that are in contact with their skin position. The patient's supine for five minutes with extended arms and legs. Clean the back of the hand and the right foot with 70%alcohol.To classify cachexia by BIVA, download the BIVA tolerance Rxc Graph software, and open it. Go to the second worksheet titled Reference Populations and choose a row that corresponds to the reference population. Then copy and paste it into the second row highlighted in yellow.Next, go to the fifth worksheet titled Subjects:and in column A, enter the patient's ID;And in column B, enter the number one. In column E, using M for men and F for women, enter the patient's sex. In columns F and G, input the previously noted resistance and reactance values at 50 kilohertz.Then enter height in centimeters and weight in kilograms in the next two columns. In column J, enter the number corresponding to the reference population chosen in the second worksheet. Following this, in column K, input a number between one and 10 for the point graph sheet.Enter the patient's age in the next column. From the options bar at the top of the software, click on the compliments, then select the calculate option and click it. Next, navigate to sheet three Point graph to observe a BIVA graph according to the chosen reference population.Upon seeing a dialogue box, select the group code entered in column K, then click OK.A BIVA graph is displayed with the patient's vector drawn as a geometric figure. Next, observe the tolerance ellipses of 50, 75, and 95%in the quadrants I, II, III, and IV in the BIVA graph.

악액질 연구에서 참가자 분류를 위한 사전 테스트 및 생체 전기 임피던스 분석 측정

Dynamic Exercise Program for Evaluation of Joint Health in Rheumatoid Arthritis Patients

Before beginning the exercise session, ask the patients to describe any pain or discomfort felt in their joints. Next, for the upper extremity warmup, instruct the patient to reach a range of motion with no discomfort for each joint movement. For the lower extremity, guide the patient to perform warmup exercises in a standing position with both feet grounded on a stable surface.Then instruct the patient to reach a non-painful movement. Speed through the range of motion for each joint while sitting on the chair in the setup phase. Instruct the patient to perform functional movement patterns with more than two joints per segment.Initiate the work phase by setting a comfortable walking speed for the patient on the treadmill. After five minutes, adjust the speed while concurrently measuring the heart rate. With a pulse oximeter, increase the speed until reaching a heart rate zone between 55 and 75%of the maximum heart rate.After 10 minutes, assess the patient using a perceived effort rating scale for the final five minutes. Lower the treadmill speed to a comfortable pace for the patient. Next, perform upper extremity mobility resistance exercises while handling a wooden stick with both hands.After teaching the patient combined exercises encompassing the range of motion for more than two joints. Instruct the patient to place one end of the resistance band on the floor and step on it with their foot. Then perform elbow flexion against the band's resistance.For lower extremity exercises, have the patient sit in a stable chair with 90 degree hip and knee flexion. Then perform hip flexions for each leg up to 20 to 30 degrees above the starting position. Then ask the patient to perform a slight hip flection above 10 degrees from the base position, followed by a hip abduction.Lastly, lead the patient to return at a slow tempo to the base position. Next, make a soccer goal by placing two chairs approximately 1.3 meters apart. Direct the patient to kick a 30 centimeter plastic at a three meter spot in front of the soccer goal.Finally, gently perform a global stretch for cooling without putting stress on the joints. Participants who did not undertake the exercise program had a similar disease activity, but a slightly higher average age and BMI. No changes were made to any patient's pharmacological treatment during the intervention period.Before the exercise, all patients were classified as cachexia and had an average resistance of 630 and a reactance of 46. After exercise, the patients were reclassified as normal with an average resistance of 577 and reactants of 57. The patients who did not participate in the exercise program showed a shift in BIVA classification toward cachexia.Over six months, implementing the dynamic exercise program resulted in a decrease in resistance per height and an increase in reactance per height. No statistically significant changes were observed in the group that did not undergo the exercise program.