Prediction of Bodyy whole body fat from skinfolds: importance of Body fat calipers accuracy skinfolds accuracyy the thigh and calf in falipers, healthy Body fat calipers accuracy and women. Use your dominant thumb to press the caliper arm until it is fully depressed. Indeed, other methods such as hydrostatic weighing are thought to be superior. More information is needed about the accuracy of these methods. Bodyweight should be shifted to the left foot throughout.

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How to Measure Body Fat Percentage (Male) - Skinfold Caliper Testing Nursing Skill

Body fat calipers accuracy -

The upper and lower medial length-marking points were first set for each body part. The distance in between was measured, and divided by the number of fields defined and marked along the virtual line. The width of a rectangle was determined by further landmarks or delimited by adjacent fields.

For example, fields 47—49 on the posterior thigh have their medial origin at their anatomically defined location and adjoin fields 35—37 on the anterior thigh Fig. The center of each field represented the spot of interest. An accurate description of the landmarks is found in Supplementary Table S1.

To avoid a labeling error, a preliminary examination was carried out. The thickness of skinfolds was measured with a Holtain caliper Holtain, Dyfed, UK, range 0—40 mm with 0.

After mapping, the measurement started with the subject in supine position. The caliper was applied at right angles to the pinch. Within each field, two measurements formed an average value, which was divided by two due to the skinfold double layer.

To avoid discomfort and to leave the measurement accuracy unaffected in the presence of glandular tissue, no caliper measurements were taken on fields 12 and 17 in women. Once all the anterior parts had been measured, the subject moved into a prone position.

The US images were generated by a B-Mode device GE Healthcare GmbH, LOGIQ e, Vivid series with linear transducers of 12 MHz in longitudinal position to measure SFT depending on the approximate tissue depth. However, an optimum of brightness, gain and dynamic range was individually adjusted by the observers to achieve the best possible tissue delimitability.

The measurement area should be aligned to the center of the image. When boundaries were clearly distinguishable, the US probe was slowly lifted off until the pressure was low enough due to SFT viscoelasticity. When the area of interest was clearly definable, the image was captured.

In abdominal areas, the image was captured when the subject stopped breathing at mid-tidal expiration. As the MRI or the caliper cannot clearly differentiate fibrous structures or the skin, they were not excluded from US either.

The distance between skin and muscle tissue was measured to 0. Since the caliper involves the skin, it was not excluded from US either. In 50 participants MRI measurements of SFT at 4 sites were performed fields: 2, 15, 36, 39; Philips Achieva 1. In 34 of these participants, additional measurements of skinfolds were conducted to visualize the anatomy of field This was done in order to clarify the marked differences between US and Caliper in field 15, which revealed the highest incongruence A whole body coil was selected.

The cross-sectional image was displayed after fields were marked with a specific pellet Fig. As the Caliper is incompatible with MRI, the test person held the marked skinfold in field 15 with their own hands after receiving detailed instructions.

A sagittal slice was obtained while the subject was in supine position. Although we were aware that the skinfold pressure would vary individually, this idea was primarily used to elucidate the difference between US and Caliper.

Only for descriptive purposes, TBF was determined via Body Comp Software 8. de using the segmental BIA Anniversary Sport Edition Akern srl, Florence, Italy.

SFT and TBF measurements were carried out consecutively. All statistical evaluations are done with the programs SPSS 23 SPSS Inc. Arithmetic mean x̅ , standard deviation SD , standard deviation of difference s D and mean difference d̅ are calculated for descriptive statistics. The two-way random effects model was used to calculate the ICC of interrater reliability and two-way mixed effects for intrarater reliability To visualize test differences, a Bland—Altman plot illustrated the results We evaluated 53 participants for caliper and 54 for US measurements applying our mapping method.

One had to be excluded for caliper as his skinfold measurement was not applicable during the measuring process. There were no systematic errors in these measurements.

Bland—Altman-Plot a : intrarater caliper reliability mean The first observer is a highly experienced sonographer 5 years of musculoskeletal US and caliper , whereas the second observer was trained 4 months US and caliper until his US images met the qualitative standard: a optimum of brightness, gain and depth, b tissue aligned to the center of the image, c distinguishable boundaries, d adequate echogenicity of inspected tissue, e detecting and minimizing artifacts, f reproducible image.

Fourtythree participants were engaged for the interrater assessment. Another participant for caliper was excluded because of difficulties during the measuring process.

Figure 2 c represents the Bland—Altman analysis showing SAT differences between the two caliper measurements plotted against the mean. It illustrates a mean of difference of 0.

In comparison, US had 10 of 56 sites showing an ICC lower than 0. The lower arm on the other hand was not reliable. The values for the different measuring sites are given in Table 2.

