The application of bioelectrical impedance analysis in assessing body composition of patients undergoing cardiac rehabilitation
G Halevi, N Rentsler, O Golan, O Caspi, B ZafrirAbstract
Introduction
Bioelectrical impedance analysis (BIA) is a simple, non-invasive, and accessible method to estimate body composition, with prognostic implications regarding health and nutritional status. We aimed to explore the changes in anthropometrics and body composition parameters using BIA in patients participating in a multidisciplinary cardiac rehabilitation (CR) program.
Methods
Body composition was measured using a multiple-frequency BIA device, at admission (pre-CR) and after completing ≥16 sessions (post-CR). CR included aerobic and resistance exercise as well as nutritional counselling via educational kitchen. BIA parameters were compared between the 2 timepoints in each patient and included: weight, Body mass index (BMI), body fat mass (BFM), percent body fat (PBF), skeletal muscle index (SMI), and fat-free mass (FFM). Handgrip strength (HGS) was measured using a hand-held dynamometer.
Results
The study included 87 patients (74 men; mean age 64±12 years). Weight (kg) (80.9±15.4 pre-CR vs. 81±14.9 post-CR, p=0.481) and BMI (kg/m2) (27.7±4.8 vs. 27.6±4.6, p=0.490) were not significantly different between timepoints. In contrast, BFM (kg) (24.9±9.6 vs. 24.1±8.7, p=0.003) and PBF (%) (30.2±8.4 vs. 29.3±8, p<0.001) decreased, whereas FFM (kg) (56±10.3 vs. 57±10.4, p<0.001) and SMI (kg/m2) (7.8±1 vs. 7.9±1, p<0.001) increased. FFM gain compared to FFM loss of ≥2kg was observed in 23.1% vs. 7.7% of women, 28.4% vs. 2.7% of men, 28.8% vs. 3% of non-obese and 23.8% vs. 4.8% of obese patients, respectively (Figure). HGS (kg) markedly increased (31.7±13.4 vs. 34.7±13.5, p<0.001) and was correlated post-CR with SMI (r=0.66, p<0.001), FFM (r=0.76, p<0.001) and inversely with PBF (r= -0.41, p<0.001), but not with BMI (r=0.11, p=0.332).
Conclusions
CR intervention was associated with favorable changes in body composition that were correlated with an increase in HGS. These changes were not reflected by BMI, underscoring the importance of incorporating body composition measures into routine CR assessment.Figure