[HTML][HTML] Segmental musculoskeletal examinations using dual-energy X-ray absorptiometry (DXA): positioning and analysis considerations

NH Hart, S Nimphius, T Spiteri… - Journal of sports …, 2015 - ncbi.nlm.nih.gov
Journal of sports science & medicine, 2015ncbi.nlm.nih.gov
Musculoskeletal examinations provide informative and valuable quantitative insight into
muscle and bone health. DXA is one mainstream tool used to accurately and reliably
determine body composition components and bone mass characteristics in-vivo. Presently,
whole body scan models separate the body into axial and appendicular regions, however
there is a need for localised appendicular segmentation models to further examine regions
of interest within the upper and lower extremities. Similarly, inconsistencies pertaining to …
Abstract
Musculoskeletal examinations provide informative and valuable quantitative insight into muscle and bone health. DXA is one mainstream tool used to accurately and reliably determine body composition components and bone mass characteristics in-vivo. Presently, whole body scan models separate the body into axial and appendicular regions, however there is a need for localised appendicular segmentation models to further examine regions of interest within the upper and lower extremities. Similarly, inconsistencies pertaining to patient positioning exist in the literature which influence measurement precision and analysis outcomes highlighting a need for standardised procedure. This paper provides standardised and reproducible: 1) positioning and analysis procedures using DXA and 2) reliable segmental examinations through descriptive appendicular boundaries. Whole-body scans were performed on forty-six (n= 46) football athletes (age: 22.9±4.3 yrs; height: 1.85±0.07 cm; weight: 87.4±10.3 kg; body fat: 11.4±4.5%) using DXA. All segments across all scans were analysed three times by the main investigator on three separate days, and by three independent investigators a week following the original analysis. To examine intra-rater and inter-rater, between day and researcher reliability, coefficients of variation (CV) and intraclass correlation coefficients (ICC) were determined. Positioning and segmental analysis procedures presented in this study produced very high, nearly perfect intra-tester (CV≤ 2.0%; ICC≥ 0.988) and inter-tester (CV≤ 2.4%; ICC≥ 0.980) reliability, demonstrating excellent reproducibility within and between practitioners. Standardised examinations of axial and appendicular segments are necessary. Future studies aiming to quantify and report segmental analyses of the upper-and lower-body musculoskeletal properties using whole-body DXA scans are encouraged to use the patient positioning and image analysis procedures outlined in this paper.
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