Schröder Guido, Flachsmeyer Dirk, Bende Anne, Andresen Julian Ramin, Andresen Reimer, Schober Hans-Christof
Klinik für Orthopädie und Unfallchirurgie, Warnow Klinik Bützow, Am Forsthof 3, 18246, Bützow, Deutschland.
Medizinische Fakultät, Universität Rostock, Rostock, Deutschland.
Orthopadie (Heidelb). 2023 Jan;52(1):54-64. doi: 10.1007/s00132-022-04329-3. Epub 2022 Nov 29.
Osteoporosis (OP) in the elderly is accompanied by reduced muscle mass and reduced muscle strength, also known as sarcopenia. This results in functional limitations and a high risk of falls and injuries. The determination of physical performance parameters such as grip strength and trunk strength on the one hand, and balance abilities on the other, provide information about the individual's general neuromuscular condition and serve as an indicator of physical performance in the elderly. The extent to which previous osteoporotic vertebral fractures (VFs) restrict an individual's physical performance has not been adequately investigated yet.
In total, 118 persons, with a mean age of 71.5 ± 9 years, participated in the clinical trial (ethics committee approval number A2020-0041). Patients were divided into an OP group (58 patients) and a control group (CG; 60 patients). OP patients with (VFs) and without vertebral fractures (0VFs) were viewed separately in the subgroup analysis. Data concerning physical status, including hand grip strength (HGS), the chair-rising test (CRT), tandem stance (TS), tandem gait (TG), and single-leg stance (SLS) were available for all patients. All data were analyzed using SPSS, Version 23.0.
No significant difference (p > 0.05) was registered between the OP and CG groups with regard of HGS, CRT, TG, TS, and SLS. In the subgroup analysis, OP patients with VFs had a lower HGS than OP patients without 0 VFx (VFs 24.3 ± 10.2 kg vs. 0 VFs 29.7 ± 9.5 kg, p = 0.026). TS was maintained longer by OP patients 0 VFs (VFs 7.8 ± 3.2 s vs. 0 VFs 9.5 ± 1.8 s, p = 0.008). The latter were also able to maintain their balance in TG over more numerous steps (VFs 4.8 ± 3.0 vs. 0 VFs 6.7 ± 2.4, p = 0.011). In a regression analysis, body size, gender, and age were shown to be independent factors influencing HGS (p < 0.001).
Patient age, constitution, and gender have a relevant influence on HGS, with baseline conditions after diagnosed OP at comparable levels in this age group. In a subgroup of OP patients with VFs, there is a close relationship between bone and muscle with an increasing deterioration of the musculoskeletal system. For prophylaxis of osteosarcopenia, early training seems reasonable.
老年人骨质疏松症(OP)伴有肌肉量减少和肌肉力量下降,即肌肉减少症。这会导致功能受限以及跌倒和受伤的高风险。一方面,测定诸如握力和躯干力量等身体性能参数,另一方面测定平衡能力,可提供有关个体总体神经肌肉状况的信息,并作为老年人身体性能的指标。既往骨质疏松性椎体骨折(VFs)对个体身体性能的限制程度尚未得到充分研究。
共有118名平均年龄为71.5±9岁的患者参与了该临床试验(伦理委员会批准号A2020 - 0041)。患者被分为OP组(58例患者)和对照组(CG;60例患者)。在亚组分析中,分别观察了有椎体骨折(VFs)和无椎体骨折(0VFs)的OP患者。所有患者均有关于身体状况的数据,包括握力(HGS)、从椅子上起身测试(CRT)、串联站立(TS)、串联步态(TG)和单腿站立(SLS)。所有数据均使用SPSS 23.0版进行分析。
OP组和CG组在HGS、CRT、TG、TS和SLS方面无显著差异(p>0.05)。在亚组分析中,有VFs的OP患者的HGS低于无0VFx的OP患者(VFs组为24.3±10.2kg,0VFs组为29.7±9.5kg,p = 0.026)。0VFs的OP患者保持TS的时间更长(VFs组为7.8±3.2秒,0VFs组为9.5±1.8秒,p = 0.008)。后者在TG中也能在更多步数上保持平衡(VFs组为4.8±3.0,0VFs组为6.7±2.4,p = 0.011)。在回归分析中,体型、性别和年龄被证明是影响HGS的独立因素(p<0.001)。
患者年龄、体质和性别对HGS有显著影响,在该年龄组中,OP诊断后的基线状况处于可比水平。在有VFs的OP患者亚组中,骨骼与肌肉之间存在密切关系,肌肉骨骼系统的恶化程度不断增加。对于预防骨质疏松性肌肉减少症,早期训练似乎是合理的。