{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:49:20Z","timestamp":1777571360507,"version":"3.51.4"},"reference-count":58,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T00:00:00Z","timestamp":1592697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: accurate prognostic tools are relevant for decision-making in cancer care. Objective measures, such as bioelectrical impedance (BI), have the potential to improve prognostic accuracy for these patients. This cross-sectional study aimed to investigate whether phase angle (PhA) derived from the electrical properties of the body tissues is a predictor of muscular strength in breast cancer survivors (BCS). Methods: a total of 41 BCS (age 54.6 \u00b1 9.2 years) were evaluated. PhA, obtained at frequency 50 kHz, was assessed with BI spectroscopy, and muscular strength with a handgrip dynamometer. Moderate-to-vigorous physical activity (MVPA) was assessed using the International Physical Activity Questionnaire (IPAQ). Measurements were performed in the morning after an overnight fast. Results: linear regression analysis showed that PhA accounted for 22% (r2 = 0.22) of muscular strength variance. PhA remained a borderline predictor of muscular strength variance independently of age and MVPA. Conclusions: the findings of this study suggest that PhA is a significant predictor of maximal forearm isometric strength and a potential indicator of disease-related functionality in BCS.<\/jats:p>","DOI":"10.3390\/ijerph17124452","type":"journal-article","created":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T06:46:12Z","timestamp":1592808372000},"page":"4452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Phase Angle as a Marker of Muscular Strength in Breast Cancer Survivors"],"prefix":"10.3390","volume":"17","author":[{"given":"Catarina N.","family":"Matias","sequence":"first","affiliation":[{"name":"Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal"},{"name":"Physiology and Biochemistry of Exercise Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade Lisboa, 1499-002 Lisboa, Portugal"}]},{"given":"Joana","family":"Cavaco-Silva","sequence":"additional","affiliation":[{"name":"ScienceCircle-Scientific and Biomedical Consulting, 1600 544 Lisboa, Portugal"}]},{"given":"Mafalda","family":"Reis","sequence":"additional","affiliation":[{"name":"Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3028-7802","authenticated-orcid":false,"given":"Francesco","family":"Campa","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-2499","authenticated-orcid":false,"given":"Stefania","family":"Toselli","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Science, University of Bologna, 40126 Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6230-6027","authenticated-orcid":false,"given":"Lu\u00eds","family":"Sardinha","sequence":"additional","affiliation":[{"name":"Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8984-8600","authenticated-orcid":false,"given":"Analiza M.","family":"Silva","sequence":"additional","affiliation":[{"name":"Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1046\/j.1532-5415.2002.50312.x","article-title":"Handgrip strength and mortality in older Mexican Americans","volume":"50","author":"Markides","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/0895-4356(95)00533-1","article-title":"Physical-strength tests and mortality among visitors to health-promotion centers in Japan","volume":"48","author":"Fujita","year":"1995","journal-title":"J. Clin. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/ije\/dyl224","article-title":"Grip strength, body composition, and mortality","volume":"36","author":"Gale","year":"2007","journal-title":"Int. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1097\/00005768-200205000-00002","article-title":"Musculoskeletal fitness and risk of mortality","volume":"34","author":"Katzmarzyk","year":"2002","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1093\/gerona\/57.10.B359","article-title":"Skeletal muscle strength as a predictor of all-cause mortality in healthy men","volume":"57","author":"Metter","year":"2002","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.amjmed.2006.04.018","article-title":"Grip strength predicts cause-specific mortality in middle-aged and elderly persons","volume":"120","author":"Sasaki","year":"2007","journal-title":"Am. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"a439","DOI":"10.1136\/bmj.a439","article-title":"Association between muscular strength and mortality in men: Prospective cohort study","volume":"337","author":"Ruiz","year":"2008","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"M168","DOI":"10.1093\/gerona\/55.3.M168","article-title":"Muscle strength and body mass index as long-term predictors of mortality in initially healthy men","volume":"55","author":"Rantanen","year":"2000","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1007\/s11357-011-9256-y","article-title":"Midlife muscle strength and human longevity up to age 100 years: A 44 year prospective study among a decent cohort","volume":"34","author":"Rantanen","year":"2012","journal-title":"Age (Dordr.)"