Thursday, 14 February 2013

Body mass functional index  (BMFI)
Dr.Murali Krishna Bangalore index (MKB index)
                World health organization WHO defines health as “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”
          Modern medicine has defined clearly about various diseases but Modern medicine has failed to define Normal Health or good health. If a person is not sick then we can call him Healthy, In medical world Diseases are defined properly but Good health is still a very abstract phenomenon. What are the physical parameters for a Healthy individual?. What are the ways to define the Physical health, does All diseases fit into this definition of Health? when one analyses Modern disease like Diabetes, Hypertension, Obesity, Osteoarthritis, backaches these diseases do not fit into this definition. In all these diseases individuals are physically healthy, yet these instances are classified as diseases.  What are the physical standards for well being  and how do you assess the physical well being of an individuals. This is  a grey area that needs a greater explanation.         Every individual differs in their  physical endurance, physical performances,  and Physical Activity. physical Activity  depends on activity and functioning of the Muscles and bones of the individuals. physical performances and Activity are the sole differentiating factors between individuals across the spectrum of ages and sexes.
          We have developed so many tests to assess the functioning of the Heart, lungs, kidney, liver, Brain and other endocrine glands. Muscles and bones forms 47% of the body tissues in females and 57% of the body tissues in males, yet there are absolutely no tests to determine and assess the functioning of the Muscle sand bones. At Present basal activity levels needed to sustain normal life is not defined, Physical Performance and activity levels in healthy status and in various chronic diseases need to be defined.
          At present Muscles strength is assessed by MRC scale, this  is widely used  to test the strength of muscles.  Muscle strength is tested using the Medical Research Council (MRC) Scale, In this scale muscle strength is graded on a scale from 0 to 5. Clinical grading scale employed for functional assessments Grade 0: normal. MRC scale muscle test indicates whether muscles and its innervations are functioning or not, it depicts a neurological innervations of the muscles. Clinical grading scale employed for functional assessments Grade 0 is normal.  MRC scale does not quantify the performance and activity levels  of the muscles. Activity and function musculo skeletal tissues  is a very important indicator of level of activity in real life situation. Ultimate Human intelligence is expressed in the form of Musculoskeletal actions, these actions of human body shows the ultimate functioning  of individual to the external world, like walking, working, writing, doing, or computing or any complex task.  Thus functioning of  muscles need to be quantified to test the activity and intelligence of Human beings.
          At present Body mass index (BMI) is used widely as an indicator of good health.  Body mass index is defined as the individual's body weight divided by the square of his or her height in meters. BMI provides a simple numeric measure of a person's "fatness" or "thinness", allowing health professionals to discuss over- and under-weight problems more objectively with their patients. However, BMI has become controversial because many people, including physicians, have come to rely on its apparent numerical authority for medical diagnosis, but that was never the BMI's purpose; it is meant to be used as a simple means of classifying sedentary (physically inactive) individuals with an average body composition.
          Body Mass Index (BMI) is used by the World Health Organization (WHO) as the standard for recording obesity statistics since early 1980s, BMI has become a standard to assess the individuals in terming the individual as obese or non obese, BMI has significance that it assess the individuals risk for life style diseases like Type 2 Diabetes, hypertension, cardiovascular disease and other diseases. BMI does not take into any considerations of the physical built and functional performance of the musculoskeletal tissues.

