Annals of Rehabilitation Medicine

"Electric impedance"

Original Articles

Cardiopulmonary rehabilitation

Phase Angle Is Associated With Handgrip Strength in Older Patients With Heart Failure: Wataru Kawakami, Takuya Umehara, Yoshitaka Iwamoto, Makoto Takahashi, Nobuhisa Katayama; Ann Rehabil Med 2023;47(2):129-137. Published online March 21, 2023; DOI: https://doi.org/10.5535/arm.22138

Abstract
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Objective
To assess the relationships between phase angle and muscle mass, strength, and physical function in patients with heart failure.
Methods
This study used a cross-sectional design. The analysis included 51 patients with heart failure. The Short Physical Performance Battery, one-leg standing time, handgrip strength, phase angle, and skeletal muscle index were measured. To identify explanatory variables of phase angle, hierarchical multiple regression analysis was performed.
Results
Handgrip strength was found to be an explanatory variable of phase angle independent of age, sex, and body mass index. This model was able to explain 30.4% of the model variance for phase angle.
Conclusion
In patients with heart failure, improving muscle strength rather than muscle mass or physical function might be more important for improving phase angle. Handgrip strength is an important outcome for improving prognosis in patients with heart failure.

Citations

Citations to this article as recorded by

Phase Angle and Impedance Ratio as Indicators of Physical Function and Fear of Falling in Older Adult Women: Cross-Sectional Analysis
Danielle A Sterner, Jeffrey R Stout, Kworweinski Lafontant, Joon-Hyuk Park, David H Fukuda, Ladda Thiamwong
JMIR Aging.2024; 7: e53975. CrossRef
Prevalence and clinical characteristics of Sarcopenia in older adult patients with stable chronic obstructive pulmonary disease: a cross-sectional and follow-up study
Sang Hun Kim, Cho Hui Hong, Myung-Jun Shin, Ki Uk Kim, Tae Sung Park, Jun Yong Park, Yong Beom Shin
BMC Pulmonary Medicine.2024;[Epub] CrossRef
Malnutrition in Amyotrophic Lateral Sclerosis: Insights from Morphofunctional Assessment and Global Leadership Initiative on Malnutrition Criteria
María Teresa Zarco-Martín, Carmen Freire, María Carmen Andreo-López, Socorro Leyva-Martínez, María Luisa Fernández-Soto
Nutrients.2024; 16(16): 2625. CrossRef

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Effects of Extracorporeal Shockwave Therapy on Improvements in Lymphedema, Quality of Life, and Fibrous Tissue in Breast Cancer-Related Lymphedema: Kyeong Woo Lee, Sang Beom Kim, Jong Hwa Lee, Young Sam Kim; Ann Rehabil Med 2020;44(5):386-392. Published online September 28, 2020; DOI: https://doi.org/10.5535/arm.19213

Abstract
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Objective
To evaluate the effects of extracorporeal shockwave therapy (ESWT) on improving lymphedema, quality of life, and fibrous tissue in patients with stage 2 lymphedema.
Methods
Breast cancer-related lymphedema patients referred to the rehabilitation center were recruited. We enrolled stage 2 lymphedema patients who had firmness of the skin at their forearm, a circumference difference of more than 2 cm between each arm, or a volume difference between upper extremities greater than 200 mL, confirmed by lymphoscintigraphy. The patients were randomly divided into the ESWT group and the control group. ESWT was performed for 3 weeks (two sessions per week); both groups received complex decongestive physical therapy. All patients were evaluated at baseline and at 3 weeks after treatment. The measurements performed included visual analog scale score, volume, circumference, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) score, bioelectrical impedance, and skin thickness.
Results
The patients in both groups (n=15 in each group) completed the 3-week therapy experiment. No significant differences were observed in demographic characteristics between groups. After the 3-week treatment period, improvement was noted in the circumference difference below the elbow, volume, ratio of extracellular water to total body water, and skin thickness in the ESWT group. A significant difference was found in all the above-mentioned areas except in circumference below the elbow in the ESWT group.
Conclusion
ESWT reduced edema and skin fibrosis without significant complications. Therefore, ESWT can be used together with complex decongestive physical therapy for treating lymphedema.