Our comparison of caliper to US at 56 sites demonstrated clear differences in mean SAT depth of all areas 0. To enable an overview of the total subcutaneous fat depth, all fields in each subject were cumulated total SFT , as shown in Fig.

The mean value of the total SFT difference between caliper and US was The two graphs illustrate remarkably the difference between these methods, particularly when there is more subcutaneous body fat.

Caliper vs. US Bland—Altman-Plot: a : mean of SFT depth of each field 1—56 ; mean: 0. Considering the difference in SFT between caliper and US, especially at abdominal field 15 , a sagittal MRI SI was done to detect discrepancies. Thirty four participants from the total MRI sample were evaluated.

The MRI images contain two measurements: 1 native, transversal image MRI TI to show the mean value of the subcutaneous fat depth Fig. Field 15 a : MRI sagittal slice SI of lower abdomen when subject held skinfold to explain the difference between US and caliper SFT values.

b : US image measured with a 12 Hz probe showing a 4. c : MRI transversal image shows the pellet marked at field The line illustrates SFT depth. The interrater reliability at 8 standardized sites of ISAK is shown in Table 4.

For two dimensional SFT thickness measurements US is comparable to MRI measurement. Wagner et al. Measurements were taken on the chest, abdomen, and thigh in the men, and on the triceps, upper thigh, and suprailiac in the women.

ICC values of 0. Pérez-Chirinos Buxade et al. Two raters took measurements at the triceps, subscapular, biceps, iliac crest, supraspinal, abdominal, front thigh and medial calf Another study achieved similar results at eight sites, namely the upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh and medial calf However, their Spearman correlation coefficient ρ amounted to 0.

Weiss 19 investigated the intrarater reliability of B-mode ultrasound in 30 college students. Images were taken at clearly defined locations on the front and back of the right thigh. Chandler et al.

When measuring total SFT, US exhibited smaller overall intrarater differences although it is particularly sensitive since it measures quite punctiformly, while caliper captures a larger area. Disparities may arise by more or less compression or greater fat fluctuations within a field.

As a result, both methods identify changes in fat distribution in sites when determined by the same observer. Regarding the caliper, 42 sites showed a good ICC above 0. The posterior thigh and calf tended especially toward poor to moderate reliability.

Kispert and Merrifield 21 measured sites in male triceps, chest, and subscapular and female participants triceps, abdomen, and iliac crest.

However, we only analyzed statistics of the entire cohort. The ISAK considers 8 sites as standard: biceps, triceps, iliac crest, subscapular, supraspinale, calf, front thigh and abdominal According to our results, six ISAK sites were very reliable; only the abdominal and medial calf revealed moderate to poor caliper reliability.

Hume and Marfell-Jones 22 obtained similar findings, but considered the biceps and triceps also as critical, which we could not confirm in this study.

Gonzáles-Ruíz et al. Durnin and Womersley 7 reported more variability in measured values in persons with a higher percentage of body fat. Their finding is evidence of many skinfold formulas, especially considering the relationship between subcutaneous fat and body fat mass.

All ISAK sites revealed good to excellent interrater reliability. Müller et al. The greatest difficulties with ultrasound measurements occur when determining the fat-muscle transition, especially when a deep fat layer is present Hoyos et al.

This can be particularly important in areas with unevenly distributed fat layers such as the gluteal femoral, abdominal, and paralumbar areas Breathing also affects abdominal SFT measurements, so special caution is required there also In conclusion, with increasing SFT, the absolute scatter for US increases, but the relative deviation remains constant.

MRI and US showed very good to excellent reliability except for field 2 0. US measures were systematically higher than MRI. Additionally, the narrow space in the MRI device can also affect the results, particularly when the arms must be hold very close to the body and the fat layer is moved.

As Störchel et al. MRI TI vs. US showed an ICC of 0. Mechelli et al. Except for field 2 and 15, both methods show a good reliability at mid front thigh and mid lateral thigh see Table 2. The apparent difference in field 15 2.

To investigate the theory, the participant produced a skinfold in field 15 in supine position, because the caliper itself is incompatible with the magnetic field. Although individual hand pressures of skinfolds vary, MRI SI data resembled the Caliper values 1.

Considering the US and transversal MRI TI image Fig. There are of course differences, depending on gender, amount of body fat, its distribution and location Female participants are much more likely to present a thicker fat layer in the abdomen up to the umbilicus than is detected in most of the inferior area If the DFL is not incorporated within the caliper at that area, both layers must be relocatable.

Lancerotto et al. They found that the SFL consists of large fat lobes organized in single or multiple layers. Fibrous septa encased the fat lobes like in a honeycomb, and were positioned consistently and perpendicularly to the dermis. On the contrary, they found that the DFL consists of fat lobes being smaller and arranged in a less well-structured pattern The fibrous septa, however, are more obliquely-horizontally aligned, and there are few elastic components.

