KAATSU Cuff Tightness and Limb Anthropometry: Effect on Blood Flow Restriction

abstractKAATSU resistance training involves low loads (20%1RM) and partial blood flow restriction (BFR). When applying a BFR cuff, the initial cuff tightness (ICT) is important. ICTs can potentially impact the degree of BFR (%BFR) caused by the subsequent inflation to the target training pressures. It’s known that limb anthropometrics can affect the amount of BFR that is produced at specific pressures. Understanding the interaction between limb anthropometrics and ICT is an important first step in standardizing BFR dose between individuals for KAATSU training prescription. Purpose: To determine what limb anthropometrics (circumference, muscle or fat composition) have the greatest effect on %BFR with various ICTs. Methods: Forty-two volunteers (26 men, 16 women) provided informed consent. Caliper skin folds (anterior and posterior), Gulick tape circumferences, and peripheral quantitative computed tomography (pQCT) scans were performed on the randomly assigned ipsilateral arm and leg at the level of the KAATSU cuff. %BFR was measured via pulse-wave Doppler ultrasound at baseline (no cuff) and at 5 ICT pressures (20, 30, 40, 50 and 60mmHg). Variable relationships were assessed using Pearson correlations and stepwise linear regression. Results: The dependent variable for regression analysis was %BFR at each ICT. pQCT-determined muscle (R2= .147, .614, .445, .360, & .232, respectively) and fat composition (R2= .138, .587, .429, .338, & .220, respectively) were significant (p<.05) determinants of BFR at all ICT pressures in the arm. At 30mmHg, circumference was also a determinant (R2=.163). There were no significant correlations between %BFR and any of the ICT pressures for the leg. pQCT fat composition and sum of skin folds correlated significantly (r=.915, p<.05). pQCT circumference and Gulick circumference measures correlated significantly (r=.991, p<.05). Conclusion: Arm anthropometrics impact the %BFR created by 5 ICTs in the arm. Skin fold measures and circumference measures were highly correlated with pQCT data. As a result, skin fold and Gulick circumference measures can be used to predict arm composition at the level of the cuff and may inform prescription of appropriate ICTs that result in more consistent initial %BFR across individuals

Initial KAATSU Cuff Tightness: Effect of Limb Anthropometrics on Blood Flow Restriction

abstractINTRODUCTION KAATSU training involves low load (20%1RM) resistance exercise combined with partial blood flow restriction (BFR). BFR is achieved by positioning a specially designed pneumatic cuff around the proximal aspect of the limb, cinching it to an initial cuff tightness (ICT), then inflating the cuff to a higher restrictive training pressure. ICTs can potentially impact the degree of BFR (%BFR) caused at the higher training pressures, yet many studies use the same ICTs for all subjects (1). Identifying that discrepancies in %BFR exist between subjects with different limb anthropometrics is an important step in moving toward standardization of BFR dose for KAATSU training prescription. The purpose of this study was to identify variation in %BFR between subjects experiencing the same ICT and what limb anthropometrics (circumference, muscle, and fat composition) may be determinants. METHODS Forty-two volunteers (26 men, 16 women) provided informed consent. Caliper skin folds, Gulick tape circumferences, and peripheral quantitative computed tomography (pQCT) scans were performed on the randomly assigned ipsilateral arm and leg at the level of the KAATSU cuff application. %BFR was measured via pulse-wave Doppler ultrasound at baseline (no cuff) and at an ICT of 30 mmHg. Variable relationships were assessed using Pearson correlations and stepwise linear regression. RESULTS The average %BFR (avg±st. dev.) for the arm and leg was 16.01±11.42% and 16.75±9.27% with a range of 46.66% and 36.41%, respectively. The dependent variable for regression analysis was %BFR. In the arm, pQCT-determined muscle (R2=0.614) and fat composition (R2=0.587) were significant (p<0.05) determinants of %BFR. Circumference was also a determinant (R2=0.163). There were no significant correlations between %BFR and the anthropometrics for the leg. pQCT fat composition and sum of skin folds correlated significantly (r=0.915, p<0.05). pQCT circumference and Gulick circumference measures correlated significantly (r=0.991, p<0.05). DISCUSSION Conflicting BFR training results have been reported in the literature. A potential cause could be universal ICT usage causing some individuals to receive an inadequate training stimulus. Individuals using a 30 mmHg ICT will experience different %BFR when limb anthropometrics vary. Thus a method of assigning ICTs specific to individuals’ anthropometric characteristics is needed to ensure equally potent stimuli. Skin fold measures and circumference measures were highly correlated with pQCT data. As a result, skin fold and Gulick circumference measures can be used to predict arm composition at the level of the cuff and may inform prescription of appropriate ICTs that result in more consistent initial %BFR across individuals