Citations

Citations to this article as recorded by

Advancements in Treatment and Surgery for Breast Cancer Related Lymphedema
Alicia Huff Arnold, Christina H. Bae, Shawn M. Doss, Mohamed Nofal, Shaan Haider, Isha Darshane, Cameron Jackson, Sweta Munagapati, Christopher Painter, Kyra Urquhart-Foster, Katharine Tracy, Alexandra Metzger, Lauren A. Herrera, Hari Kashyap
Current Breast Cancer Reports.2025;[Epub] CrossRef
Role of Electro-Therapeutic Modalities in Breast Cancer-Related Lymphedema and Shoulder Dysfunction: A Systematic Review and Meta-Analysis
Renu Pattanshetty, Asmita Shrestha, Nikita Pawar
Indian Journal of Palliative Care.2025; 0: 1. CrossRef
Surgical Treatment, Rehabilitative Approaches and Functioning Assessment for Patients Affected by Breast Cancer-Related Lymphedema: A Comprehensive Review
Paola Ciamarra, Alessandro de Sire, Dicle Aksoyler, Giovanni Paolino, Carmen Cantisani, Francesco Sabbatino, Luigi Schiavo, Renato Cuocolo, Carlo Pietro Campobasso, Luigi Losco
Medicina.2025; 61(8): 1327. CrossRef
Fotobiomodulação Associada ou Não a Outras Técnicas Terapêuticas no Tratamento do Linfedema Pós-Câncer de Mama: Revisão Sistemática da Literatura
Larissa Silva dos Reis, Tarcísio Souza da Silva, Priscila Godoy Januário
Revista Brasileira de Cancerologia.2025; 71(3): e. CrossRef
Which Physical Therapy Intervention Is Most Effective in Reducing Secondary Lymphedema Associated with Breast Cancer? A Systematic Review and Network Meta-Analysis
Raúl Alberto Aguilera-Eguía, Pamela Serón, Ruvistay Gutiérrez-Arias, Brenda Herrera-Serna, Víctor Pérez-Galdavini, Gloria Inostroza-Reyes, Cristian Yáñez-Baeza, Héctor Fuentes-Barría, Hellen Belmar Arriagada, Jaqueline Inostroza-Quiroz, Mariana Melo-Lonco
Journal of Clinical Medicine.2025; 14(19): 6762. CrossRef
Comparison of Extracorporeal Shock Wave Therapy and Complex Regional Decongestive Treatment in the Treatment of Postmastectomy Lymphedema: A Randomized Controlled Trial
Zeynep ALKAN, Hülya UZKESER
Journal of Oncological Sciences.2025;[Epub] CrossRef
Conservative medical intervention as a complement to CDT for BCRL therapy: a systematic review and meta-analysis of randomized controlled trials
Chuyu Deng, Zhiguo Wu, Zijie Cai, Xiaoyan Zheng, Chunzhi Tang
Frontiers in Oncology.2024;[Epub] CrossRef
Shock wave therapy in oncology: in vitro, in vivo, rehabilitation
T.I. Grushina, I.I. Orlov
Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(3): 58. CrossRef
Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review
Alessandro de Sire, Luigi Losco, Lorenzo Lippi, Davide Spadoni, Juste Kaciulyte, Gokhan Sert, Paola Ciamarra, Marco Marcasciano, Roberto Cuomo, Alberto Bolletta, Marco Invernizzi, Emanuele Cigna
Medicina.2022; 58(7): 954. CrossRef
The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial
Mahboobeh Hemmati, Zahra Rojhani-Shirazi, Zeinab Sadat Zakeri, Majid Akrami, Nasrin Salehi Dehno
BMC Musculoskeletal Disorders.2022;[Epub] CrossRef
Long-Term Effects of Extracorporeal Shock Wave Therapy on Breast Cancer-Related Lymphedema
Jong-Hwa Lee, Sang-Beom Kim, Kyeong-Woo Lee, Won-Wook Ha
Journal of Clinical Medicine.2022; 11(22): 6747. CrossRef
Pilot study of oncological safety of extracorporeal shock wave therapy for post-mastectomy lymphedema in patients with breast cancer
T.I. Grushina, I.I. Orlov
Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(6): 30. CrossRef
Effect of extracorporeal shock wave therapy on keratinocytes derived from human hypertrophic scars
Hui Song Cui, So Young Joo, Yoon Soo Cho, Ji Heon Park, Yu Mi Ro, June-Bum Kim, Cheong Hoon Seo
Scientific Reports.2021;[Epub] CrossRef
A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea
Sangah Jeong, Byung Joo Song, Jiyoung Rhu, Cheolki Kim, Sun Im, Geun-Young Park
Annals of Rehabilitation Medicine.2021; 45(5): 401. CrossRef
Extracorporeal Shock Wave Therapy Combined with Complex Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Systemic Review and Meta-Analysis
Yu Lin Tsai, Ting Jie I, Ya Chi Chuang, Yuan Yang Cheng, Yu Chun Lee
Journal of Clinical Medicine.2021; 10(24): 5970. CrossRef

