Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
Postgraduate Program in Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
Aging Clin Exp Res. 2020 Jun;32(6):1067-1076. doi: 10.1007/s40520-019-01296-2. Epub 2019 Aug 30.
Despite the clinical importance, it has remained unclear which changes in the trunk muscle function parameters are more associated with the presence of vertebral fracture (VF).
The aim of this study was to verify the association between the trunk muscle function performance and the presence of VF in older women with low bone mass. The secondary aim was to evaluate the correlation between trunk muscle function and both fall history and muscle mass.
This cross-sectional study was composed by 94 women over 60 years within value of T-Score lumbar spine BMD <- 1.0 DP. Multidimensional evaluations were performed: appendicular skeletal muscle mass index (ASMI) was determined by the total body DEXA; the radiographic evaluations measured the degree of thoracic kyphosis and classification of VF. The trunk muscle function parameters, such as peak torque (PT), rate of torque development (RTD) and torque steadiness (TS) were evaluated by isokinetic dynamometer. The trunk muscle endurance was evaluated by the timed loaded standing test. The adjusted multivariate logistic regression model and multivariate linear regression were performed to verify the association between the variables studied.
The results showed that the trunk muscle function parameter with greater association with the presence of VF is TS extensors (OR = 1.70; p < 0.001). The other two significant muscle parameters were: RTD flexors (OR = 0.31; p = 0.033) and PT extensors (OR = 0.13; p = 0.009). No statistical association was found between the presence of VF and the ASMI and trunk muscle endurance. No correlation between trunk muscle function and fall history was observed. There was a weak correlation between ASMI and extensor PT (R = 0.21; p = 0.027) and extensor RTD (R = 0.21; p = 0.026).
This study demonstrated that deficit in trunk muscle function has shown a strong association with the presence of VF, highlighting issues heretofore unexplored regarding the association between VF with muscle power and motor control.
尽管临床意义重大，但仍不清楚躯干肌肉功能参数的哪些变化与椎体骨折（VF）的存在更相关。
本研究旨在验证骨量低的老年女性躯干肌肉功能表现与 VF 存在的相关性。次要目的是评估躯干肌肉功能与既往跌倒史和肌肉质量之间的相关性。
这项横断面研究由 94 名 T 评分腰椎骨密度 <-1.0 DP 的 60 岁以上女性组成。进行了多维评估：四肢骨骼肌质量指数（ASMI）通过全身 DEXA 确定；放射学评估测量了胸椎后凸程度和 VF 分类。通过等速测力计评估躯干肌肉功能参数，如峰值扭矩（PT）、扭矩发展率（RTD）和扭矩稳定性（TS）。躯干肌肉耐力通过计时负重站立测试进行评估。进行调整后的多变量逻辑回归模型和多变量线性回归以验证所研究变量之间的关联。
结果表明，与 VF 存在相关性最强的躯干肌肉功能参数是伸肌 TS（OR=1.70；p<0.001）。另外两个重要的肌肉参数是：屈肌 RTD（OR=0.31；p=0.033）和伸肌 PT（OR=0.13；p=0.009）。VF 的存在与 ASMI 和躯干肌肉耐力之间没有统计学关联。VF 的存在与既往跌倒史之间没有相关性。躯干肌肉功能与跌倒史之间没有相关性。ASMI 与伸肌 PT（R=0.21；p=0.027）和伸肌 RTD（R=0.21；p=0.026）之间存在弱相关性。
本研究表明，躯干肌肉功能缺陷与 VF 的存在有很强的关联，突出了以前尚未探讨过的 VF 与肌肉力量和运动控制之间的关联问题。
