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Mongold SJ, Georgiev C, Naeije G, Vander Ghinst M, Stock MS, Bourguignon M. Age-related changes in ultrasound-assessed muscle composition and postural stability. Sci Rep 2024; 14:18688. [PMID: 39134635 PMCID: PMC11319795 DOI: 10.1038/s41598-024-69374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
While the simultaneous degradation of muscle composition and postural stability in aging are independently highly investigated due to their association with fall risk, the interplay between the two has received little attention. Thus, the purpose of this study is to explore how age-related changes in muscle composition relate to postural stability. To that aim, we collected posturography measures and ultrasound images of the dominant Vastus Lateralis and Biceps Brachii from 32 young (18-35 year old) and 34 older (65-85 year old) participants. Muscle properties were quantified with echo-intensity and texture-based metrics derived from gray-level co-occurrence matrix analysis, and postural stability with the variability of the center of pressure during bipedal stance tasks. Ultrasound parameters revealed that young muscle possessed lower echo-intensity and higher homogeneity compared to the elderly. Echo-intensity and muscle thickness, and several texture-based parameters possessed outstanding young versus older classification performance. A canonical correlation analysis demonstrated a significant relationship between ultrasound and postural measures only within the young group (r = 0.53, p < 0.002), where those with 'better' muscle composition displayed larger postural sways. Our results indicate that, in older individuals, postural stability and muscle composition, two common fall risk factors, are unrelated. In view of this decoupling, both may contribute independently to fall risk. Furthermore, our data support the view that texture-based parameters provide a robust alternative to echo-intensity in providing markers of muscle composition.
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Affiliation(s)
- Scott J Mongold
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium.
| | - Christian Georgiev
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Gilles Naeije
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Centre de Référence Neuromusculaire, Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Marc Vander Ghinst
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Service d'ORL et de Chirurgie Cervico-Faciale, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Matt S Stock
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, Florida, 32816, USA
| | - Mathieu Bourguignon
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- BCBL, Basque Center on Cognition, Brain and Language, 20009, San Sebastian, Spain
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Rodriguez C, Mota JD, Palmer TB, Heymsfield SB, Tinsley GM. Skeletal muscle estimation: A review of techniques and their applications. Clin Physiol Funct Imaging 2024; 44:261-284. [PMID: 38426639 DOI: 10.1111/cpf.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Quantifying skeletal muscle size is necessary to identify those at risk for conditions that increase frailty, morbidity, and mortality, as well as decrease quality of life. Although muscle strength, muscle quality, and physical performance have been suggested as important assessments in the screening, prevention, and management of sarcopenic and cachexic individuals, skeletal muscle size is still a critical objective marker. Several techniques exist for estimating skeletal muscle size; however, each technique presents with unique characteristics regarding simplicity/complexity, cost, radiation dose, accessibility, and portability that are important factors for assessors to consider before applying these modalities in practice. This narrative review presents a discussion centred on the theory and applications of current non-invasive techniques for estimating skeletal muscle size in diverse populations. Common instruments for skeletal muscle assessment include imaging techniques such as computed tomography, magnetic resonance imaging, peripheral quantitative computed tomography, dual-energy X-ray absorptiometry, and Brightness-mode ultrasound, and non-imaging techniques like bioelectrical impedance analysis and anthropometry. Skeletal muscle size can be acquired from these methods using whole-body and/or regional assessments, as well as prediction equations. Notable concerns when conducting assessments include the absence of standardised image acquisition/processing protocols and the variation in cut-off thresholds used to define low skeletal muscle size by clinicians and researchers, which could affect the accuracy and prevalence of diagnoses. Given the importance of evaluating skeletal muscle size, it is imperative practitioners are informed of each technique and their respective strengths and weaknesses.
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Affiliation(s)
- Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob D Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Steven B Heymsfield
- Metabolism and Body Composition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Simó-Servat A, Ibarra M, Libran M, Escobar L, Perea V, Quirós C, Puig-Jové C, Barahona MJ. Prospective Study to Evaluate Rectus Femoris Muscle Ultrasound for Body Composition Analysis in Patients Undergoing Bariatric Surgery. J Clin Med 2024; 13:3763. [PMID: 38999329 PMCID: PMC11242698 DOI: 10.3390/jcm13133763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and consequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study was to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evaluation of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aimed to demonstrate how MUS of RFT correlates with quality of life (QoL) in this population, likely due to its ability to detect regional quadriceps muscle sarcopenia compared to the other mentioned methods. Methods: This was a prospective pilot study that included 77 participants (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA, and RFT was measured by MUS. Moreover, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was assessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p = 0.001). Firstly, we observed a positive correlation pre-surgery between HOMA and RFT (r = 0.27, p = 0.02), iFFM (r = 0.36, p = 0.001), AMI (r = 0.31, p = 0.01) and dynamometer readings (r = 0.26, p = 0.02). In addition, we found a correlation between RFT and iFFM (pre-surgery: r = 0.31, p = 0.01; post-surgery: r = 0.25, p = 0.05) and between RFT and lower-extremity AMI post-surgery (r = 0.27, p = 0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p = 0.001), but not in dynamometer readings (p = 0.94). Finally, a tendency to a positive correlation between QoL questionnaire and RFT post-surgery results (r = 0.23, p = 0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS is useful for evaluating SO and for the follow-up of these patients after BS. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.
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Affiliation(s)
- Andreu Simó-Servat
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Montse Ibarra
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Mireia Libran
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Lilian Escobar
- Department of General Surgery, Hospital Universitari MútuaTerrassa, 08221 Terrassa, Spain;
| | - Verónica Perea
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Carmen Quirós
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Carlos Puig-Jové
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
| | - Maria-José Barahona
- Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (V.P.); (C.Q.); (C.P.-J.)
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Parkington T, Broom D, Maden-Wilkinson T, Nawaz S, Klonizakis M. Evaluating the between-day reliability and likelihood of change of a test battery incorporating vastus lateralis muscle thickness, ankle-brachial pressure index, maximal voluntary torque, and six-minute walk test in patients with claudication. Vascular 2024:17085381241257735. [PMID: 38807381 DOI: 10.1177/17085381241257735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
OBJECTIVE The study aims to evaluate the between-day reliability of a proposed test battery for patients with claudication that can be used for monitoring the effectiveness of exercise interventions and other therapeutic strategies tailored to this patient population. METHODS Twenty-five men with claudication were recruited. The test battery consisted of the Vastus Lateralis muscle thickness (VL-MT), ankle-brachial pressure index (ABI), unilateral isometric knee extension maximal voluntary torque (MVT) and 6-minute walk test (6MWT). A single investigator conducted the tests for each patient on two separate testing sessions (T1 and T2) 5-7 days apart. RESULTS Good to excellent reliability was observed for VL-MT (ICC = 0.95, 95% LOA = ±3.10 mm, SEM = 0.81 mm), ABI (ICC = 0.97, 95% LOA = ±0.10, SEM = 0.02), MVT (ICC = 0.97, 95% LOA = ±24.0 N·m, SEM = 6.31 N·m), 6MWT distance (ICC = 0.99, 95% LOA = ±39.6 m, SEM = 11.0 m), 6MWT time to claudication (ICC = 0.99, 95% LOA = ±30.8 s, SEM = 7.8 s), and 6MWT ratings of pain (ICC = 0.87, 95% LOA = ±2.4 CR-10+, SEM = 0.7 CR-10+ ). Analysis derived from reliability data indicates a change of 1.4 mm for VL-MT, 0.14 for ABI, 12 N·m for MVT, 25 m for 6MWT distance, 15 s for 6MWT time to claudication and 1 CR-10+ for 6MWT ratings of pain is required to be interpreted as the minimum 'likely' change (76% chance). CONCLUSIONS The test battery provides a reliable assessment of patients with claudication and can be widely used to evaluate the effects of exercise programmes and other therapeutic interventions. For the individual, changes in VL-MT, ABI, MVT, and 6MWT greater than the minimum likely change as a result of an exercise programme or an intervention are likely changes and less influenced by error associated with the test.