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Bioimpedance Analysis for Predicting Outcomes of Complex Decongestive Therapy for Gynecological Cancer Related Lymphedema: A Feasibility Study: Su Hwan Bae, Won Jun Kim, Yu Jin Seo, JaYoung Kim, Jae Yong Jeon; Ann Rehabil Med 2020;44(3):238-245. Published online June 30, 2020; DOI: https://doi.org/10.5535/arm.19102

Abstract
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Objective
To determine whether the bioimpedance analysis (BIA) ratios of upper to lower extremities could predict treatment outcomes after complex decongestive therapy (CDT) for gynecological cancer related lymphedema (GCRL).
Methods
A retrospective study, from March 2015 to December 2018, was conducted. The study sample comprised patients receiving CDT, 30 minutes per day, for 10 days. Bioimpedance was measured pre- and post-CDT. Circumference measurements were obtained at 20 and 10 cm above the knee (AK) and 10 cm below the knee (BK). We calculated the expected impedance at 0 Hz (R0) of extremities and upper/lower extremity R0 ratios (R0_U/L). We evaluated the relationship between R0_U/L and changes in R0_U/L and circumferences, pre- and post-CDT.
Results
Overall, 59 patients were included in this study. Thirty-one lower extremities in 26 patients comprised the acute group, and 38 lower extremities in 33 patients comprised the chronic group. Pre-treatment R0_U/L was significantly correlated with R0_U/L change after adjusting for age and BMI (acute: R=0.513, p<0.01; chronic: R=0.423, p<0.01). In the acute group, pre-treatment R0_U/L showed a tendency to be correlated with circumference change (AK 20 cm: R=0.427, p=0.02; AK 10 cm: R=0.399, p=0.03).
Conclusion
Our study results suggested that pre-treatment BIA could predict volume reductions after CDT in the early stages of GCRL. These findings implied that BIA value could be one possible parameter to apply in treatment outcomes prediction, during the early stage of GCRL. Therefore, further large-scale prospective studies will be beneficial.

Citations

Citations to this article as recorded by

Efficacy of complex decongestive therapy on venous flow, internal saphenous diameter, edema, fat mass of the limbs and quality of life in patients with chronic venous insufficiency: A randomized clinical trial
Ana Martín Jiménez, Beatriz María Bermejo Gil, Alejandro Santos-Lozano, Francisco Jose Pinto- Fraga, Carolina García Barroso, Leonardo Raul Vittori, Aurymar Fraino, Héctor Menéndez Alegre
Journal of Vascular Surgery: Venous and Lymphatic Disorders.2025; 13(2): 102005. CrossRef
Comparing the direct effect of lymphatic dynamic transport after lower-level laser therapy in healthy volunteers: a randomized controlled trial
Hasuk Bae, Jae Yong Jeon, Su Hong Choi, Min-Hyung Rhee, Ye Ji Kim, In Joo Kong, Ju-Ri Eom, Jin A Yoon
Lasers in Medical Science.2025;[Epub] CrossRef
Decompression of Axillary Vein: An Essential Adjunct for Advanced Lymphedema
Hyung Hwa Jeong, In Ah Yoon, Feras M. Al-Shomer, HyunSuk Peter Suh, ChangSik John Pak, Peter Neligan, Joon Pio Hong
Plastic & Reconstructive Surgery.2024; 154(1): 218. CrossRef
Factors Predicting the Effect of a Complex Decongestive Therapy in Patients with Mild Lymphedema Following Mastectomy for Early Stage Breast Cancer
Ju Hyeon Kim, Han Eum Choi, Jae Hyun Lee, Young-Joo Sim, Ho Joong Jeong, Ghi Chan Kim
Lymphatic Research and Biology.2024; 22(5): 241. CrossRef
Lymphedema Index Ratio As Predictive Factor of Treatment in Patients with Breast Cancer-Related Lymphedema
Han Eum Choi, Yeong Kyun Bae, Jae Hyun Lee, Ghi Chan Kim, Ho Joong Jeong, Young Joo Sim
Lymphatic Research and Biology.2022; 20(3): 302. CrossRef
Recent Trends in Rehabilitation for Cancer Patients
Kwan-Sik Seo
Annals of Rehabilitation Medicine.2022; 46(3): 111. CrossRef
Update August 2020
Francine Blei
Lymphatic Research and Biology.2020; 18(4): 381. CrossRef

7,253 View
114 Download
6 Web of Science
7 Crossref

Comparison of Fat Mass Percentage and Body Mass Index in Koreans With Spinal Cord Injury According to the Severity and Duration of Motor Paralysis: Sang Hoon Han, Bum-Suk Lee, Hyun Soo Choi, Min-Soo Kang, Bo Ra Kim, Zee-A Han, Hye Jin Lee; Ann Rehabil Med 2015;39(3):384-392. Published online June 30, 2015; DOI: https://doi.org/10.5535/arm.2015.39.3.384

Abstract
PDF

Objective

To analyze the relationship of the change in fat mass percentage (FMP) and body mass index (BMI) with the change in obesity rate according to gender, extent of spinal cord injury (SCI) and the duration.

