OK Good afternoon everyone.

Again like as a said My
name is Denise Larkin's and

I will be presenting to you today on
the comparison of body composition

measurements and
amputees versus Nanine tees.

So first of all what is body composition.

Body composition is simply a way of
describing the percentage of fat bone and

muscle and the human body.

There are many different ways
of assessing body composition so

many of which are beyond
the scope of the study.

However the three main ones that we'll be
focusing on and this study are dual energy

X. ray Observatory on the tree also
known as Dr Second we have biological

impedance or you'll hear me referred to as
B. IRA And finally the skinfold technique.

I chose these three methods because
they are the most clinically applicable

there noninvasive and relatively easy to
use with the right training involved.

So why is body composition
measurement important.

Well first of all it's superior
to weight measures if you or

I were to stand on a scale we
would only be given one number

we wouldn't know our percent body fat Our
percent lean mass or our bone density.

But knowing these values we have important
information for nutritional status and

health risks we can determine
if we are at risk for

certain diseases such as heart
disease osteoporosis or diabetes.

And in addition with the reading obesity
rates currently in the United States.

Knowing our body composition it is
important now more than it is ever

in regards to amputees.

It has been shown that there is a greater
incidence of cardiovascular disease and

this population as well as many in can
tease adopt a sedentary lifestyle.

On the other hand more in me to use these
days have been faced with greater fitness

opportunities with these two factors
combined it is important to note

that it continues need in Achree an easy
way to assess their body composition

just as not maybe to use one.

So until recently the most.

Accurate way of assessing body composition
has been known as hybrid densitometer.

It's based on the concept
of water displacement and

I calculation involving density
equals mass of a volume.

As you can see from the picture on
the gray this procedure is demanding and

often difficult for patients to perform.

So this leads us to explore other
ideas of assessing body composition

that are accurate as well.

From the literature as been shown that
docs say is also comparable to hydrogen

such commentary and it's an accurate
way to assess body composition.

Thus it will be used as our
gold standard and the study.

That's what has been shown to most
highly correlate with skin fold and

then biological.

Awhile ballot to compute A N's biological
kids in Schiphol are accurate tools for

assessing body composition.

They have been shown to be
less accurate for that.

So you can stream ends of body fat us.

So if someone is extremely obese or
extremely lean

these men methods of assessing body
composition may not be as accurate.

A finally and biological Keenan's
has been shown to underestimate body

fat as compared to docs and some studies

in regards to the literal looking
amputees not much currently exists.

One study did show that biology from here
on this was theoretically practical for

amputees.

But it was a study involving
non amputee teens and

it only simulated amputations
through placements of electrodes.

Most studies agree that further
validation is needed for

altered body composition
measurements such as with amputees.

So this brings us to our two
main questions in this study.

The first question is is there
a significant difference and

body composition depending
on measurement method.

And we hypothesize that body
composition will differ by method for

individuals above or below average body
fat and as a stated in the literature.

Are second question is is the discovered
sand measurement method for

body composition greater.

M.P.T. is then it will be for
an army bases.

And we hypothesize that body composition
will differ by method more for Abts

then for not maybe t's we hypothesize this
because with an amputee you're going to

have more muscle atrophy and limb tissues
that could alter their body composition.

So our subjects for the study fell into
two main categories they were either

enduring change or
untrain within each category we had both

matched amputees in the knee amputees they
were matched based on their age their

height their weight sex gender ethnicity
and self-important activity level.

As you can see most of rest objects fall
between the ages of eighteen and forty.

We had both males and females
Caucasians and African-Americans and

in both above me and below me
amputees we did our best to try and

get a really well diversified
group of subjects in the study.

So the first method that we looked at in
assessing money composition was Darkseid

it was done on the moon our prodigy

decks a table as you can see
from the picture on the right.

We had our participants lay down
on the table of this scan took

about five minutes for the arm to pass
over them and it would have meant to X.

ray beings into their body and

give a three compartment model their three
compartment model tells us their percent

burned inside me their percent fat mass
and fat free mass however for this study

we will mainly be concerned with their
percent fat mass which we will report as

their gold standard in comparison to other
methods of measuring body composition.

The only problem with tax is that it can
be really expensive and takes up a lot

of space and you need training in
order to operate this equipment.

Our second method of measuring body
composition must there my left

home peanuts.

With this we use the commercially
available hand-held body fat analyzer.

Which was used on twenty
two different subjects.

As you can see on the far left this is a
picture of the device in order to operate

this you would input certain parameters
such as the person's height weight and

sex into this device.

Then the person stands with the device
ninety degrees to their body parallel to

the floor they press the Start button and
about ten seconds they get a reading of

their percent body fat which happens
after a small current is passed and

there are programs in the process
of those devices and that's easy.

T. Is it can't tell it's quick like
I said only takes about ten seconds.

That's an expensive you could
get this at Walmart Target and

it's noninvasive consulate's device
however at the are that there's many

Americans to control for so
you have to get to control for

someone's hydration status their
food intake and the time of day.

The last method of body composition you
left out was the skin fall technique.

This was done.

I'm seven different sites on a person's
body as you can see from the picture

on the left those of the seven sites
that were from the skin fold on for

each seven site three trials were done and

then averaged together to implanter our
calculation for the skinfold technique.

From the US were able to get a percent
body fat rating for each individual.

The person of the service and
then it's an expensive and portable.