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Affiliation(s)
- Thomas Parkington
- Physical Activity, Wellness and Public Health Research Group, School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK
| | - David Broom
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Thomas Maden-Wilkinson
- Physical Activity, Wellness and Public Health Research Group, School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK
| | - Shah Nawaz
- Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Markos Klonizakis
- Lifestyle, Exercise and Nutrition Improvement Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
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5
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Barry DJ, Farragher JB, Betik AC, Fyfe JJ, Convit L, Cooke MB. Investigating the effects of synbiotic supplementation on functional movement, strength and muscle health in older Australians: a study protocol for a double-blind, randomized, placebo-controlled trial. Trials 2024; 25:307. [PMID: 38715143 PMCID: PMC11077830 DOI: 10.1186/s13063-024-08130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Aging has been associated with a progressive loss of skeletal muscle quality, quantity and strength, which may result in a condition known as sarcopenia, leading to a decline in physical performance, loss of independence and reduced quality of life. While the cause of impaired physical functioning observed in elderly populations appears to be multifactorial, recent evidence suggests that age-associated alterations in gut microbiota could be a contributing factor. The primary objective will be to assess the effects of a dietary synbiotic formulation on sarcopenia-related functional outcomes such as handgrip strength, gait speed and physical performance within older individuals living independently. The secondary objective will be to examine associations between changes in gut microbiota composition, functional performance and lean muscle mass. METHODS Seventy-four elderly (60-85 years) participants will be randomized in a double-blind, placebo-controlled fashion to either an intervention or control group. The intervention group (n = 37) will receive oral synbiotic formulation daily for 16 weeks. The control group (n = 37) will receive placebo. Assessments of physical performance (including Short Physical Performance Battery, handgrip strength and timed up-and-go tests) and muscle ultrasonography will be performed at 4 time points (baseline and weeks 8, 16 and 20). Likewise, body composition via bioelectric impedance analysis and blood and stool samples will be collected at each time point. Dual-energy X-ray absorptiometry will be performed at baseline and week 16. The primary outcomes will be between-group changes in physical performance from baseline to 16 weeks. Secondary outcomes include changes in body composition, muscle mass and architecture, fecal microbiota composition and diversity, and fecal and plasma metabolomics. DISCUSSION Gut-modulating supplements appear to be effective in modifying gut microbiota composition in healthy older adults. However, it is unclear whether these changes translate into functional and/or health improvements. In the present study, we will investigate the effects of a synbiotic formulation on measures of physical performance, strength and muscle health in healthy older populations. TRIAL REGISTRATION This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000652774) in May 2022.
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Affiliation(s)
- David J Barry
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Joshua B Farragher
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Jackson J Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Lilia Convit
- Centre for Sports Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Matthew B Cooke
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia.
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Sabatino A, Sola KH, Brismar TB, Lindholm B, Stenvinkel P, Avesani CM. Making the invisible visible: imaging techniques for assessing muscle mass and muscle quality in chronic kidney disease. Clin Kidney J 2024; 17:sfae028. [PMID: 38444750 PMCID: PMC10913944 DOI: 10.1093/ckj/sfae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Indexed: 03/07/2024] Open
Abstract
Muscle wasting and low muscle mass are prominent features of protein energy wasting (PEW), sarcopenia and sarcopenic obesity in patients with chronic kidney disease (CKD). In addition, muscle wasting is associated with low muscle strength, impaired muscle function and adverse clinical outcomes such as low quality of life, hospitalizations and increased mortality. While assessment of muscle mass is well justified, the assessment of skeletal muscle should go beyond quantity. Imaging techniques provide the means for non-invasive, comprehensive, in-depth assessment of the quality of the muscle such as the infiltration of ectopic fat. These techniques include computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Dual energy X-ray absorptiometry is also an imaging technique, but one that only provides quantitative and not qualitative data on muscle. The main advantage of imaging techniques compared with other methods such as bioelectrical impedance analysis and anthropometry is that they offer higher precision and accuracy. On the other hand, the higher cost for acquiring and maintaining the imaging equipment, especially CT and MRI, makes these less-used options and available mostly for research purposes. In the field of CKD and end-stage kidney disease (ESKD), imaging techniques are gaining attention for evaluating muscle quantity and more recently muscle fat infiltration. This review describes the potential of these techniques in CKD and ESKD settings for muscle assessment beyond that of muscle quantity.
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Affiliation(s)
- Alice Sabatino
- Department of Nephrology, Parma University Hospital, Parma, Italy
- Division of Renal Medicine, Baxter Novum. Department of Clinical Science, Intervention and Technology. Karolinska Institute, Stockholm, Sweden
| | - Kristoffer Huitfeldt Sola
- Unit of Radiology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, and Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Torkel B Brismar
- Unit of Radiology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, and Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Bengt Lindholm
- Division of Renal Medicine, Baxter Novum. Department of Clinical Science, Intervention and Technology. Karolinska Institute, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Baxter Novum. Department of Clinical Science, Intervention and Technology. Karolinska Institute, Stockholm, Sweden
| | - Carla Maria Avesani
- Division of Renal Medicine, Baxter Novum. Department of Clinical Science, Intervention and Technology. Karolinska Institute, Stockholm, Sweden
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Di Lenarda L, Buoite Stella A, Ratti C, Ruggiero L, Bernard M, Cavarzerani LP, Canton G, Murena L. Assessing Muscle Mass in the Orthopedic Clinical Setting: Application of the Ultrasound Sarcopenia Index in Elderly Subjects with a Recent Femoral Fracture. Nutrients 2024; 16:711. [PMID: 38474844 PMCID: PMC10934151 DOI: 10.3390/nu16050711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Sarcopenia poses a risk factor for falls, disability, mortality, and unfavorable postoperative outcomes. Recently, the Ultrasound Sarcopenia Index (USI) has been validated to assess muscle mass, and this study aimed to apply the USI in the clinical setting. METHODS This prospective observational study included 108 patients aged >65 years, hospitalized for proximal femoral traumatic fracture. Patients were divided into two groups based on anamnestic data: patients with independent walking (IW) and patients requiring walking aid (WA) before admission. All the participants received an ultrasound examination. Other parameters evaluated were handgrip strength, limb circumferences, nutrition (MNA), and activity of daily living (ADL) scores. RESULTS Fifty-six IW patients (83 ± 6 y; 38 females) and 52 WA patients (87 ± 7 y; 44 females) were recruited. The USI was significantly higher in the IW group compared to the WA group (p = 0.013, Cohen's d = 0.489). Significant correlations were found between the USI and other sarcopenia-associated parameters, such as handgrip strength, MNA, ADLs, other muscle ultrasound parameters, and limb circumferences. CONCLUSION The application of the USI in the orthopedic surgery setting is feasible and might support the diagnosis of sarcopenia when combined with other measures of strength and function.
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Affiliation(s)
- Luca Di Lenarda
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Alex Buoite Stella
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Chiara Ratti
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Luca Ruggiero
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Monica Bernard
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Luisa Priscamaria Cavarzerani
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Gianluca Canton
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Luigi Murena
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
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8
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Durak A, Binay Safer V, Catikkas NM. The relationship between pressure injuries and ultrasonographically measured rectus femoris muscle thickness. J Tissue Viability 2024; 33:60-66. [PMID: 38103986 DOI: 10.1016/j.jtv.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/13/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Ayfer Durak
- University of Health Sciences Istanbul, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, Department of Internal Medicine, Division of Geriatrics, Sancaktepe, 34785, Istanbul, Turkey.
| | - Vildan Binay Safer
- University of Health Sciences Istanbul, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, Department of Internal Medicine / Department of Physical Medicine and Rehabilitation, Sancaktepe, 34785, Istanbul, Turkey
| | - Nezahat Muge Catikkas
- University of Health Sciences Istanbul, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, Department of Internal Medicine, Division of Geriatrics, Sancaktepe, 34785, Istanbul, Turkey
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Ritsche P, Franchi MV, Faude O, Finni T, Seynnes O, Cronin NJ. Fully Automated Analysis of Muscle Architecture from B-Mode Ultrasound Images with DL_Track_US. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:258-267. [PMID: 38007322 DOI: 10.1016/j.ultrasmedbio.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE B-mode ultrasound can be used to image musculoskeletal tissues, but one major bottleneck is analyses of muscle architectural parameters (i.e., muscle thickness, pennation angle and fascicle length), which are most often performed manually. METHODS In this study we trained two different neural networks (classic U-Net and U-Net with VGG16 pre-trained encoder) to detect muscle fascicles and aponeuroses using a set of labeled musculoskeletal ultrasound images. We determined the best-performing model based on intersection over union and loss metrics. We then compared neural network predictions on an unseen test set with those obtained via manual analysis and two existing semi/automated analysis approaches (simple muscle architecture analysis [SMA] and UltraTrack). DL_Track_US detects the locations of the superficial and deep aponeuroses, as well as multiple fascicle fragments per image. RESULTS For single images, DL_Track_US yielded results similar to those produced by a non-trainable automated method (SMA; mean difference in fascicle length: 5.1 mm) and human manual analysis (mean difference: -2.4 mm). Between-method differences in pennation angle were within 1.5°, and mean differences in muscle thickness were less than 1 mm. Similarly, for videos, there was overlap between the results produced with UltraTrack and DL_Track_US, with intraclass correlations ranging between 0.19 and 0.88. CONCLUSION DL_Track_US is fully automated and open source and can estimate fascicle length, pennation angle and muscle thickness from single images or videos, as well as from multiple superficial muscles. We also provide a user interface and all necessary code and training data for custom model development.
