Yee Xianyang Sherman, Ng Yee Sien, Allen John Carson, Latib Aisyah, Tay Ee Ling, Abu Bakar Huda Mukhlis, Ho Chien Yee Jolene, Koh Wan Cheen Charissa, Kwek Hwee Heem Theresa, Tay Laura
Duke-NUS Medical School, 20 College Road, Singapore, 169856, Singapore.
Department of Rehabilitation Medicine, Singapore General Hospital and Sengkang General Hospital, Singapore, Singapore.
Eur Rev Aging Phys Act. 2021 Jan 8;18(1):1. doi: 10.1186/s11556-020-00255-5.
The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants - Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) - with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults.
This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance.
Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = - 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = - 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = - 0.531; both p < 0.01) and dynamic balance (30CST, r = - 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05).
In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.
坐立试验（STS）已被用作肌肉减少症诊断中力量或身体机能的替代指标。本研究探讨两种常见的STS变体——五次坐立试验（5TSTS）和30秒椅子站立试验（30CST）——与握力、肌肉量和功能指标的关系，以及它们对社区居住老年人肌肉减少症患病率的影响。
这是一项对887名年龄≥50岁的社区居住成年人的横断面分析。参与者完成了一系列体能测试——5TSTS、30CST、握力、步速、用于动态平衡的计时起立行走试验（TUG）和用于心肺耐力的六分钟步行试验（6MWT）。使用多频节段生物电阻抗分析（BIA）测量肌肉量。我们对STS表现与其他体能指标和肌肉量进行了相关性分析，随后对STS表现的独立决定因素进行了多元线性回归分析。
参与者的平均年龄为67.3±7岁，女性占多数（72.9%）。STS测试与握力呈弱相关性（30CST，r = 0.290；5TSTS，r = -0.242；两者p<0.01），与步速（30CST，r = 0.517；5TSTS，r = -0.533；两者p<0.01）、耐力（30CST，r = 0.558；5TSTS，r = -0.531；两者p<0.01）和动态平衡（30CST，r = -0.501；5TSTS，r = 0.646；两者p<0.01）呈更强的相关性。肌肉量与握力相关，但与STS无关。在多元回归分析中，所有体能指标均与30CST表现独立相关。两种STS测试的表现均与肌肉量无关。使用握力或STS进行可能的肌肉减少症诊断的患病率无显著差异（30CST，25.0%；5TSTS，22.1%；握力，22.3%；p = 0.276）。当同时使用这两种指标时，患病率显著更高（42.0%；p = 0.276）。与握力相比，纳入肌肉量后确诊的肌肉减少症患病率使用STS显著更低（30CST，4.6%；5TSTS，4.1% vs.握力，7.1%；p<0.05）。
在肌肉减少症的构成中，STS测试更能代表肌肉身体机能而非肌肉力量。根据所使用的测试，可识别出不同的可能患有肌肉减少症的人群亚组。与握力相比，STS表现与肌肉量缺乏关联导致确诊的肌肉减少症患病率较低，但可能更好地反映肌肉质量的变化。