Leg-length inequality is not associated with greater trochanteric pain syndrome

INTRODUCTION. Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although leg-length inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested. METHODS. A cross-sectional analysis of greater trochanteric tenderness to palpation was performed in subjects with complaints of hip pain and no signs of hip osteoarthritis or generalized myofascial tenderness. Subjects were recruited from one clinical center of the Multicenter Osteoarthritis Study, a multicenter population-based study of community-dwelling adults aged 50 to 79 years. Diagnosis of GTPS was based on a standardized physical examination performed by trained examiners, and technicians measured leg length on full-limb anteroposterior radiographs. RESULTS. A total of 1,482 subjects were eligible for analysis of GTPS and leg length. Subjects' mean ± standard deviation age was 62.4 ± 8.2 years, and 59.8% were female. A total of 372 lower limbs from 271 subjects met the definition for having GTPS. Leg-length inequality (difference ≥ 1 cm) was present in 37 subjects with GTPS and in 163 subjects without GTPS (P = 0.86). Using a variety of definitions of leg-length inequality, including categorical and continuous measures, there was no association of this parameter with the occurrence of GTPS (for example, for ≥ 1 cm leg-length inequality, odds ratio = 1.17 (95% confidence interval = 0.79 to 1.73)). In adjusted analyses, female sex was significantly associated with the presence of GTPS, with an adjusted odds ratio of 3.04 (95% confidence interval = 2.07 to 4.47). CONCLUSION. The present study found no evidence to support an association between leg-length inequality and greater trochanteric pain syndrome.National Institutes of Health and National Institute of Child Health and Human Development (5K12HD001097-08); National Insititues of Health and National Institue on Aging (1 U01 AG18832; 1 U01 AG18820; 1 U01 AG19069, 1 U01 AG18947

Mechanisms underlying the exquisite sensitivity of Candida albicans to combinatorial cationic and oxidative stress that enhances the potent fungicidal activity of phagocytes

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The effects of Pilates training on flexibility and body composition: an observational study”. Arch Phys Med Rehabil,

ABSTRACT. Segal NA, Hein J, Basford JR. The effects of Pilates training on flexibility and body composition: an observational study. Arch Phys Med Rehabil 2004;85:1977-81. Objective: To assess claims regarding the effects of Pilates training on flexibility, body composition, and health status. Design: An observational prospective study. Setting: A community athletic club. Participants: A sample of 47 adults (45 women, 2 men) who presented for Pilates training. Interventions: Not applicable. Main Outcome Measures: Fingertip-to-floor distance, truncal lean body mass by bioelectric impedance, health status by questionnaire and visual analog scale were assessed at baseline, 2, 4, and 6 months (Ϯ1wk). Results: Thirty-two of 47 enrolled subjects met the protocol requirements of missing no more than 1 weekly 1-hour session Pilates mat class during each 2-month period. Investigators were blinded to measurements from previous time points. Median (interquartile range [IQR]) fingertip-to-floor distance improved from baseline by 3.4cm (1.3-5.7cm), 3.3cm (0.3-7.8cm), and 4.3cm (1.5-7.6cm) at 2, 4, and 6 months, respectively (paired nonparametric analysis, all PϽ.01). There were no statistically significant changes in truncal lean body mass, height, weight, or other body composition parameters. Selfassessment of health also did not change in a statistically significant manner from its baseline median (IQR) value of 77mm (69 -85mm). Conclusions: Pilates training may result in improved flexibility. However, its effects on body composition, health status, and posture are more limited and may be difficult to establish. Further study might involve larger sample sizes, comparison with an appropriate control group, and assessment of motor unit recruitment as well as strength of truncal stabilizers

Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT.