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Affiliation(s)
- Paul Ritsche
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Olivier Seynnes
- Department for Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Neil J Cronin
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland; School of Sport & Exercise, University of Gloucestershire, Gloucester, UK
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10
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Parkington T, Broom D, Maden-Wilkinson T, Nawaz S, Klonizakis M. Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial. Vasc Med 2023; 28:554-563. [PMID: 37819259 PMCID: PMC10693738 DOI: 10.1177/1358863x231200250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND Claudication is a common and debilitating symptom of peripheral artery disease, resulting in poor exercise performance and quality of life (QoL). Supervised exercise programs are an effective rehabilitation for patients with claudication, but they are poorly adhered to, in part due to the high pain and effort associated with walking, aerobic, and resistance exercise. Low-intensity resistance exercise with blood flow restriction (BFR) represents an alternative exercise method for individuals who are intolerant to high-intensity protocols. The aim of this study was to evaluate the feasibility of a supervised BFR program in patients with claudication. METHODS Thirty patients with stable claudication completed an 8-week supervised exercise program and were randomized to either BFR (n = 15) or a control of matched exercise without BFR (control; n = 15). Feasibility, safety, and efficacy were assessed. RESULTS All success criteria of the feasibility trial were met. Exercise adherence was high (BFR = 78.3%, control = 83.8%), loss to follow up was 10%, and there were no adverse events. Clinical improvement in walking was achieved in 86% of patients in the BFR group but in only 46% of patients in the control group. Time to claudication pain during walking increased by 35% for BFR but was unchanged for the control. QoL for the BFR group showed improved mobility, ability to do usual activities, pain, depression, and overall health at follow up. CONCLUSION A supervised blood flow restriction program is feasible in patients with claudication and has the potential to increase exercise performance, reduce pain, and improve QoL. (Clinicaltrials.gov Identifier: NCT04890275).
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Affiliation(s)
- Thomas Parkington
- Department of Nursing and Midwifery, Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, UK
- Department of Sport and Physical Activity, Physical Activity, Wellness and Public Health Research Group, Sheffield Hallam University, Sheffield, UK
| | - David Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Thomas Maden-Wilkinson
- Department of Sport and Physical Activity, Physical Activity, Wellness and Public Health Research Group, Sheffield Hallam University, Sheffield, UK
| | - Shah Nawaz
- Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Markos Klonizakis
- Department of Nursing and Midwifery, Lifestyle, Exercise and Nutrition Improvement Research Group, Sheffield Hallam University, Sheffield, UK
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11
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Erul E, Guven DC, Onur MR, Yazici G, Aksoy S. Role of sarcopenia on survival and treatment-related toxicity in head and neck cancer: a narrative review of current evidence and future perspectives. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-08014-9. [PMID: 37188907 DOI: 10.1007/s00405-023-08014-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/08/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE The purpose of this article is to provide an up-to-date summary of sarcopenia and its clinical implications for patients with head and neck cancer (HNC). METHODS We conducted a literature review of recent studies investigating the prevalence of sarcopenia in HNC patients, its detection using MRI or CT scans, and its association with clinical outcomes such as disease-free and overall survival time, radiotherapy-related side effects, cisplatin toxicity, and surgical complications. RESULTS Sarcopenia, characterized by low skeletal muscle mass (SMM), is a prevalent condition in HNC patients and can be effectively detected using routine MRI or CT scans. Low SMM in HNC patients is associated with increased risks of shorter disease-free and overall survival times, as well as radiotherapy-related side effects such as mucositis, dysphagia, and xerostomia. In addition, cisplatin toxicity is more severe in HNC patients with low SMM, leading to higher dose-limiting toxicity and treatment interruptions. Low SMM may also predict higher risks of surgical complications in head and neck surgery. Identifying sarcopenic patients can aid physicians in better riskstratifying HNC patients for therapeutic or nutritional interventions to improve clinical outcomes. CONCLUSIONS Sarcopenia is a significant concern for HNC patients and can impact their clinical outcomes. Routine MRI or CT scans can effectively detect low SMM in HNC patients. Identifying sarcopenic patients can aid physicians in better risk-stratifying HNC patients for therapeutic or nutritional interventions to improve clinical outcomes. Further research is needed to explore the potential of interventions to mitigate the negative effects of sarcopenia in HNC patients.
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Affiliation(s)
- Enes Erul
- Department of Internal Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | | | - Gozde Yazici
- Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
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12
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Bres E, Bouvier J, Courtay A, Delaire L, Humblot J, Cuerq C, Tripoz-Dit-Masson S, Fauvernier M, Gilbert T, Bonnefoy M. FGF19 and muscle architecture in older patients. Exp Gerontol 2023; 174:112120. [PMID: 36764368 DOI: 10.1016/j.exger.2023.112120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Sarcopenia has a significant medical and economic impact. Serum fibroblast growth factor 19 (FGF19) has recently been described as promoting muscle mass and strength, and could be an interesting marker for early diagnosis of sarcopenia and prevention of its consequences. Ultrasound is a robust non-invasive technique used to measure muscle parameters, which cannot be evaluated by usual body composition measures, but are known to be associated with muscle function. In this cross-sectional cohort study, we aimed to determine whether FGF19 levels were correlated with functional muscle tests and muscle ultrasound parameters. METHODS Patients over 70 years old with a mobility disability risk were recruited from the cohort of the "well on your feet" mobility loss prevention program. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older Patients 2 (EWGSOP2) criteria. We have performed functional battery tests, muscle ultrasound measures and bioimpedance spectroscopy. FGF19 levels were measured by the ELISA method. RESULTS Out of 52 patients involved (34 women, mean age 81.3 years), 30 patients were sarcopenic (15 patients with probable sarcopenia and 15 with certain sarcopenia). Sarcopenic patients were older (mean 82.8 versus 79.6 years, P = 0.033), with higher frailty Fried score (P = 0.006), lower IADL score (P = 0.008), had lower daily protein intakes (P = 0.023) and were less performant to muscle functional tests than non-sarcopenic patients. Serum FGF19 levels were negatively correlated with the SPPB score (rs = 0.28; P = 0.045). FGF19 levels were correlated positively with the pennation angle (rs = 0.31; P = 0.024), but negatively with muscle fiber length (rs = -0.44; P = 0.001). We found no association between FGF19 and muscle thickness (P = 0.243). CONCLUSION We highlighted in older patients significant correlations between FGF19 levels, pennation angle and muscle fiber length, suggesting that FGF19 could provide an enabling environment for the development of large muscle fibers, as previously suggested in histological studies in mice. However, high FGF-19 levels were unexpectedly associated with a low SPPB score. Further studies are needed to validate and further elucidate these exploratory findings.