However the cons are that their skills
required in order to operate the calipers

the sting consistency can vary from person
to person making the results variable and

it's time consuming depending
on how much skill you have.

So the results for the Study of a first
I'd like to get you oriented to this graph

because you'll see another one
similar to and a couple of slides.

But along the X. axis you can see
the measurements of biological peanuts and

skin bald and on along the Y.
axis we're looking at the discrepancy from

docs that were the percent difference that
biological impedances from Doc so are.

Skinfold is from ducks I'm so in this
graph we're comparing people of average

percent body fat and above average percent
body fat average in green above average

and read by two way in the left if
found that there's a man effect for

measurement method and post-hoc showing
that there's a significant difference

between docs and biological parents
with the P. value point zero one.

However there was no significant
difference between the skinfold and docs.

There was also no interaction effect for
measurement method and body fat and so

it didn't depend on someone whether
someone was of average percent body fat or

above average percent body fat.

There is no significant
difference between them.

This next graphic is only by amputees so
this tells you their percent body fat.

According to Dr scam bone and
biological parents.

So as you can see from these results
skinfold index were very somewhere about

biological impugns was much less.

Which is somewhat similar to what
we would see with Nonie teens

and then finally we're
looking at a comparison

of amputees versus nodding between Again
this is the same graph we just previously

saw we're looking at biological
parents and seven sites dimpled and

their percent difference from Dexia
again by two we see that there's

a main effect or measurement method with
a post-hoc showing there's a significant

difference between biological M.P.'s and
dexa the Peabody zero point zero four.

This is significant difference difference
regardless of whether someone is

an amputee or an empty.

There's no significant difference
however between scamble index.

And also there is no known or interaction
effect for measurement method and type of

individual so there's not a significant
difference whether someone is an empty or

an Ani Choying.

We think a clue that there's
a significant difference and

body composition depending
on measurement method so

significant difference being between
biological implements and X.M..

There's also a trend for.

Body composition to differ more about
method for subjects with above average

percent body fat than for
subjects with average percent body fat.

Likewise there's a trend for body
composition to differ more by method for

ab to use them for non amputees for

both of the last two bullets be
hypothesized that if we had more subjects

in our study we might be able to
actually get more significant results.

There were a few limitations to
the study one in patient matching

it was much harder to find
patient matches for the being

group that was the untrained group than
the group that was in different strain.

Projects and we did have one patient
the had an artifact in their leg and

biological implements we controlled for
hydration up to a certain threshold so

they all had to be at a certain
amount of hydration level but

then after that they could have varied
a little bit between each other and

first unfolded only about half of our
patients we were able to collect skinfold

data on in the future we would
like to get a greater sample size.

As we hope that this will increase the
significance in our results and further

studies could drive in between appropriate
formulas for body composition testing

and so my reference that's what that
I'd like to think about Brown and

Dr Mindy Millard Stafford for all their
guidance and support with this project.

Scott Congar for all has to just
to call how about December for

patient recruitment is a closure for
all of his research guidance Crist's and

homework and for
all of his research slash academic and

by our guidance all my patient models for
their time and

talent and that for all and S.P.O.
and their intends to that volunteers.

I graciously helped with my project and
second impressions.

Thank you.

Yes Chris.

Right.

The reason for
that was this was a two part study.

One study and it's retrospective so
the data had already been collected and

I basically went back and
collected all of that data and

the other half of it was the first part
there which is why I recently collected so

I added skinfold so that the other half
of that I didn't have this components but

I added that my portion

is you know just being

me and I definitely didn't
have a thousand subjects

that I got to practice and so I guess you
consider that limitation to the study.

I did we compare my skinfold
taking skills to someone

else who had previously done it before so
and we got our speed pretty close.

And then I had to head several pilot
testing on my fellow students.

So in order to get practice on the backs
the level of expertise that I'm involved.

Well I did two Inova but show.

That there wasn't a significant enough
difference between the two and so

I took that as being that they were
significantly enough close to each other

whereas biological impedance was not
significantly similar to next up.

Yes From what

I know.

I guess at this point I would suggest you
send them to someone who is certified and

doing skin folds and have that done
it would be a lot easier than you

going through all the trouble
to acquire that skill.

So right now.

I think that that's the most
accurate method out of these

three methods anyway secondary to Dec so

you can buy in just have
to keep in mind that

it's not going to be the US accurate and
you have to control for several variables.

Yes your liver

is I think that's fair.

Honestly possible and

I think that should definitely be left up
in a further study and that's what I have

listed up as future study is I think
that would be a really good idea.

I know there's formulas out there for
correcting for weight.

So I think that that can be applied and
may be implanted into the device.

I can't now

because you would have to have the person
you have to reenter in their way and

have the person stand with the device
in the future standing secretive.

And even if you control.

Yes Well you

know I don't think on trial for that.

Then all my amputees had to be you
post two years and be patient.

So I didn't want any
recent entreaties that

might have the the swelling in the limb
by inflection ration that kind.

There are actually affect their results
but that's how I tried the route go back

controlling for
him was right that something

isn't right right right.

Because that's a limitation to biological
humans that mean the time of day and that

is tougher for amputees that would have
the lumbar implant tradition but I don't

believe any of mine really had problems
with that as going to there are any right.

Yes there

are trees and

there's two different energy beams but

they're very low intense news so
you're going to get less X.

ray exposure than you would
flying across the country and

have an airplane that's very la la.

OK Thank you Jamie.