Comparison of segmental lean tissue mass in individuals with spinal cord injury measured by dual energy X-ray absorptiometry and predicted by bioimpedance spectroscopy


Study design



To compare two methods for predicting segmental (arms, legs, trunk) lean tissue mass (LTM: non-bone fat-free mass) from bioimpedance spectroscopy (BIS) against LTM measured from dual energy X-ray absorptiometry (DXA) in individuals with acute spinal cord injury (SCI).


Austin Health Victorian Spinal Cord Service, Victoria, Australia.


Fourteen participants (two female), within 8 weeks of traumatic SCI had BIS measured following an overnight fast and within 24 h of DXA scanning. Total body fat-free mass (FFM, body weight minus fat mass) and segmental LTM were predicted from BIS using manufacturer’s proprietary software and a previously established SCI-specific prediction method. Appendicular LTM (ALM) was calculated from the sum of the LTM of the arms and legs. Agreement and strength of relationships with DXA for predicted LTM measures using both approaches were assessed using Lin’s concordance coefficient and limits of agreement analysis (LOA).


The BIS proprietary method performed better than the SCI-specific prediction method in predicting DXA LTM, demonstrating substantial concordance for total body FFM (rc = 0.80), ALM (rc = 0.78), arm (rc = 0.76) and leg LTM (rc = 0.65) and a smaller bias and LOA for ALM (+0.8 vs. −3.4 kg; LOA −4.9–6.4 vs. −11.9–5.1 kg), arm (+0.02 vs. −0.3 kg; LOA −1.1–1.1 kg vs. −2.2–1.6 kg) and leg (+0.4 vs. −1.4 kg; LOA −2.0–2.8 vs. −5.6–2.8) LTM.


BIS can be used to accurately predict total body FFM, segmental LTM and ALM in individuals with acute SCI.

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Fig. 1: Ratio of extracellular water (ECW) and intracellular water (ICW) volumes in body segments of spinal cord injury (SCI) participants (n = 14) and controls (n = 58) for this study.

Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.


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The authors acknowledge the contributions of Dr. Andrew Nunn of the Victorian Spinal Cord Service for facilitating participant access, dietitians Helena Rodi and Jillian Rafferty for assistance with data collection, as well as the contributions of the participants and their families.


Original data collection was funded by a grant from the Transport Accident Commission through the Institute for Safety, Compensation and Recovery Research (ISCRR project #NGE-E-13-078). Author KJD was supported by a grant from the Austin Medical Research Foundation and MGP by an Australian Postgraduate Award.

Author information




KJD participated in the design of the study, performed data collection, data entry, and analysis and contributed to paper preparation. MGP participated in the design of the study, performed data collection and contributed to paper preparation. LCW advised on the design of data collection protocol, performed quality assurance on the data, contributed to statistical analyses and paper preparation. MPG developed the concept for and designed the study, contributed to grant procurement and paper preparation. NK and RMD contributed to the interpretation of the results and preparation of the paper. All authors read and approved the final version of the paper.

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Correspondence to Katherine J. Desneves.

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Conflict of interest

Author LCW consults to Impedimed Ltd. All other authors have no conflicts of interest to declare.

Ethical approval

Ethical approval for this study was obtained from the Austin Health Human Research Ethics Committee (H2013/05117) and all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed.

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Desneves, K.J., Panisset, M.G., Galea, M.P. et al. Comparison of segmental lean tissue mass in individuals with spinal cord injury measured by dual energy X-ray absorptiometry and predicted by bioimpedance spectroscopy. Spinal Cord (2020).

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