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Affiliation(s)
- Emilie Bres
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
| | - Julia Bouvier
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Aymeric Courtay
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Léo Delaire
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Joannes Humblot
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Charlotte Cuerq
- Department of Biochemistry, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | | | - Mathieu Fauvernier
- Department of Biostatistics, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, Cedex F-69495, France
| | - Thomas Gilbert
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; Research on Healthcare professionals and Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon1, Lyon, France
| | - Marc Bonnefoy
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; CarMeN Laboratory, INSERM U1060, INRA 1397, Université Claude Bernard Lyon 1, INSA Lyon, Oullins, France
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13
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Yapici H, Gülü M, Yagin FH, Ugurlu D, Comertpay E, Eroglu O, Kocoğlu M, Aldhahi MI, Karayigit R, Badri AL-Mhanna S. The effect of 8-weeks of combined resistance training and chocolate milk consumption on maximal strength, muscle thickness, peak power and lean mass, untrained, university-aged males. Front Physiol 2023; 14:1148494. [PMID: 37007992 PMCID: PMC10064218 DOI: 10.3389/fphys.2023.1148494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
The overarching aim of this study was to investigate the combined effects of chocolate milk consumption (500 mL) with 8-week of resistance training on muscle hypertrophy, body composition, and maximal strength in untrained healthy men. A total of 22 Participants were randomly divided into two experimental groups: combined resistance training (3 sessions per week for 8 weeks) and chocolate milk consumptions (include 30 g protein) Resistance Training Chocolate Milk (RTCM) (Age: 20.9 ± 0.9 years old) and resistance training (RT) only (Age: 19.8 ± 0.7 years old). Muscle thickness (MT), using a portable ultrasound, body composition, body mass, maximal strength (one repetition maximum (1 RM), counter movement jump (CMJ) and peak power (PP) were determined at baseline and 8 weeks later. In the RTCM, finding showed a significant improvement in the outcomes compared to the RT group, besides the main effect of time (pre and post). The 1 RM total increased by 36.7% in RTCM group compared to 17.6% increased in the RT group (p < 0.001). Muscle thickness increased by 20.8% in the RTCM group and 9.1% in the RT group (p < 0.001). In the RTCM group, the PP increased by 37.8% compared to only 13.8% increase in the RT group (p = 0.001). The group*time interaction effect was significant for MT, 1RM, CMJ, and PP (p < 0.05), and it was observed that the RTCM and the 8-week resistance training protocol maximized performance. Body fat percentage (%) decreased more in the RTCM (18.9%) group than in the RT (6.7%) group (p = 0.002). In conclusion, chocolate milk (500 mL) with high protein content consumed in addition to resistance training provided superior gains in terms of MT, 1 RM, body composition, CMJ, and PP. The finding of the study demonstrated the positive effect of casein-based protein (chocolate milk) and resistance training on the muscle performance. Chocolate milk consumption has a more positive effect on muscle strength when combined with RT and should be considered as a suitable post-exercise nutritional supplement. Future research could be conducted with a larger number of participants of different ages and longer study durations.
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Affiliation(s)
- Hakan Yapici
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
- *Correspondence: Mehmet Gülü,
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Türkiye
| | - Dondu Ugurlu
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Ertan Comertpay
- Department of Emergency Medicine, Faculty of Medicine, Kirikkale University, Kirikkale, Türkiye
| | - Oguz Eroglu
- Department of Emergency Medicine, Faculty of Medicine, Kirikkale University, Kirikkale, Türkiye
| | - Melike Kocoğlu
- Graduate School of Health Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Raci Karayigit
- Department of Coaching Education, Faculty of Sport Sciences, Ankara University, Ankara, Türkiye
| | - Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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14
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García-Almeida JM, García-García C, Vegas-Aguilar IM, Ballesteros Pomar MD, Cornejo-Pareja IM, Fernández Medina B, de Luis Román DA, Bellido Guerrero D, Bretón Lesmes I, Tinahones Madueño FJ. Nutritional ultrasound®: Conceptualisation, technical considerations and standardisation. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 1:74-84. [PMID: 36935167 DOI: 10.1016/j.endien.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/13/2022] [Indexed: 03/19/2023]
Abstract
Nutritional ultrasound® is a new concept that uses ultrasound to assess body composition. It is composed of the evaluation of fat-free mass and fat mass. It is an emerging, economical, portable, non-invasive technique that evaluates the musculoskeletal area with linear, broadband, multifrequency probes, with a depth field of 20-100mm. It quantifies muscle modifications in malnutrition and provides information on functional changes (echogenicity). Although there are no validated specific cut-off points, the anterior rectum area of the quadriceps can be used as a criterion for malnutrition. The distribution of adipose tissue provides information on the energy reserve and the inflammatory pattern. It is important to integrate nutritional ultrasound® measures in clinical practice adapted to different settings and pathologies. It is necessary to establish training plans in nutritional ultrasound® for use by Endocrinology and Nutrition Specialists, with the aim of improving the diagnosis and treatment of their patients.
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Affiliation(s)
- José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, IBIMA, CIBEROBN, Hospital Quirónsalud, University of Málaga, Spain.
| | - Cristina García-García
- PhD Program in Biomedicine, Translational Research and New Health Technologies, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Isabel María Vegas-Aguilar
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, FIMABIS, Málaga, Spain
| | | | - Isabel María Cornejo-Pareja
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, IBIMA, CIBEROBN, Carlos III Health Institute, Málaga, Spain
| | - Beatriz Fernández Medina
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Daniel A de Luis Román
- Department of Endocrinology and Nutrition, Institute of Endocrinology and Nutrition, Medicine School and Department of Endocrinology and Investigation, Hospital Clínico Universitario, University of Valladolid, Valladolid, Spain
| | - Diego Bellido Guerrero
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Ferrol, A Coruña, Spain
| | - Irene Bretón Lesmes
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Francisco J Tinahones Madueño
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, CIBEROBN, Carlos III Health Institute (ISCIII), University of Málaga, Spain
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15
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Usefulness of Ultrasound in Assessing the Impact of Bariatric Surgery on Body Composition: a Pilot Study. Obes Surg 2023; 33:1211-1217. [PMID: 36849786 PMCID: PMC10079718 DOI: 10.1007/s11695-023-06510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Bariatric surgery (BS) has a significant impact on body composition. The purpose of the study is to evaluate the usefulness of musculoskeletal ultrasound (MUS) to bioelectrical impedance (BIA) in the follow-up of patients undergoing BS in terms of body composition and quality of life (QoL). METHODS This is a prospective pilot study including 32 subjects (75% female, mean age: 49.15 ± 1.9 years) who underwent BS. Fat mass (FM), lean mass (LM), and skeletal muscle index (SMI) were calculated by BIA. MUS measured subcutaneous fat (SF) and thigh muscle thickness (TMT) of the quadriceps. QoL was assessed by the Moorehead-Ardelt questionnaire. All these measurements were performed 1 month prior to BS and at 12-month follow-up. RESULTS The mean BMI decreased by 6.63 ± 1.25 kg/m2 (p=0.001). We observed significant reductions in FM (p=0.001) and SF (p=0.007) and in LM (p=0.001) but not in SMI and TMT. We found a correlation between the FM and SF (pre-surgical, r=0.42, p=0.01; post-surgical, r=0.52, p=0.003) and between SMI and TMT (pre-surgical, r=0.35, p=0.04; post-surgical, r=0.38, p=0.03). QoL test showed significant improvement (p=0.001). In addition, a correlation between the QoL questionnaire and TMT post-surgery (r=0.91, p=0.019) was observed. However, we did not find any statistically significant correlation between QoL assessment and SMI or LM. CONCLUSIONS Our results suggest that MUS can be complementary to BIA for the evaluation and the follow-up of body composition after BS. TMT of quadriceps can provide relevant information about regional sarcopenia and has a significant correlation with QoL.
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16
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Möller Parera I, Miguel M, Blasi J, Piccasso R, Hammer HB, Ortiz-Sagrista J, Zaottini F, Martinoli C, Terslev L. Ultrasound assessment of degenerative muscle sarcopenia: the University of Barcelona ultrasound scoring system for sarcopenia. RMD Open 2023; 9:rmdopen-2022-002779. [PMID: 36707106 PMCID: PMC9884912 DOI: 10.1136/rmdopen-2022-002779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
AIM This study aimed to (1) determine the intraobserver and interobserver reliability of ultrasonographic measurement of muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris and biceps brachii, correlating these values with manual measurements on dissected cadavers and (2) develop the first semiquantitative musculoskeletal ultrasound (MSUS) scoring system of muscle morphology in sarcopenia and assess its intraobserver and interobserver reliability. In addition, the MSUS morphology score was compared with the corresponding histological images to verify concurrent validity. METHODS Ten cryopreserved limbs of 10 cadavers aged 68-91 years were evaluated. The MSUS scoring system was based on the severity of muscle degeneration on a 3-point qualitative scale: grade 1 (normal), grade 2 (moderate changes) and grade 3 (severe changes). Reliability was assessed with intraclass correlation coefficient (ICC) for the MT and CSA and with Cohen's kappa coefficients (κ) for the MSUS scoring system. Concurrent validity was analysed with ICC. RESULTS The results showed excellent intraobserver and interobserver reliability for both the MSUS evaluation of MT and CSA (ICC ≥0.93). The MSUS scoring system showed excellent intraobserver reliability (κ=1.0) and very good interobserver reliability (κ=0.85). There was also a high intra- and inter-observer reliability for the histological scorings (ĸ ≥0.85 and mean ĸ=0.70, respectively), as well as high reliability between the histology and MSUS scoring systems (ICC=0.92). All results were statistically significant (p≤0.001). CONCLUSION MSUS measures of MT and CSA and the novel MSUS scoring system for degenerative muscle changes in sarcopenia was found to be reliable and strongly associated with histological findings.