Body Mass function index:
          First time in the world an effort is made to quantify the activity and functioning of the musculo skeletal tissues across the Human body. Muscles of the Upper limb, Muscles of the Lower limb, Muscles of the trunk are assessed for their work capacity in a systematic way. Active contraction of the muscle on bones produce actions or mechanical work, this  activity and functioning of the musculo skeletal tissues are measured using the Physics principles.
        In physics mechanical work is defined as the amount of energy transferred by a force acting through a distance in the direction of the force. If a force F that is constant with respect to time acts on an object while the object is displaced in a straight line along the length and direction of a vector d, the mechanical work done by the force on the object is the product of the vectors F and d:  Work= F*D.
          Muscles of Humans can be grouped as Muscles of the upper limb, muscles of the lower limb and muscles of the spines; these muscles form 98% of the skeletal muscles and These muscles provide major activity of the body. The activity or the functions of the muscles are assessed according to the range of motion and the activity.  
          Every individual has musculo skeletal tissues across Upper limb, Lower Limb and Thoraco-abdomen and has specific group of muscles , each group of muscles perform specific actions. An Individual is asked to undergo a series of exercises as defined , using the exercise equipments available in the market. A person is allowed to do exercise for 3 minutes per set of exercise, across various ranges of movements available in the Upper limb, Lower limb and Thoraco abdomen. each set of exercise uses unique group of muscles producing an unique movement and displace the weights attached to the exercise equipments. Weights in the exercise equipments are adjusted to the capacity of the individual and to that group of muscles, allowed to do number of repetitions depending on the endurance of that group of muscles. Total amount of work done by each group of muscles are derived by the formula W=F*D and multiplied by the number of repetitions. The total work of all groups of muscles are computed by adding the work of individual exercises.
          Definition of Body Mass function index: BMFI is defined as the amount of work done by all groups of muscles of the upper limb, all groups of muscles of the lower limb and muscles of the back by an individual in one hour of time per BMI
Work done by each group is calculated by the formula
Work = weight displaced in kilograms*distance the weight travelled* number of repetitions.
        Total work is derived by adding the total work done by each group of muscles in one hour.
BMFI= Total work done by the individual in one hour/ BMI,     
Body mass index of that individuals calculated using the formula
BMI= weight (in kilograms)/ height square,
           According to widdowson and white et al, of all human body tissues, Muscle and Bones  forms 57.1% of body tissues in males and 47.1% of body tissues in females, vital organs like Blood, Brain, heart, liver, lungs, kidneys ,skin, spleen forms a total of 16.3% of tissues in males and females, Adipose tissues form about 17.9% in males and 29.3% in females.
          Body Mass function index (BMFI) or Musculo skeletal function testing  not only a measure of  the skeletal  muscles capacity but also tests cardiovascular endurance, respiratory function, glucose metabolism, fat metabolism, and renal functions. Assessing the functional muscle strength means measuring the person’s unique activity for the whole body be it multi joint, multi muscle group, this testing of all muscles, bone, and joints of the body is  not  the just  test for musculoskeletal system but also a tests Human body as a whole. It test all other organs of the Human body.
          Bones and muscle are the only organs that consume variable energy depending on the work we do, vital organs consume energy and oxygen in a very fixed range, energy consumption by muscle and bones while doing difficult activity can rise to upto 5 times the basal levels of energy consumption. functioning of  musculo skeletal tissues also provide proper stimulus to  different organs of our body like Heart, lungs, kidney liver, brain and different endocrine glands for optimum functioning, activity of the muscle and bones make other organs to rise to the occasion and provide the logistics needed to carry out the Physical activity, Thus muscular activity is important for indicator of  the functional capacity of the body as a whole
          Musculo skeletal activity levels is not quantified in any of the chronic diseases like Diabetes, Hypertension, osteoarthritis of the Hip Knee, obesity and in any other diseases. Muscular activity is an important criteria which determines the outcome of the prognosis of any diseases. well built and young people come out of any difficult surgeries yet in older people the outcome is so uncertain. Hence measuring the Physical activity is an important event in medical field. 
Assessing the functional muscle strength means measuring the person’s unique activity for the whole body be it multi joint, multi muscle group, this testing of all muscles, bone, and joints of the body is  not  the test for musculoskeletal system but also a test for other organs of the body and issues like glucose metabolism, fat metabolism, and renal functions.
The significance of the present innovation Body Mass Functional Index (BMFI):
          Determining the Body Mass Functional Index (BMFI)  of an individual is provides a valuable insights about the activity levels of the individual, It measures the full functional activity of the Human body. Body Mass Functional Index (BMFI) assesses the individuals functional activity of every organ of the body, it determines the activity of the musculo skeletal tissues, Heart, Lungs, kidneys, Brain and all other vital organs. Body Mass Functional Index (BMFI) also asses the glucose, fat, and protein metabolism. in a way Body Mass Functional Index (BMFI) estimates the full functioning of the body as a whole.
          Body Mass Functional Index (BMFI) paves the way of diagnosing the life style diseases by the determining the person’s Body Mass Functional Index (BMFI), any low Body Mass Functional Index (BMFI) can be an indicator of predisposition to life style diseases. Body Mass Functional Index (BMFI) determination can accurately predict the chances of getting life style diseases in near future.  by improving the  Body Mass Functional Index (BMFI) one can treat life style diseases by prescribing the muscle building exercises. Body Mass Functional Index (BMFI) is useful in geriatrics and  old aged patients. Most of the diseases of old age people may be a consequence of loss  bulk of their muscle bulk. systematically improving the Body Mass Functional Index (BMFI) by all round exercises provide  geriatric people to improve their muscle bulk.
          Thus Body Mass Functional Index (BMFI) can test the functioning of the whole body, improving the Body Mass Functional Index (BMFI) can prevent diseases improve the life expectancy and quality of Human life. Body Mass Functional Index (BMFI) has lot of significance in this modern technological world in serving the humanity to live the fullest of their potentials.

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