Methods

The retrospective study was conducted with medical records of 915 patients. FMP was calculated with BMI and bioelectrical impedance analysis (BIA). Statistical analysis of the relationship between FMP and gender, extent of SCI and the duration after SCI was done.

Results

FMP increased in relation to the duration. The mean FMP was higher in the motor complete tetraplegia group, as compared to the motor incomplete group. The rate of obesity was 69.8% with cutoff FMP values of over 22% and 35% for male and female patients, respectively. Rate of obesity was correlated with the duration after SCI and degree of paralysis. The rate of obesity was 17.1% with a cutoff value of BMI 25 kg/m² and 51.3% with a cutoff value of 22 kg/m². For evaluation of the diagnostic value of BMI to predict obesity according to FMP standards, a cutoff value of 25 kg/m² showed a sensitivity level of 22.3% and specificity level of 94.9%. When the cutoff level for BMI was set at 22 kg/m², the sensitivity and specificity were 59.3% and 67.0%, respectively.

Conclusion

In Korean SCI patients, FMP showed good correlation with the duration of SCI and the extent of SCI, while BMI did not. Especially in the motor complete tetraplegia group, the diagnostic value of BMI decreased as the duration after SCI increased. This study suggested that FMP could be used complementarily when evaluating the obesity of SCI patients.

Citations

Citations to this article as recorded by

Association Between Sarcopenic Obesity and Activities of Daily Living in Individuals with Spinal Cord Injury
Ryu Ishimoto, Hirotaka Mutsuzaki, Yukiyo Shimizu, Ryoko Takeuchi, Shuji Matsumoto, Yasushi Hada
Journal of Clinical Medicine.2024; 13(23): 7071. CrossRef
Prevalence of Sarcopenic Obesity and Factors Influencing Body Composition in Persons with Spinal Cord Injury in Japan
Ryu Ishimoto, Hirotaka Mutsuzaki, Yukiyo Shimizu, Hiroshi Kishimoto, Ryoko Takeuchi, Yasushi Hada
Nutrients.2023; 15(2): 473. CrossRef
Body Composition and Metabolic Assessment After Motor Complete Spinal Cord Injury: Development of a Clinically Relevant Equation to Estimate Body Fat
David R. Gater, Gary J. Farkas, David R. Dolbow, Arthur Berg, Ashraf S. Gorgey
Topics in Spinal Cord Injury Rehabilitation.2021; 27(1): 11. CrossRef
Pathophysiology of Neurogenic Obesity After Spinal Cord Injury
David R. Gater, Gary J. Farkas, Eduard Tiozzo
Topics in Spinal Cord Injury Rehabilitation.2021; 27(1): 1. CrossRef
Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis
Peter Francis Raguindin, Alessandro Bertolo, Ramona Maria Zeh, Gion Fränkl, Oche Adam Itodo, Simona Capossela, Lia Bally, Beatrice Minder, Mirjam Brach, Inge Eriks-Hoogland, Jivko Stoyanov, Taulant Muka, Marija Glisic
Journal of Clinical Medicine.2021; 10(17): 3911. CrossRef
Classification of obesity, cardiometabolic risk, and metabolic syndrome in adults with spinal cord injury
Amy M. Yahiro, Brooks C. Wingo, Sujit Kunwor, Jason Parton, Amy C. Ellis
The Journal of Spinal Cord Medicine.2020; 43(4): 485. CrossRef
Are Body Composition, Strength, and Functional Independence Similarities Between Spinal Cord Injury Classifications? A Discriminant Analysis
Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro, Frederico Ribeiro Neto
Journal of Sport Rehabilitation.2020; 29(3): 277. CrossRef
Body Composition in Swiss Elite Wheelchair Athletes
Joelle Leonie Flueck
Frontiers in Nutrition.2020;[Epub] CrossRef
Neurogenic obesity and systemic inflammation following spinal cord injury: A review
Gary J. Farkas, David R. Gater
The Journal of Spinal Cord Medicine.2018; 41(4): 378. CrossRef