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Affiliation(s)
- Ingrid Möller Parera
- Reumatologia, Instituto Poal de Reumatologia, Barcelona, Spain,Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), University of Barcelona, Barcelona, Spain
| | - Maribel Miguel
- Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), University of Barcelona, Barcelona, Spain
| | - Joan Blasi
- Unidad de Histologia, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), University of Barcelona, Barcelona, Spain
| | - Riccardo Piccasso
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Hilde Berner Hammer
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Sykehus AS, Oslo, Norway,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Carlo Martinoli
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark .,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Cheng D, Luo H, Ren S, Wang N, Wu J. The Effects of Fluid Hydration Status on Ultrasound Muscle Measurement in Hemodialysis Patients. J Ren Nutr 2023; 33:214-218. [PMID: 35597319 DOI: 10.1053/j.jrn.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/16/2022] [Accepted: 04/24/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE This study aimed to explore the effects of fluid hydration status on ultrasound muscle measurement in hemodialysis (HD) patients. METHODS Ultrasound muscle examination of the right rectus femoris and bioelectrical impedance analysis measurement of the right lower limb were performed in HD patients at the periods of predialysis and postdialysis. The correlations between the changes in the corresponding ultrasound and bioelectrical impedance analysis variables were analyzed. RESULTS A total of 50 patients on maintenance HD were included, with mean age of 52.6 ± 13.5 years. Patients were 40% female (n = 20), and average dialysis duration was 2.62 ± 2.42 years. Compared to predialysis, the measurements of cross-sectional area, muscle thickness, echo intensity (EI), and their percentage changes all decreased significantly after the HD procedure (P < .05). The change in EI and its percentage change were significantly correlated with changes in total body water, intracellular water, and extracellular water (P < .05). CONCLUSIONS The HD session may have significant effects on ultrasound muscle measurement. Both the indicators of muscle quantity (cross-sectional area and muscle thickness) and quality (EI) significantly decreased after HD, which may contribute to the change in fluid hydration status and the change in fluid composition.
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Affiliation(s)
- Dongsheng Cheng
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Haiqing Luo
- Department of Nephrology, People's Hospital of Menghai County, China
| | - Shunrong Ren
- Department of Nephrology, People's Hospital of Menghai County, China
| | - Niansong Wang
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
| | - Junzhen Wu
- Department of Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
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18
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Isaka M, Sugimoto K, Akasaka H, Yasunobe Y, Takahashi T, Xie K, Onishi Y, Yoshida S, Minami T, Yamamoto K, Kamide K, Rakugi H. The Muscle Thickness Assessment Using Ultrasonography is a Useful Alternative to Skeletal Muscle Mass by Bioelectrical Impedance Analysis. Clin Interv Aging 2022; 17:1851-1861. [PMID: 36545348 PMCID: PMC9762259 DOI: 10.2147/cia.s385469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Muscle mass, a key index for the diagnosis of sarcopenia, is currently assessed using the appendicular skeletal muscle mass index (ASMI) by bioelectrical impedance analysis (BIA). Muscle thickness (MT) assessed by ultrasonography (US) may be a better determinant and/or predictor of muscle condition than ASMI. Thus, we compared it to the ASMI determined by the BIA. Patients and Methods Our study included 165 ambulatory older adults (84 males, 81 females, mean age: 76.82 years). The ASMI by the BIA method, MT by US, and the distribution of body mass index (BMI) and body fat percentage (BFP) were examined using defined values for men and women. These were used as the basis for examining the association of MT and ASMI with handgrip strength (HGS), leg muscle strength (LMS), gait speed (GS), and echo intensity (EI). We compared HGS, LMS, GS, and EI for high and low ASMI among lower BMI or BFP. The same was also done for MT assessed by US. Results MT, as well as ASMI, was strongly associated with HGS and LMS. There was a correlation between MT and GS and EI but not between ASMI and GS and EI. There were significant differences in the prevalence between high ASMI and high MT or low ASMI and low MT in those with lower BMI or BFP. In non-overweight participants, HGS, LMS, GS, and EI were significantly higher in those with high MT than in those with low MT; however, there were no significant differences in them between those with high and low ASMI. Conclusion In the non-overweight group, the MT assessment by US showed a stronger relationship to muscle strength and muscle quality than the ASMI assessment by BIA. The MT assessment using US is a useful alternative to BIA-assessed ASMI, especially in non-overweight participants.
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Affiliation(s)
- Masaaki Isaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan,Department of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan,Physical Therapy, Osaka Yukioka College of Health Science, Ibaraki, Osaka, Japan
| | - Ken Sugimoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan,Department of General Geriatric Medicine, Kawasaki Medical School, Okayama, Okayama, Japan,Correspondence: Ken Sugimoto, Department of General Geriatric Medicine, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, Okayama, 700-8505, Japan, Tel +81 86 225 2111, Fax +81 86 232 8343, Email
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukiko Yasunobe
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Toshimasa Takahashi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keyu Xie
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yuri Onishi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shino Yoshida
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tomohiro Minami
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kei Kamide
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan,Department of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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19
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Ritsche P, Wirth P, Cronin NJ, Sarto F, Narici MV, Faude O, Franchi MV. DeepACSA: Automatic Segmentation of Cross-Sectional Area in Ultrasound Images of Lower Limb Muscles Using Deep Learning. Med Sci Sports Exerc 2022; 54:2188-2195. [PMID: 35941517 DOI: 10.1249/mss.0000000000003010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Muscle anatomical cross-sectional area (ACSA) can be assessed using ultrasound and images are usually evaluated manually. Here, we present DeepACSA, a deep learning approach to automatically segment ACSA in panoramic ultrasound images of the human rectus femoris (RF), vastus lateralis (VL), gastrocnemius medialis (GM) and lateralis (GL) muscles. METHODS We trained three muscle-specific convolutional neural networks (CNN) using 1772 ultrasound images from 153 participants (age = 38.2 yr, range = 13-78). Images were acquired in 10% increments from 30% to 70% of femur length for RF and VL and at 30% and 50% of muscle length for GM and GL. During training, CNN performance was evaluated using intersection-over-union scores. We compared the performance of DeepACSA to manual analysis and a semiautomated algorithm using an unseen test set. RESULTS Comparing DeepACSA analysis of the RF to manual analysis with erroneous predictions removed (3.3%) resulted in intraclass correlation (ICC) of 0.989 (95% confidence interval = 0.983-0.992), mean difference of 0.20 cm 2 (0.10-0.30), and SEM of 0.33 cm 2 (0.26-0.41). For the VL, ICC was 0.97 (0.96-0.968), mean difference was 0.85 cm 2 (-0.4 to 1.31), and SEM was 0.92 cm 2 (0.73-1.09) after removal of erroneous predictions (7.7%). After removal of erroneous predictions (12.3%), GM/GL muscles demonstrated an ICC of 0.98 (0.96-0.99), a mean difference of 0.43 cm 2 (0.21-0.65), and an SEM of 0.41 cm 2 (0.29-0.51). Analysis duration was 4.0 ± 0.43 s (mean ± SD) for analysis of one image in our test set using DeepACSA. CONCLUSIONS DeepACSA provides fast and objective segmentation of lower limb panoramic ultrasound images comparable with manual segmentation. Inaccurate model predictions occurred predominantly on low-quality images, highlighting the importance of high-quality image for accurate prediction.
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Affiliation(s)
- Paul Ritsche
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
| | | | - Neil J Cronin
- Neuromuscular Research Centre, Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, FINLAND
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, ITALY
| | | | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
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20
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Hogenbirk RNM, Viddeleer AR, Hentzen JEKR, van der Plas WY, van der Schans CP, de Bock GH, Kruijff S, Klaase JM. Thickness of Biceps and Quadriceps Femoris Muscle Measured Using Point-of-Care Ultrasound as a Representation of Total Skeletal Muscle Mass. J Clin Med 2022; 11:jcm11226606. [PMID: 36431082 PMCID: PMC9695176 DOI: 10.3390/jcm11226606] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Generalized loss of muscle mass is associated with increased morbidity and mortality in patients with cancer. The gold standard to measure muscle mass is by using computed tomography (CT). However, the aim of this prospective observational cohort study was to determine whether point-of-care ultrasound (POCUS) could be an easy-to-use, bedside measurement alternative to evaluate muscle status. Patients scheduled for major abdominal cancer surgery with a recent preoperative CT scan available were included. POCUS was used to measure the muscle thickness of mm. biceps brachii, mm. recti femoris, and mm. vasti intermedius 1 day prior to surgery. The total skeletal muscle index (SMI) was derived from patients’ abdominal CT scan at the third lumbar level. Muscle force of the upper and lower extremities was measured using a handheld dynamometer. A total of 165 patients were included (55% male; 65 ± 12 years). All POCUS measurements of muscle thickness had a statistically significant correlation with CT-derived SMI (r ≥ 0.48; p < 0.001). The strongest correlation between POCUS muscle measurements and SMI was observed when all POCUS muscle groups were added together (r = 0.73; p < 0.001). Muscle strength had a stronger correlation with POCUS-measured muscle thickness than with CT-derived SMI. To conclude, this study indicated a strong correlation between combined muscle thickness measurements performed by POCUS- and CT-derived SMI and measurements of muscle strength. These results suggest that handheld ultrasound is a valid tool for the assessment of skeletal muscle status.