Lateral displacement was easily realized, but the original position was inconsistently regained. This appears to clarify the displacement of SFL and DFLs when taking caliper measurements. Similarly, thigh and gluteal areas also possess these two layers, a factor that needs to be considered when using a caliper The two devices were equivalent only in the lower medial and lateral back.

Caliper measures Higher SFT values for US were already measured by Kuczmarski et al. Akyer et al. The compression of skin and fat tissue can result in lower measured values Determining the fat-muscle transition becomes difficult also when fibrous structures are embedded in the muscle.

Concerning the ISAK, in this study we found that only the subscapular area and anterior thigh proved to show good to excellent reliability in caliper-to-US comparisons. While taking these measurements, we noticed that the caliper and US skinfold values differed tremendously at certain parts of the body.

Therefore, which sites function equivalently must be clearly defined, especially when body-fat analyses are relying on caliper measurements.

Compression seems to play some kind of a role in such differences between these methods as the caliper compresses fat tissue more than US does. The abdomen area especially field 15 showed a Measurement-value deviations differ in only one direction despite including a wide range of body types.

Due to the non-inclusion of the DFL into the caliper at the abdominal area, sites consisting of a double layer should be interpreted with caution.

To ensure comparability among studies, a standardized protocol should be adopted that relies on both reliability and validity data for statistical analyses i. ICC, coefficient of variance. This mapping method of ours includes 56 measuring points conceived as specific landmarks.

Note that the measurements were taken in one session relying on previous markings. Even if the labeling process revealed no mean differences between observers, it can still affect the variance.

Since the body is rather cone-shaped, rectangles are arranged somewhat inhomogeneously. Furthermore, a standard routine for taking ultrasound and caliper measurements is imperative to ensure reliability.

Such examinations should only be conducted by experienced sonographers. Handling these instruments requires adequate qualification. Furthermore, the ISAK sites we relied on were not pinpointed, but were nevertheless incorporated within the measurement area.

These results allow only a statement for the included study population. For validity conclusions, a higher sample size is required.

As measuring subcutaneous fat via US or caliper yields significant differences at most areas, the two methods are not interchangeable. Caliper drastically underestimates the depth of subcutaneous fat tissue depending on its location. Both measurement methods yield very good intrarater data and relative changes can be identified.

In direct comparisons, the lower medial and lateral back deliver equivalent results. Regarding ISAK skinfolds, the Iliac crest, subscapular and thigh can be measured interchangeably and equally reliably via caliper or US. The calf, on the contrary, is only measured reliably via US.

However, to obtain accurate SFT depth measurements, ultrasound is the method of preference as it captures all fat layers most precisely. When compared to MRI, US is more readily available in the daily practice, although both methods yield similar results.

Subcutaneous fat tissues consisting of a double fat layer like the abdomen must be examined with particular caution, when measuring with a caliper, as it does not measure both fat layers. The original contributions presented in the study are included in the article supplementary material ; further inquiries can be directed to the corresponding authors.

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Suarez-Arrones, L. Body fat assessment in elite soccer players: Cross-validation of different field methods. Football 2 , — Reilly, T. How well do skinfold equations predict percent body fat in elite soccer players?. Withers, R. Relative body fat and anthropometric prediction of body density of male athletes.

Koo, T. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Bland, J. Measuring agreement in method comparison studies. Methods Med. Wagner, D. Validity and reliability of A-mode ultrasound for body composition assessment of NCAA division I athletes.

PLoS ONE 11 , e Article CAS PubMed PubMed Central Google Scholar. Pérez-Chirinos Buxadé, C. Assessing subcutaneous adipose tissue by simple and portable field instruments. Skinfolds versus A-mode ultrasound measurements.

PLoS ONE 13 , e Standardized ultrasound measurement of subcutaneous fat patterning: High reliability and accuracy in groups ranging from lean to obese. Ultrasound Med. Weiss, L. The use of B-mode ultrasound for measuring the thickness of skeletal muscle at two upper leg sites.

Statistical analyses performed: The relationships among skinfold, ultrasound, and computed-tomography measurements were analyzed by determining Pearson correlation coefficients. A graphical method described by Bland and Altman was also used to assess agreement among the three methods. The graphical method revealed that the variation in the ultrasound measurements was much greater than that of the skinfold measurements when compared to computed-tomography values.

This finding enhances the potential use of skinfold calipers in the clinical setting, particularly in view of the fact that measurement of subcutaneous body fat at different body sites is becoming increasingly important for the characterization of risk of certain disease states.

Abstract Objective: The purpose of this study was to compare skinfold caliper and ultrasound measurement of subcutaneous body fat at three abdominal sites with computed tomography, which is considered to be the gold standard. Publication types Comparative Study Research Support, Non-U.

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