PP466 - INTEGRATING BIOELECTRICAL IMPEDANCE ANALYSIS IN ROUTINE AMYOTROPHIC LATERAL SCLEROSIS CARE: PRELIMINARY RESULTS

PP466

INTEGRATING BIOELECTRICAL IMPEDANCE ANALYSIS IN ROUTINE AMYOTROPHIC LATERAL SCLEROSIS CARE: PRELIMINARY RESULTS

M. Kuiper^1,2,*, W. Kruithof^1,2, N. Broekman-Peters³, J. Hoeijmakers³, A. Kok³, J. van Meel³, J. M. Visser-Meily^1,2, A. Beelen^1,2

¹Department of Rehabiliation, Physical Therapy Science and Sports, University Medical Centre Utrecht, ²Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, ³Department of Dietetics, University Medical Centre Utrecht, Utrecht, Netherlands

Rationale: Loss of fat-free mass (FFM) and fat mass are negative prognostic factors in ALS¹. Bioelectrical impedance analysis (BIA) is a quick, non-invasive method to assess body composition, typically in supine position. This study explored patient acceptability and feasibility of BIA in routine ALS care, including comparisons between supine and seated, as well as left‑ and right‑side measurements.

Methods: BIA was integrated into routine ALS care at our centre and was conducted bilaterally in supine position (if feasible). To enhance feasibility seated BIA was introduced. Agreement with supine BIA was evaluated in a subset of participants (n=20) using paired t‑tests and Bland–Altman analysis. FFM was estimated with the Kyle equation. Feasibility outcomes included completion rates and patient acceptability (3-item, 10-point rating scale, conducted at visit 2).

Results: Preliminary data of 39 patients were available. Seated BIA completion rate was 100% (20/20) and supine 77% (30/39), with missed assessments due to wheelchair dependence and dyspnea while supine. Patient acceptability was high (n=12, median[IQR] 10[9-10]), perceived burden (1[1-1]) and level of emotional confrontability low (1[1-1.5]). Agreement between supine and seated FFM was good (mean bias 0.5 kg, limits of agreement (LoA) -2.0 to 0.9 kg, n=20). Bilateral measurements showed wide LoA (-2.7 to 4.9 kg, n=27).

Conclusion: BIA appears feasible in ALS care, with high patient acceptability. Supine BIA was infeasible in some patients. However, seated and supine BIA showed good agreement. Therefore, seated BIA may provide a practically feasible alternative. Large side-to-side variability suggests influence of asymmetrical muscle atrophy, but further research is needed.

References: ¹Tandan R, et al. Body composition in ALS and its effect on progression and survival. Am J Clin Nutr. 2022.

Disclosure of Interest: None declared