Mokhtarzadeh Hossein, Anderson Dennis E
Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.
Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RN115, Boston, MA, 02215, USA.
Curr Osteoporos Rep. 2016 Jun;14(3):67-76. doi: 10.1007/s11914-016-0305-4.
This review examines the current evidence for associations between vertebral fractures (VFx), the most common type of fracture in older adults, and trunk muscles, which are intimately tied to spinal loading and function. Individuals with prevalent VFxs have more fat infiltration in the trunk muscles, lower trunk extension strength, and altered muscle activation patterns. However, no longitudinal studies have examined whether assessment of trunk muscle can contribute to prediction of fracture risk. A few studies report that exercise interventions targeting the trunk muscles can reduce the risk of VFx, improve trunk strength and endurance in patients who have had a VFx, and reduce the risk of falling, a common cause of VFx, but the quality of evidence is low. Trunk muscles likely have an important role to play in prediction, prevention, and management of VFx, but additional longitudinal studies and randomized controlled trials are needed to clarify this role.
本综述探讨了老年人中最常见的骨折类型——椎体骨折（VFx）与躯干肌肉之间关联的现有证据，躯干肌肉与脊柱负荷及功能密切相关。患有椎体骨折的个体，其躯干肌肉中有更多的脂肪浸润，躯干伸展力量较低，且肌肉激活模式改变。然而，尚无纵向研究考察躯干肌肉评估是否有助于预测骨折风险。一些研究报告称，针对躯干肌肉的运动干预可降低椎体骨折风险，改善椎体骨折患者的躯干力量和耐力，并降低跌倒风险（椎体骨折的常见原因），但证据质量较低。躯干肌肉可能在椎体骨折的预测、预防和管理中发挥重要作用，但需要更多纵向研究和随机对照试验来阐明这一作用。
