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类风湿关节炎患者的股四头肌特性:对肌肉形态、激活和功能能力的深入了解。

Quadriceps muscle properties in rheumatoid arthritis: insights about muscle morphology, activation and functional capacity.

机构信息

Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Adv Rheumatol. 2020 May 19;60(1):28. doi: 10.1186/s42358-020-00132-w.

Abstract

BACKGROUND

Rheumatoid arthritis (RA) is an inflammatory and chronic autoimmune disease that leads to muscle mass loss and functional capacity impairment, potentiated by physical inactivity. Despite evidences demonstrate neuromuscular impairments in RA patients, aging effects may have masked the results of similar previous studies. The aim of study was to verify (i) the effects of RA on functional capacity and muscle properties in middle-aged patients and (ii) the association between age, clinical characteristics, quadriceps muscle properties and functional capacity.

METHODS

Thirty-five RA women and 35 healthy age-matched women were compared with the following outcomes: (i) physical activity level through the International Physical Activity Questionnaire (IPAQ); (ii) timed-up and go (TUG) test; (iii) isometric knee extensor muscular strength; and (iv) vastus lateralis muscle activation and muscle architecture (muscle thickness, pennation angle and fascicle length) during an isometric test. An independent Student t-test and partial correlation (controlled by physical activity levels) were performed, with p < 0.05.

RESULTS

Compared with healthy women, RA presented (i) lower physical activity level (- 29.4%; p < 0.001); (ii) lower isometric knee extensor strength (- 20.5%; p < 0.001); (iii) lower TUG performance (- 21.7%; p < 0.001); (iv) smaller muscle thickness (- 23.3%; p < 0.001) and pennation angle (- 14.1%; p = 0.011). No differences were observed in muscle activation and fascicle length. Finally, the correlation demonstrated that, with exception of TUG, muscle strength and muscle morphology were not associated with age in RA, differently from healthy participants.

CONCLUSION

Middle-aged RA patients' impairments occurred due to the disease independently of the aging process, except for functional capacity. Physical inactivity may have potentiated these losses.

摘要

背景

类风湿关节炎(RA)是一种炎症性和慢性自身免疫性疾病,会导致肌肉质量下降和功能能力受损,而身体活动不足会使其恶化。尽管有证据表明 RA 患者存在神经肌肉损伤,但衰老的影响可能掩盖了之前类似研究的结果。本研究的目的是验证(i)RA 对中年患者功能能力和肌肉特性的影响,以及(ii)年龄、临床特征、股四头肌特性和功能能力之间的相关性。

方法

比较 35 名 RA 女性和 35 名年龄匹配的健康女性,结果包括:(i)通过国际体力活动问卷(IPAQ)评估体力活动水平;(ii)计时起立行走测试(TUG);(iii)等长膝关节伸肌肌力;(iv)等长测试时股外侧肌激活和肌肉结构(肌肉厚度、肌纤维角和肌束长度)。进行独立学生 t 检验和偏相关(控制体力活动水平),p<0.05。

结果

与健康女性相比,RA 呈现出(i)较低的体力活动水平(-29.4%;p<0.001);(ii)较低的等长膝关节伸肌力量(-20.5%;p<0.001);(iii)TUG 表现更差(-21.7%;p<0.001);(iv)肌肉厚度较小(-23.3%;p<0.001)和肌纤维角较小(-14.1%;p=0.011)。肌肉激活和肌束长度没有差异。最后,相关性表明,除了 TUG 外,肌肉力量和肌肉形态与 RA 患者的年龄无关,与健康参与者不同。

结论

中年 RA 患者的损伤是由疾病引起的,与衰老过程无关,除了功能能力。身体活动不足可能加剧了这些损失。

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