Department of Radiology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.
Aging Clin Exp Res. 2022 Sep;34(9):2099-2105. doi: 10.1007/s40520-022-02156-2. Epub 2022 Jun 6.
Although the loss of skeletal limb muscle mass and muscle strength in the elderly have been demonstrated, the aging process of the back muscles to maintain core stability is not well known. This 1-year prospective observational study aimed to investigate the natural aging course of the lumbar extensor muscles (LEMs) compared with the extremity muscles and determine whether muscle strength or mass decreases more in community-dwelling older women.
Twenty-four older urban-dwelling women aged 70 years or older were initially enrolled. Their demographic variables, conventional and spinal sarcopenia indices, and functional outcome parameters were evaluated. We also measured back extensor strength, radiological parameters for spinal sagittal balance on whole-spine radiography, and volumetric parameters of the LEM on computed tomography.
After the exclusion of 6 subjects, 18 older women were finally analyzed. All variables related to extremity muscle mass, muscle strength, physical performance, and LEM volume declined over the study period, but the changes were insignificant. However, back extensor strength decreased significantly (median, first, and third quartile: 35.20 [30.80, 44.00] N to 31.40 [29.25, 37.90] N, P = 0.026). Among spinal sagittal balance-related parameters, lumbar lordosis (44.25 [39.30, 47.35]° to 43.15 [31.43, 45.75]°, P = 0.043) and sagittal vertical axis (33.85 [3.57, 58.75] mm to 45.15 [25.35, 58.68] mm, P = 0.004) showed significant changes during the study.
When the natural aging course of LEM in women aged 70 years or older was observed for 1 year, muscle mass decreased less than back extensor strength and spinal sagittal balance. Measurements of back extensor strength and spinal sagittal balance are necessary for the clinical evaluation of spinal aging.
尽管老年人的四肢骨骼肌质量和肌肉力量已经得到证实，但背部肌肉维持核心稳定性的衰老过程尚不清楚。本项为期 1 年的前瞻性观察研究旨在探讨与四肢肌肉相比，腰椎伸肌（LEM）的自然老化过程，并确定在社区居住的老年女性中，肌肉力量还是质量下降更为明显。
最初纳入了 24 名年龄在 70 岁或以上的城市居住的老年人。评估了他们的人口统计学变量、常规和脊柱肌少症指数以及功能结局参数。我们还测量了腰背伸肌力量、全脊柱 X 线片上脊柱矢状平衡的放射学参数以及 CT 上 LEM 的容积参数。
排除 6 名受试者后，最终分析了 18 名老年女性。所有与四肢肌肉质量、肌肉力量、身体表现和 LEM 体积相关的变量在研究期间均呈下降趋势，但变化不明显。然而，腰背伸肌力量显著下降（中位数、第一四分位数和第三四分位数：35.20 [30.80，44.00] N 至 31.40 [29.25，37.90] N，P=0.026）。在与脊柱矢状平衡相关的参数中，腰椎前凸（44.25 [39.30，47.35]°至 43.15 [31.43，45.75]°，P=0.043）和矢状垂直轴（33.85 [3.57，58.75] mm 至 45.15 [25.35，58.68] mm，P=0.004）在研究期间均有显著变化。
当观察 70 岁或以上女性的 LEM 自然老化过程 1 年时，肌肉质量的下降幅度小于腰背伸肌力量和脊柱矢状平衡。腰背伸肌力量和脊柱矢状平衡的测量对于脊柱老化的临床评估是必要的。
