Browsing by Person "Lewis, Susan"

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Longitudinal changes in muscle strength and mass after acute stroke.
(2006-02) Carin-Levy, Gail; Greig, Carolyn; Young, Archie; Lewis, Susan; Hannan, Jim; Mead, Gillian; The Stroke Association
BACKGROUND: Reduced mobility after stroke may cause a loss of muscle mass which may, in theory, contribute to disability. We investigated longitudinal changes in muscle strength, lean cross-sectional area and muscle mass in all limbs after acute stroke. METHODS: We recruited 17 patients within 72 h of hospital admission and measured (a) hand grip strength, (b) knee extensor strength and (c) arm and leg lean cross-sectional area on 6 occasions over 6 months. Appendicular and total muscle mass (dual-energy X-ray absorptiometry) were measured at 3 weeks and 6 months. RESULTS: There was no significant change over time in the strength, lean cross-sectional area and muscle mass of the arms or legs. We noted that muscle strength was substantially lower in all limbs compared with population norms. CONCLUSION: We found no evidence of a decline in muscle strength or mass in any limb after the stroke, which could have been attributed to reduced mobility. The observed muscle weakness in the ipsilateral side may have pre-dated the stroke.
The effect of different body positions on anthropometric measurements and derived estimates of body composition
(Smith-Gordon, 2008) Carin-Levy, Gail; Greig, Carolyn; Lewis, Susan; Stewart, A.; Young, Archie; Mead, Gillian
Purpose: Measurement of cross-sectional lean limb area using physical anthropometry is usually performed in the standing position, but sometimes this may be impractical. Our aim was to determine the effect of different positions on cross-sectional lean area of the upper arm, calf and thigh derived from girth and skin-fold measurements. Methods: Twenty healthy volunteers participated. Girth and skin-fold thickness of the upper arm, calf and thigh were measured in the standing, sitting and supine positions. We derived lean cross-sectional area (cm2), and calculated the mean difference, its 95% confidence intervals (CI), and the 95% limits of agreement (LOA) between standing and the other two positions. Results: For the upper arm, mean differences in lean cross-sectional area for the supine-standing and sitting-standing positions were 0.7cm2, (95% CI -0.6 to 2.0) and -0.6cm2, (95% CI -1.4 to 0.3) respectively. Mean differences for thigh were 3.9cm2 (95% CI -2.3 to 10.1) and -4.3cm2 (95% CI -8.6 to 0.0) for supine-standing and sitting-standing respectively. For the calf, mean difference for supine-standing was -3.1cm2 (95% CI -5.3 to -0.9), while for sitting-standing it was 0.3cm2 (95% CI -1.8 to 2.4). The range of values expected to cover agreement for 95% of subjects (LOA) was widest for the thigh and narrowest for the upper arm. Conclusion: In young healthy subjects, lean cross-sectional area differs according to measurement position, particularly for the lower limb. The same measurement method should be used in any one individual when monitoring change.