Background Imaging of structural disease in osteoarthritis has traditionally relied on MRI and radiography. Joint space mapping (JSM) can be used to quantitatively map joint space width (JSW) in three dimensions from CT images. Purpose To demonstrate the reproducibility, repeatability, and feasibility of JSM of the knee using weight-bearing CT images. Materials and Methods Two convenience samples of weight-bearing CT images of left and right knees with radiographic Kellgren-Lawrence grades (KLGs) less than or equal to 2 were acquired from 2014 to 2018 and were analyzed retrospectively with JSM to deliver three-dimensional JSW maps. For reproducibility, images of three sets of knees were used for novice training, and then the JSM output was compared against an expert's assessment. JSM was also performed on 2-week follow-up images in the second cohort, yielding three-dimensional JSW difference maps for repeatability. Statistical parametric mapping was performed on all knee imaging data (KLG, 0-4) to show the feasibility of a surface-based analysis in three dimensions. Results Reproducibility (in 20 individuals; mean age, 58 years ± 7 [standard deviation]; mean body mass index, 28 kg/m2 ± 6; 14 women) and repeatability (in nine individuals; mean age, 53 years ± 6; mean body mass index, 26 kg/m2 ± 4; seven women) reached their lowest performance at a smallest detectable difference less than ±0.1 mm in the central medial tibiofemoral joint space for individuals without radiographically demonstrated disease. The average root mean square coefficient of variation was less than 5% across all groups. Statistical parametric mapping (33 individuals; mean age, 57 years ± 7; mean body mass index, 27 kg/m2 ± 6; 23 women) showed that the central-to-posterior medial joint space was significantly narrower by 0.5 mm for each incremental increase in the KLG (threshold P < .05). One knee (KLG, 2) demonstrated a baseline versus 24-month change in its three-dimensional JSW distribution that was beyond the smallest detectable difference across the lateral joint space. Conclusion Joint space mapping of the knee using weight-bearing CT images is feasible, demonstrating a relationship between the three-dimensional joint space width distribution and structural joint disease. It is reliably learned by novice users, can be personalized for disease phenotypes, and can be used to achieve a smallest detectable difference that is at least 50% smaller than that reported to be achieved at the highest performance level in radiography. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Roemer in this issue

Gene Essentiality Analyzed by In Vivo Transposon Mutagenesis and Machine Learning in a Stable Haploid Isolate of Candida albicans

This work was supported by European Research Council Advanced Award 340087 (RAPLODAPT) to J.B., the Dahlem Centre of Plant Sciences (DCPS) of the Freie Universität Berlin (R.K.), Israel Science Foundation grant no. 715/18 (R.S.), the Wellcome Trust (grants 086827, 075470, 101873, and 200208) and the MRC Centre for Medical Mycology (N006364/1) (N.A.R.G.). Data availability.All of the code and required dependencies for analysis of the TnSeq data are available at https://github.com/berman-lab/transposon-pipeline. Library insertion sequences are available at NCBI under project PRJNA490565 (https://www.ncbi.nlm.nih.gov/bioproject/PRJNA490565). Datasets S1 through S9 are available at https://doi.org/10.6084/m9.figshare.c.4251182.Peer reviewedPublisher PD

Recognition and blocking of innate immunity cells by Candida albicans chitin

Peer reviewedPublisher PD

Efficacy and safety results from IMblaze370, a randomised Phase III study comparing atezolizumab+cobimetinib and atezolizumab monotherapy vs regorafenib in chemotherapy-refractory metastatic colorectal cancer

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Effect of Quadriceps Strength and Proprioception on Risk for Knee Osteoarthritis

. Purpose: Impaired quadriceps strength and joint position sense (JPS) have been linked with knee osteoarthritis (OA) crosssectionally. Although neither has been independently associated with incident radiographic OA, their combination may mediate risk. The purpose of this study was to determine whether better sensorimotor function protects against the development of incident radiographic or symptomatic knee OA. Methods: The Multicenter Osteoarthritis study is a longitudinal study of adults aged 50-79 yr at high risk for knee OA. Participants underwent bilateral, weight-bearing, fixed-flexion radiographs, JPS acuity tests, and isokinetic quadriceps strength tests. The relationships between combinations of the tertiles of sex-specific baseline peak strength and mean JPS and development of incident radiographic (Kellgren-Lawrence (KL) grade Q2) or symptomatic knee OA (KL grade Q2 and frequent knee pain or stiffness) at a 30-month follow-up were evaluated. Secondary analyses defined JPS as the variance during the 10 JPS trials and also assessed the interaction of strength and JPS in predicting each outcome. Results: The study of incident radiographic knee OA included 1390 participants (age = 61.2 T 7.9 yr and body mass index = 29.4 T 5.1 kgIm j2 ), and the study of incident symptomatic knee OA included 1829 participants (age = 62.2 T 8.0 yr and body mass index = 30.0 T 5.4 kgIm j2 ). Greater strength at baseline protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile. There was no significant relationship between the strength-JPS interaction and the development of radiographic or symptomatic knee OA. Conclusions: The finding that quadriceps strength protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile suggests that strength may be more important than JPS in mediating risk for knee OA