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1016\/j.jacc.2010.12.025","article-title":"A prospective study of muscular strength and all-cause mortality in men with hypertension","volume":"57","author":"Artero","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1093\/annonc\/mdt551","article-title":"Muscle dysfunction in cancer patients","volume":"25","author":"Christensen","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e7279","DOI":"10.1136\/bmj.e7279","article-title":"Muscular strength in male adolescents and premature death: Cohort study of one million participants","volume":"345","author":"Ortega","year":"2012","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1590\/S0100-720320140005004","article-title":"Short-term changes in handgrip strength, body composition, and lymphedema induced by breast cancer surgery","volume":"36","author":"Gomes","year":"2014","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1034\/j.1600-0579.2003.00207.x","article-title":"Handgrip strength and cause-specific and total mortality in older disabled women: Exploring the mechanism","volume":"51","author":"Rantanen","year":"2003","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3536","DOI":"10.1200\/JCO.2007.14.4899","article-title":"Lymphedema after breast cancer: Incidence, risk factors, and effect on upper body function","volume":"26","author":"Hayes","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1684\/mrh.2015.0389","article-title":"Magnesium and phase angle: A prognostic tool for monitoring cellular integrity in judo athletes","volume":"28","author":"Matias","year":"2015","journal-title":"Magnes. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gupta, D., Lammersfeld, C.A., Vashi, P.G., King, J., Dahlk, S.L., Grutsch, J.F., and Lis, C.G. (2008). Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer, 8.","DOI":"10.1186\/1471-2407-8-249"},{"key":"ref_18","first-page":"44","article-title":"Bioimpedance analysis in the assessment of lymphoedema diagnosis and management","volume":"2","author":"Rockson","year":"2007","journal-title":"J. Lymphoedema"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1123\/ijspp.2019-0285","article-title":"Identifying Athlete Body-Fluid Changes During a Competitive SeasonWith Bioelectrical Impedance Vector Analysis","volume":"15","author":"Campa","year":"2020","journal-title":"Int. J. Sports Physiol. Perform."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.clnu.2019.02.016","article-title":"Phase angle and bioelectrical impedance vector analysis in the evaluation of body composition in athletes","volume":"39","author":"Marini","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Castizo-Olier, J., Irurtia, A., Jemni, M., Carrasco-Marginet, M., Fernandez-Garcia, R., and Rodriguez, F.A. (2018). Bioelectrical impedance vector analysis (BIVA) in sport and exercise: Systematic review and future perspectives. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197957"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12603-018-1151-0","article-title":"Phase Angle Is a Useful indicator for Muscle Function in Older Adults","volume":"23","author":"Yamada","year":"2019","journal-title":"J. Nutr. Health Aging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.1002\/cncr.28624","article-title":"Phase angle for prognostication of survival in patients with advanced cancer: Preliminary findings","volume":"120","author":"Hui","year":"2014","journal-title":"Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.clnu.2008.11.001","article-title":"Bioimpedance vector analysis as a measure of muscle function","volume":"28","author":"Norman","year":"2009","journal-title":"Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects","volume":"310","author":"Association","year":"2013","journal-title":"JAMA"},{"key":"ref_26","unstructured":"Lohman, T.G., Roche, A.F., and Martorell, R. (1988). Antrophometric Standardization Reference Manual, Human Kinetics Publishers. [3\u20138th ed.]."},{"key":"ref_27","unstructured":"World Health Association (2008). Waist Circumference and Waist Hip Ratio: Report of a WHO Expert Consultation, World Health Association."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40101-016-0090-x","article-title":"Associations of anthropometric measures on breast cancer risk in pre- and postmenopausal women-a case-control study","volume":"35","author":"Pacholczak","year":"2016","journal-title":"J. Physiol. Anthropol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cole, K.S., and Cole, R.H. (1941). Dispersion and absorption in dielectrics. J. Chem. Physiol., 9.","DOI":"10.1063\/1.1750906"},{"key":"ref_30","unstructured":"Sherman, P. (1968). Electrical properties of emulsions. Emulsion Science, Academic Press."},{"key":"ref_31","first-page":"E995","article-title":"Hydration of fat-free body mass: New physiological modeling approach","volume":"276","author":"Wang","year":"1999","journal-title":"Am. J. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1046\/j.1440-1630.1999.00182.x","article-title":"Handgrip strength testing: A review of the literature","volume":"46","author":"Innes","year":"1999","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_33","unstructured":"(2010, March 15). IPAQ (2005) Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)\u2014Short and Long Forms, revised on November 2005. Available online: http:\/\/www.ipaq.ki.se\/scoring.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1475-2891-7-26","article-title":"Is bioelectrical impedance accurate for use in large epidemiological studies?","volume":"7","author":"Dehghan","year":"2008","journal-title":"Nutr. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1378\/chest.06-2088","article-title":"Documenting research in scientific articles: Guidelines for authors: 3. Reporting multivariate analyses","volume":"131","author":"Lang","year":"2007","journal-title":"Chest"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.clnu.2012.05.008","article-title":"Bioelectrical phase angle and impedance vector analysis\u2014Clinical relevance and applicability of impedance parameters","volume":"31","author":"Norman","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"612","DOI":"10.3945\/ajcn.2010.29215","article-title":"Cutoff percentiles of bioelectrical phase angle predict functionality, quality of life, and mortality in patients with cancer","volume":"92","author":"Norman","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4082\/kjfm.2014.35.5.251","article-title":"The Association between Phase Angle of Bioelectrical Impedance Analysis and Survival Time in Advanced Cancer Patients: Preliminary Study","volume":"35","author":"Lee","year":"2014","journal-title":"Korean J. Fam. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1038\/s41430-018-0355-z","article-title":"Lack of agreement of in vivo raw bioimpedance measurements obtained from two single and multi-frequency bioelectrical impedance devices","volume":"73","author":"Silva","year":"2019","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Francisco, R., Matias, C.N., Santos, D.A., Campa, F., Minderico, C.S., Rocha, P., Heymsfield, S.B., Lukaski, H., Sardinha, L.B., and Silva, A.M. (2020). The Predictive Role of Raw Bioelectrical Impedance Parameters in Water Compartments and Fluid Distribution Assessed by Dilution Techniques in Athletes. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17030759"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s00421-001-0570-4","article-title":"Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis","volume":"86","author":"Selberg","year":"2002","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/ajcn\/72.2.496","article-title":"Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment","volume":"72","author":"Schwenk","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clnu.2010.09.010","article-title":"Hand grip strength: Outcome predictor and marker of nutritional status","volume":"30","author":"Norman","year":"2011","journal-title":"Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1080\/165019701300006524","article-title":"Intra- and inter-tester reliability and reference values for hand strength","volume":"33","author":"Peolsson","year":"2001","journal-title":"J. Rehabil. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/S0363-5023(84)80146-X","article-title":"Reliability and validity of grip and pinch strength evaluations","volume":"9","author":"Mathiowetz","year":"1984","journal-title":"J. Hand Surg Am."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.jamda.2013.06.013","article-title":"New normative values for handgrip strength: Results from the UK Biobank","volume":"14","author":"Spruit","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3261","DOI":"10.1007\/s00520-013-1894-4","article-title":"Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients","volume":"21","author":"Kilgour","year":"2013","journal-title":"Support. Care Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1139\/H08-122","article-title":"Precision and reliability of strength (Jamar vs. Biodex handgrip) and body composition (dual-energy X-ray absorptiometry vs. bioimpedance analysis) measurements in advanced cancer patients","volume":"33","author":"Trutschnigg","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jphys.2014.09.005","article-title":"Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: A systematic review","volume":"60","author":"Kirkham","year":"2014","journal-title":"J. Physiother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1093\/annonc\/mdm364","article-title":"Cancer treatment-induced alterations in muscular fitness and quality of life: The role of exercise training","volume":"18","author":"Schneider","year":"2007","journal-title":"Ann. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Toselli, S., Badicu, G., Bragonzoni, L., Spiga, F., Mazzuca, P., and Campa, F. (2020). Comparison of the Effect of Different Resistance Training Frequencies on Phase Angle and Handgrip Strength in ObeseWomen: A Randomized Controlled Trial. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17041163"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3389\/fphys.2012.00142","article-title":"Effects of physical activity and inactivity on muscle fatigue","volume":"3","author":"Bogdanis","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.ygyno.2015.05.026","article-title":"Physical activity and sedentary behavior in breast cancer survivors: New insight into activity patterns and potential intervention targets","volume":"138","author":"Phillips","year":"2015","journal-title":"Gynecol Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1200\/EDBK_237423","article-title":"Weight Management and Physical Activity for Breast Cancer Prevention and Control","volume":"39","author":"Ligibel","year":"2019","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12955-018-0882-2","article-title":"Effect of exercise on pain and functional capacity in breast cancer patients","volume":"16","author":"Reis","year":"2018","journal-title":"Health Qual. life Outcomes"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1055\/a-0574-3166","article-title":"Changes in Phase Angle and Handgrip Strength Induced by Suspension Training in Older Women","volume":"39","author":"Campa","year":"2018","journal-title":"Int. J. Sports Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis\u2014Part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/12\/4452\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:41:21Z","timestamp":1760175681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/12\/4452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,21]]},"references-count":58,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["ijerph17124452"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17124452","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,21]]}}}