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Affiliation(s)
- Rianne N. M. Hogenbirk
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Correspondence:
| | - Alain R. Viddeleer
- Department of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Judith E. K. R. Hentzen
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Willemijn Y. van der Plas
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Cees P. van der Schans
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Center of Expertise Healthy Ageing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Joost M. Klaase
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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21
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Gupta M, Lehl SS, Lamba AS. Ultrasonography for Assessment of Sarcopenia: A Primer. J Midlife Health 2022; 13:269-277. [PMID: 37324795 PMCID: PMC10266568 DOI: 10.4103/jmh.jmh_234_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/05/2023] [Accepted: 02/13/2023] [Indexed: 06/17/2023] Open
Abstract
The human skeletal muscle has a pivotal role in preserving health by maintaining mobility, balance, and metabolic homeostasis. Significant muscle loss as a part of aging and accelerated by disease leads to sarcopenia which becomes an important predictor of quality of life in older persons. Therefore, clinical screening for sarcopenia and validation by precise qualitative and quantitative measurement of skeletal muscle mass (MM) and function is at the center-stage of translational research. Many imaging modalities are available, each having their strengths and limitations, either in interpretation, technical processes, time constraints, or expense. B-mode ultrasonography (US) is a relatively novel approach to evaluating muscle. It can measure several parameters such as MM and architecture simultaneously including muscle thickness, cross-sectional area, echogenicity, pennate angle, and fascicle length. It can also evaluate dynamic parameters like muscle contraction force and muscle microcirculation. US has not gained global attention due to a lack of consensus on standardization and diagnostic threshold values to diagnose sarcopenia. However, it is an inexpensive and widely available technique with clinical applicability. The ultrasound-derived parameters correlate well with strength and functional capacity and provide potential prognostic information. Our aim is to present an update on the evidence-based role of this promising technique in sarcopenia, its advantages over the existing modalities, and its limitations in actual practice with the hope that it may emerge as the "stethoscope" for community diagnosis of sarcopenia.
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Affiliation(s)
- Monica Gupta
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Sarabmeet Singh Lehl
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Amtoj Singh Lamba
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
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22
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Architectural Ultrasound Pennation Angle Measurement of Lumbar Multifidus Muscles: A Reliability Study. J Clin Med 2022; 11:jcm11175174. [PMID: 36079105 PMCID: PMC9457246 DOI: 10.3390/jcm11175174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
The pennation angle has been shown to be a relevant parameter of muscle architecture. This parameter has not previously been measured in the lumbar multifidus musculature, and it is for this reason that it has been considered of great interest to establish an assessment protocol to generate new lines of research in the future. Objective: The objective of this study was to establish a protocol for measuring the pennation angle of the multifidus muscles, with a study of intra-rater and interrater reliability values. Design: This was a reliability study following the recommendations of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS). Setting: The study was carried out at University of Alcalá, Department of Physiotherapy. Subjects: Twenty-seven subjects aged between 18 and 55 years were recruited for this study. Methods: Different ultrasound images of the lumbar multifidus musculature were captured. Subsequently, with the help of ImageJ software, the pennation angle of this musculature was measured. Finally, a complex statistical analysis determined the intra- and interrater reliability. Results: The intra-rater reliability of the pennation angle measurement protocol was excellent for observer 1 in the measurement of the left-sided superficial multifidus 0.851 (0.74, 0.923), and for observer 2 in the measurement of the right-sided superficial 0.711 (0.535, 0.843) and deep multifidus 0.886 (0.798, 0.942). Interrater reliability was moderate to poor, and correlation analysis results were high for thickness vs. pennation angle. Conclusions: The designed protocol for ultrasound measurement of the pennation angle of the lumbar multifidus musculature has excellent intra-rater reliability values, supporting the main conclusions and interpretations. Normative ranges of pennation angles are reported. High correlation between variables is described.
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23
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Frundi DS, Kettig E, Popp LL, Hoffman M, Dumartin M, Hughes M, Lamy E, Fru YJW, Bano A, Muka T, Wilhelm M. Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study. Front Cardiovasc Med 2022; 9:907385. [PMID: 35935634 PMCID: PMC9354468 DOI: 10.3389/fcvm.2022.907385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background Type 2 diabetes (T2D) is associated with limitation in physical performance. Results from animal studies report enhancement of physical performance in T2D rodents treated with sodium glucose cotransporter 2 inhibitors (SGLT2is). However, in human patients with T2D and established atherosclerotic cardiovascular disease (ASCVD) or high cardiovascular risk, the impact of guideline directed SGLT2i medication on physical performance has not been sufficiently examined. Objectives The main objectives of this study are thus firstly, to assess the changes in physical performance after 4 weeks of exercise therapy in patients with established ASCVD or high cardiovascular risk categorized into three groups according to their glycemic control at baseline. Secondly, to investigate the association of glycemic control at baseline and new guideline directed antidiabetic treatment (inadequate glycemic control and diabetes + new SGLT2i vs. adequate glycemic control and diabetes vs. no diabetes) with change in physical performance. Methods and design This is a 4-week prospective observational study of 450 participants with established ASCVD or high cardiovascular risk with or without T2D and without previous SGLT2i medication undergoing exercise therapy during inpatient rehabilitation in a single center in Switzerland. Upon admission, participants are categorized into 3 groups of 150 participants each according to their glycemic control. Group I consisting of participants with inadequately controlled T2D defined as mean fasting plasma glucose (FPG) of ≥7 mmol/L, who are consequently administered new treatment with an SGLT2i. Group II comprises of participants with adequately controlled T2D with mean FPG of <7 mmol/L requiring no antidiabetic medication change. Group III consists of participants with no diabetes and mean FPG of ≤ 5.5 mmol/L. Primary outcomes are 6-min walk distance and rate of perceived exertion. Secondary outcomes are echocardiographic parameters (left ventricular mass index; global longitudinal strain average; end-diastolic volume), fatigue, muscle, metabolic, and anthropometric measures. Ethics and dissemination This study is conducted in accordance with the Declaration of Helsinki with ethical approval from the Cantonal Ethical Commission of Bern, Switzerland. The results will be published in a peer-reviewed journal. The implementation and reporting will be according to the SPIRIT guidelines. Study protocol registration https://www.clinicaltrials.gov/, identifier: NCT03422263.
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Affiliation(s)
- Devine S. Frundi
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
- Permanence Médicale, Hôpital de Sierre, Sierre, Switzerland
- *Correspondence: Devine S. Frundi
| | - Eva Kettig
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Lena Luise Popp
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Melanie Hoffman
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Marine Dumartin
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Magali Hughes
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Edgar Lamy
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | | | - Arjola Bano
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Center for Preventive Cardiology, University Hospital Bern and University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Center for Preventive Cardiology, University Hospital Bern and University of Bern, Bern, Switzerland
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24
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García-Almeida JM, García-García C, Vegas-Aguilar IM, Ballesteros Pomar MD, Cornejo-Pareja IM, Fernández Medina B, de Luis Román DA, Bellido Guerrero D, Bretón Lesmes I, Tinahones Madueño FJ. Nutritional ultrasound®: Conceptualisation, technical considerations and standardisation. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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25
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Simó-Servat A, Ibarra M, Libran M, Rodríguez S, Perea V, Quirós C, Orois A, Pérez N, Simó R, Barahona MJ. Usefulness of Muscle Ultrasound to Study Sarcopenic Obesity: A Pilot Case-Control Study. J Clin Med 2022; 11:jcm11102886. [PMID: 35629009 PMCID: PMC9143348 DOI: 10.3390/jcm11102886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background and objectives: Sarcopenic obesity (SO) is an emerging problem, especially in candidates for bariatric surgery (BS). We hypothesized that musculoskeletal ultrasound (MUS), a simple and accessible method, could be a reliable index of SO. Materials and Methods: A cross-sectional pilot study including 122 subjects (90 cases and 32 controls, 73% female, mean age: 51.2 years) who underwent BS was conducted at University Hospital Mútua Terrassa. The lean mass (LM) was calculated by bioelectrical impedance analysis (BIA) and the thigh muscle thickness (TMT) by MUS. To identify the subjects with SO by BIA, we used skeletal muscle index (SMI). The validity of MUS was determined using the ROC curve. Results: The mean BMI in the obesity group was 44.22 kg/m2. We observed a correlation between the LM and SMI assessed by BIA and the TMT assessed by MUS (R = 0.46, p < 0.001). This correlation was maintained at significant levels in the SO group (n = 40): R = 0.79; p = 0.003). The TMT assessed by MUS was able to predict SMI using BIA (AUC 0.77; 95% CI: 0.68242 to 0.84281). The optimal cut-off point for maximum efficiency was 1.57 cm in TMT (sensitivity = 75.6% and specificity = 71.1%). Conclusions: The TMT of the quadriceps assessed by US is a useful tool for identifying subjects with SO. Larger studies to validate this simple low-cost screening strategy are warranted.
