Kitamura Gakuto, Nankaku Manabu, Yuri Takuma, Kawano Takumi, Kuriyama Shinichi, Nakamura Shinichiro, Nishitani Kohei, Ikeguchi Ryosuke, Matsuda Shuichi
Rehabilitation Unit, Kyoto University Hospital, Japan.
Rehabilitation Unit, Kyoto University Hospital, Japan.
Clin Nutr ESPEN. 2024 Dec;64:418-424. doi: 10.1016/j.clnesp.2024.10.160. Epub 2024 Oct 31.
BACKGROUND & AIMS: This study aimed to clarify the association between physical activity (PA) and physical functions, including both muscle quantity and quality of ankle plantar flexor muscles in patients with knee osteoarthritis (OA).
A retrospective cohort study was conducted with ninety-two patients with knee OA. PA, leg muscle cross-sectional area (CSA), knee strength, passive knee angle, and knee pain of the affected side were assessed. PA was assessed by the 2011 Knee Society scoring system. CSA of the quadriceps and ankle plantar flexor muscles on the affected side was measured using a computed tomography image. Based on muscle attenuation assessed with Hounsfield units (HU), the muscle quality of targeted muscle was divided into 4 groups as follows: fat tissue (-190 to -30 HU), very low-density muscle (-29 to -1 HU), low-density muscle (0 to 34 HU), and normal-density muscle (NDM, 35 to 100 HU). The CSA was obtained for each of the 4 groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with PA.
The regression analysis revealed that higher PA was independently associated with the NDM CSA of ankle plantar flexor (β = 0.51), higher knee extension strength (β = 0.28), and milder knee pain (β = -0.29) after adjustment with age, sex, height, weight, and body mass index.
The present study suggested that NDM CSA of ankle plantar flexor in addition to knee function is one of the factors determining the PA in patients with knee OA.
本研究旨在阐明膝关节骨关节炎（OA）患者的身体活动（PA）与身体功能之间的关联，包括踝关节跖屈肌的肌肉量和质量。
对92例膝关节OA患者进行了一项回顾性队列研究。评估了PA、腿部肌肉横截面积（CSA）、膝关节力量、被动膝关节角度和患侧膝关节疼痛情况。PA通过2011年膝关节协会评分系统进行评估。使用计算机断层扫描图像测量患侧股四头肌和踝关节跖屈肌的CSA。根据用亨氏单位（HU）评估的肌肉衰减情况，将目标肌肉的肌肉质量分为以下4组：脂肪组织（-190至-30 HU）、极低密度肌肉（-29至-1 HU）、低密度肌肉（0至34 HU）和正常密度肌肉（NDM，35至100 HU）。获取了这4组中每组的CSA。进行单因素和多因素线性回归分析以确定与PA相关的因素。
回归分析显示，在对年龄、性别、身高、体重和体重指数进行调整后，较高的PA与踝关节跖屈肌的NDM CSA独立相关（β = 0.51）、较高的膝关节伸展力量（β = 0.28）和较轻的膝关节疼痛（β = -0.29）。
本研究表明，除膝关节功能外，踝关节跖屈肌的NDM CSA是决定膝关节OA患者PA的因素之一。
