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肌少症与髋部骨折住院康复患者平衡的相关性:一项回顾性队列研究。

Association between Sarcopenia and Balance in Patients Undergoing Inpatient Rehabilitation after Hip Fractures: A Retrospective Cohort Study.

机构信息

Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan.

Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan.

出版信息

Medicina (Kaunas). 2024 Apr 29;60(5):742. doi: 10.3390/medicina60050742.

Abstract

Sarcopenia is characterized by a decline in skeletal muscle mass, strength, and function and is associated with advancing age. This condition has been suggested as a factor that negatively influences the functional outcomes of patients with hip fractures. However, the association between sarcopenia and balance impairment in patients undergoing inpatient rehabilitation after hip fractures remains unclear. In this retrospective cohort study, we aimed to investigate the impact of sarcopenia on balance outcomes in patients undergoing inpatient rehabilitation following hip fractures. Baseline sarcopenia was diagnosed using skeletal muscle mass index and handgrip strength, with cut-off values recommended by the Asian Working Group for Sarcopenia. The primary outcome was balance, which was assessed using the Berg Balance Scale (BBS) at the time of discharge. A multiple linear regression model analyzed the association between sarcopenia and balance. The model was adjusted for age, sex, comorbidities, and cognitive function. Among the 62 patients (mean age: 78.2; sex: 75.8% women), 24.2% had sarcopenia. Patients with sarcopenia had significantly lower BBS scores than did those without sarcopenia (41 vs. 49 points, = 0.004). Multiple linear regression analysis revealed that baseline sarcopenia was independently associated with BBS scores at discharge (β = -0.282, = 0.038). Following inpatient rehabilitation, patients with baseline sarcopenia had inferior balance outcomes than did those without sarcopenia at discharge. Sarcopenia should be assessed on admission to consider and provide additional care for those with a higher risk of poor functional outcomes. More studies are needed to investigate the association between sarcopenia and functional outcomes, examine the impact of sarcopenia treatment on these outcomes, and reduce the risk of recurrent falls and fractures in patients with hip fractures.

摘要

肌肉减少症的特征是骨骼肌质量、力量和功能下降,与年龄增长有关。这种情况被认为是影响髋部骨折患者功能预后的一个负面因素。然而,髋部骨折患者在住院康复期间肌肉减少症与平衡障碍之间的关系尚不清楚。在这项回顾性队列研究中,我们旨在研究肌肉减少症对髋部骨折后住院康复患者平衡结局的影响。 使用骨骼肌质量指数和握力来诊断基线肌肉减少症,使用亚洲肌肉减少症工作组推荐的临界值。主要结局是平衡,在出院时使用 Berg 平衡量表(BBS)进行评估。使用多元线性回归模型分析肌肉减少症与平衡之间的关系。该模型调整了年龄、性别、合并症和认知功能。 在 62 名患者(平均年龄:78.2 岁;性别:75.8%为女性)中,24.2%患有肌肉减少症。患有肌肉减少症的患者 BBS 评分明显低于没有肌肉减少症的患者(41 分与 49 分, = 0.004)。多元线性回归分析显示,基线肌肉减少症与出院时 BBS 评分独立相关(β = -0.282, = 0.038)。 在住院康复后,与没有肌肉减少症的患者相比,基线肌肉减少症患者在出院时的平衡结果较差。在入院时应评估肌肉减少症,为那些功能预后较差风险较高的患者提供额外的护理。需要更多的研究来研究肌肉减少症与功能预后之间的关系,检查肌肉减少症治疗对这些结果的影响,并降低髋部骨折患者再次跌倒和骨折的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbc/11123061/507d1e28a4bf/medicina-60-00742-g001.jpg

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