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Affiliation(s)
- Andreu Simó-Servat
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
- Department of Medicine, Autonomous University of Barcelona, 08193 Bellaterra, Spain
- Correspondence: (A.S.-S.); (M.-J.B.)
| | - Montse Ibarra
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Mireia Libran
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Silvia Rodríguez
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Verónica Perea
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Carmen Quirós
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Aida Orois
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
| | - Noelia Pérez
- Department of General Surgery, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain;
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d’Hebron Research Institute and CIBERDEM (ISCIII), Autonomous University of Barcelona, 08193 Bellaterra, Spain;
| | - Maria-José Barahona
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain; (M.I.); (M.L.); (S.R.); (V.P.); (C.Q.); (A.O.)
- Correspondence: (A.S.-S.); (M.-J.B.)
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26
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Lv S, Ling L, Shi H, Chen X, Chen S, Zhu S, Lin W, Lv R, Ding G. Application of Muscle Thickness and Quality Measured by Ultrasound in Frailty Assessment in China. Front Med (Lausanne) 2022; 9:859555. [PMID: 35433721 PMCID: PMC9009442 DOI: 10.3389/fmed.2022.859555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
To explore the correlation between Fried Frailty Phenotype (FFP) and the muscle thickness and quality of local muscle, and to provide a reasonable basis for the application of ultrasound measurement in the frailty assessment. A total of 150 people (age ≥ 65 years, 58 women, 92 men) were included from the First Hospital Affiliated to Nanjing Medical University. They were divided into Normal group (40 cases), Prefrailty group (69 cases) and Frailty group (41 cases). The thickness and the quality of local muscle were detected by ultrasound. Participants in the prefrailty group had a higher grayscale value of the vastus lateralis muscle, indicating the deterioration of muscle quality. At the frailty stage, the muscle thickness and quality of the vastus lateralis muscle and the anterior tibialis muscle decreased significantly compared with the normal and the prefrailty group. Pearson's correlation analysis also showed FFP was negatively correlated with muscle thickness and quality of the lower limbs. In multiple regression model, FFP was positively associated with gray value (Vastus lateralis muscle:β =0.457, p < 0.001; Anterior tibialis muscle: β = 0.220, p = 0.037) and inversely associated with muscle thickness (Vastus lateralis muscle:β = −0.973, p = 0.031; Anterior tibialis muscle: β = −4.551, p = 0.004) in the frailty stage. Together, FFP was closely related to muscle thickness and quality, especially vastus lateralis muscle. Moreover, Muscle quality has deteriorated in the prefrailty stage, which is earlier than muscle thickness.
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Affiliation(s)
- Shan Lv
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Ling Ling
- Department of Gerontology, Suzhou Ninth People's Hospital, Suzhou, China
| | - Hui Shi
- NHC Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing, China
| | - Xing Chen
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Shu Chen
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Siping Zhu
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Wei Lin
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Rong Lv
- Department of Gerontology, Suzhou Ninth People's Hospital, Suzhou, China
- Rong Lv
| | - Guoxian Ding
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
- *Correspondence: Guoxian Ding
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27
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Prushansky T, Kaplan-Gadasi L, Friedman J. The relationship between thoracic posture and ultrasound echo intensity of muscles spanning this region in healthy men and women. Physiother Theory Pract 2022; 39:1257-1265. [PMID: 35125048 DOI: 10.1080/09593985.2022.2034076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Skeletal muscle echogenicity intensity (EI) is considered a measure of muscle quality, being associated with old age and pathologies. Whether EI variations can be identified in healthy adults, due to habitual shortened or elongated muscle position is unknown. Thus, this study aimed to assess the relationship between thoracic kyphosis angulation and EI scores of muscles spanning this region ((Lower Trapezius (LT), Rhomboid Major (RM), Erector Spine (ES)) in healthy young people and in addition to examine the relationship between the change in thoracic kyphosis angle from relaxed to upright position (∆°) and the EI of these muscles. METHODS Thoracic kyphosis in relaxed and erect standing was measured using a digital inclinometer in 29 healthy adults (16 women, 13 men), aged 25-35 years. The thoracic kyphosis angles including the difference between relaxed and erect postures (∆°) were correlated to the EI scores of right and left LT, RM and ES. RESULTS No significant differences in EI were found between the 3 muscles EI or between sides, hence they were pooled together to a total thoracic EI score (TTEI). Although the TTEI did not correlate with relaxed or erect thoracic kyphosis, it was significantly but negatively correlated with ∆° in the entire group: Pearson's correlation coefficient of r = -0.544; p = .01 and in men; r = -0.732; p = .01, failing to reach significance in women; r = -0.457. CONCLUSION The negative association between the EI of the explored muscles and ∆° could imply a possible relationship between these muscles range of movement excursions and their composition.
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Affiliation(s)
- Tamara Prushansky
- Department of Physical Therapy, the Stanley Stayer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lihi Kaplan-Gadasi
- Department of Physical Therapy, the Stanley Stayer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jason Friedman
- Department of Physical Therapy, the Stanley Stayer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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28
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Fodor D, Rodriguez-Garcia SC, Cantisani V, Hammer HB, Hartung W, Klauser A, Martinoli C, Terslev L, Alfageme F, Bong D, Bueno A, Collado P, D'Agostino MA, de la Fuente J, Iohom G, Kessler J, Lenghel M, Malattia C, Mandl P, Mendoza-Cembranos D, Micu M, Möller I, Najm A, Özçakar L, Picasso R, Plagou A, Sala-Blanch X, Sconfienza LM, Serban O, Simoni P, Sudoł-Szopińska I, Tesch C, Todorov P, Uson J, Vlad V, Zaottini F, Bilous D, Gutiu R, Pelea M, Marian A, Naredo E. The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound - Part I: Extraarticular Pathologies. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:34-57. [PMID: 34479372 DOI: 10.1055/a-1562-1455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.
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Affiliation(s)
- Daniela Fodor
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Vito Cantisani
- Department of Radiological, Oncological and Anatomo-pathological Sciences, "Sapienza" University, Rome, Italy
| | - Hilde B Hammer
- Department of Rheumatology, Diakonhjemmet Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Wolfgang Hartung
- Clinic for Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach, Germany
| | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Section Head Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Carlo Martinoli
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Fernando Alfageme
- Dermatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - David Bong
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Angel Bueno
- Department of Musculoskeletal Radiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Paz Collado
- Rheumatology Department, Transitional Care Clinic, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Maria Antonietta D'Agostino
- Istituto di Reumatologia Università Cattolica del Sacro Cuore, UOC Reumatologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | | | - Gabriella Iohom
- Department of Anaesthesiology and Intensive Care Medicine, Cork University Hospital and University College Cork, Cork, Ireland
| | - Jens Kessler
- Department of Anaesthesiology, Division of Pain Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuela Lenghel
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Clara Malattia
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI) University of Genoa, Genoa, Italy
| | - Peter Mandl
- Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | | | - Mihaela Micu
- Rheumatology Division, 2nd Rehabilitation Department, Rehabilitation Clinical Hospital Cluj-Napoca, Romania
| | - Ingrid Möller
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Aurelie Najm
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Riccardo Picasso
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Athena Plagou
- Ultrasound Unit, Private Radiological Institution, Athens, Greece
| | - Xavier Sala-Blanch
- Department of Anaesthesiology, Hospital Clinic, Department of Human Anatomy, Faculty of Medicine, University of Barcelona, Spain
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano Italy
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - Oana Serban
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paolo Simoni
- Paediatric Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | | | - Plamen Todorov
- Department of Internal Disease Propaedeutic and Clinical Rheumatology, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Jacqueline Uson
- Department of Rheumatology Hospital Universitario Móstoles, Universidad Rey Juan Carlos, Madrid, Spain
| | - Violeta Vlad
- Sf. Maria Hospital, Rheumatology Department, Bucharest, Romania
| | - Federico Zaottini
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Diana Bilous
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Gutiu
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Pelea
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anamaria Marian
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Esperanza Naredo
- Department of Rheumatology, Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Díaz, IIS Fundación Jiménez Díaz, and Universidad Autónoma de Madrid, Madrid, Spain
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Oliveria SND, Biduski GM, Moro ARP, Freitas CDLR. Muscle architecture of the vastus lateralis and rectus femoris in the production of knee extensor torque in physically inactive women. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220006422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S, Del Grande F, Sconfienza LM. Sarcopenia: imaging assessment and clinical application. Abdom Radiol (NY) 2022; 47:3205-3216. [PMID: 34687326 PMCID: PMC8536908 DOI: 10.1007/s00261-021-03294-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023]
Abstract
Sarcopenia is a progressive, generalized skeletal muscle disorder characterized by reduction of muscle mass and strength. It is associated with increased adverse outcomes including falls, fractures, physical disability, and mortality, particularly, in elderly patients. Nowadays, sarcopenia has become a specific imaging biomarker able to predict clinical outcomes of patients. Muscle fibre reduction has shown to be an unfavourable pre-operative predictive factor in patients with cancer, and is associated with worse clinical outcomes in terms of postoperative complications, morbidity, mortality, and lower tolerance of chemoradiation therapy. Several imaging modalities, including dual-energy X-ray absorptiometry, CT, MRI, and US can be used to estimate muscle mass and quality to reach the diagnosis of sarcopenia. This article reviews the clinical implications of sarcopenia, how this condition can be assessed through different imaging modalities, and future perspectives of imaging of sarcopenia.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland ,Ospedale Evangelico Betania, Napoli, Italy
| | - Domenico Albano
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy ,grid.10776.370000 0004 1762 5517Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Salvatore Gitto
- grid.4708.b0000 0004 1757 2822Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Gaetano Ruffo
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
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Teixeira J, Brauer Júnior A, Lima-Silva A, Bento P. Association between age and muscle function, architecture, and composition in long-distance master runners: a cross-sectional study. Braz J Med Biol Res 2022; 55:e12383. [DOI: 10.1590/1414-431x2022e12383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A.G. Brauer Júnior
- Universidade Federal do Paraná, Brasil; Unibrasil Centro Universitário, Brasil
| | | | - P.C.B. Bento
- Universidade Federal do Paraná, Brasil; Universidade Federal do Paraná, Brasil
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Sarcopenia: Diagnosis and Management, State of the Art and Contribution of Ultrasound. J Clin Med 2021; 10:jcm10235552. [PMID: 34884255 PMCID: PMC8658070 DOI: 10.3390/jcm10235552] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open
Abstract
Age-related muscle loss is a phenomenon that has been extensively studied in recent decades. Sarcopenia is a multisystem disease, which predisposes to muscle weakness and frailty. At around 50 years of age, an individual begins to lose muscle strength, although this becomes more evident after 70. Sarcopenia is a condition typically found in older adults but can also affect younger people. Sarcopenia is a preventable and treatable condition. In past years, methods and tools to recognize the condition early have been researched. For the development of therapeutic interventions, agreement on diagnosis is fundamental. In recent years, a possible role of ultrasonography in the diagnosis of sarcopenia has been evaluated, compared with the best-known techniques.
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Jacob I, Jones G, Francis P, Johnson MI. The effect of limb position on measured values of vastus lateralis muscle morphology using B Mode ultrasound. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Isobel Jacob
- Musculoskeletal Research Group Leeds Beckett University Leeds UK
| | - Gareth Jones
- Musculoskeletal Research Group Leeds Beckett University Leeds UK
| | - Peter Francis
- Department of Science and Health Institute of Technology Carlow Carlow Ireland
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Quantitative Ultrasound Changes in Echotexture and Functional Parameters after a Multicomponent Training Program in Pre-Frailty Individuals: A Pilot Randomized Clinical Trial. Healthcare (Basel) 2021; 9:healthcare9101279. [PMID: 34682959 PMCID: PMC8535283 DOI: 10.3390/healthcare9101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: Currently, ultrasound imaging (USI) is considered a feasible tool in the evaluation of structural and textural muscle differences due to aging. The main aim of this study was to evaluate sonographic changes in muscular structure and function after a 12-week multicomponent training program in pre-frailty individuals. Design: A prospective, randomized, clinical trial was carried out. Participants: Thirty-two pre-frailty subjects were recruited and randomly divided into a multicomponent training program group (n = 16; Multicomponent group) and a conventional care group (n = 14; Control group) with a 12-week follow up. Main outcome measures: Rectus femoris thickness, cross-sectional area (CSA), echointensity, echovariation and vastus lateralis pennation angle tests were carried out to assess the structure and echotexture, and the force-velocity (F-V) profile for muscle power and muscle strength was employed to assess the functional parameters. Results: Statistically significant differences (p < 0.05) were shown for the left rectus femoris echointensity and in the functional parameter of muscle power after a 12-week program for the multicomponent training group compared to the conventional care group. Conclusions: Pre-frailty elderly subjects showed a decrease in rectus femoris echointensity (RF-EI) and an increase in the functional parameter of muscle power after a 12-week multicomponent training program compared to the control group.
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Narici M, McPhee J, Conte M, Franchi MV, Mitchell K, Tagliaferri S, Monti E, Marcolin G, Atherton PJ, Smith K, Phillips B, Lund J, Franceschi C, Maggio M, Butler‐Browne GS. Age-related alterations in muscle architecture are a signature of sarcopenia: the ultrasound sarcopenia index. J Cachexia Sarcopenia Muscle 2021; 12:973-982. [PMID: 34060717 PMCID: PMC8350200 DOI: 10.1002/jcsm.12720] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The assessment of muscle mass is a key determinant of the diagnosis of sarcopenia. We introduce for the first time an ultrasound imaging method for diagnosing sarcopenia based on changes in muscle geometric proportions. METHODS Vastus lateralis muscle fascicle length (Lf) and thickness (Tm) were measured at 35% distal femur length by ultrasonography in a population of 279 individuals classified as moderately active elderly (MAE), sedentary elderly (SE) (n = 109), mobility impaired elderly (MIE) (n = 43), and in adult young controls (YC) (n = 60). The ratio of Lf/Tm was calculated to obtain an ultrasound index of the loss of muscle mass associated with sarcopenia (USI). In a subsample of elderly male individuals (n = 76) in which corresponding DXA measurements were available (MAE, n = 52 and SE, n = 24), DXA-derived skeletal muscle index (SMI, appendicular limb mass/height2 ) was compared with corresponding USI values. RESULTS For both young and older participants, USI values were found to be independent of sex, height and body mass. USI values were 3.70 ± 0.52 for YC, 4.50 ± 0.72 for the MAE, 5.05 ± 1.11 for the SE and 6.31 ± 1.38 for the MIE, all significantly different between each other (P < 0.0001). Based on the USI Z-scores, with reference to the YC population, the 219 elderly participants were stratified according to their muscle sarcopenic status. Individuals with USI values within a range of 3.70 < USI ≥ 4.23 were classified as non-sarcopenic (prevalence 23.7%), those with USI values within 4.23 < USI ≥ 4.76 were classified as pre-sarcopenic (prevalence 23.7%), those with USI values within 4.76 < USI ≥ 5.29 were classified as moderately sarcopenic (prevalence 15.1%), those with USI values within range 5.29 < USI ≥ 5.82 were classified as sarcopenic (prevalence 27.9%), and those with USI values >5.82 were classified as severely sarcopenic (prevalence 9.6%). The DXA-derived SMI was found to be significantly correlated with USI (r = 0.61, P < 0.0001). Notably, the USI cut-off value for moderate sarcopenia (4.76 a.u.) was found to coincide with the DXA cut-off value of sarcopenia (7.26 kg/m2 ). CONCLUSIONS We propose a novel, practical, and inexpensive imaging marker of the loss of muscle mass associated with sarcopenia, called the ultrasound sarcopenic index (USI), based on changes in muscle geometric proportions. These changes provide a useful 'signature of sarcopenia' and allow the stratification of individuals according to the presence and severity of muscle sarcopenia. We are convinced that the USI will be a useful clinical tool for confirming the diagnosis of sarcopenia, of which the assessment of muscle mass is a key-component.
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Affiliation(s)
- Marco Narici
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
- CIR‐MYO Myology CenterUniversity of PaduaPaduaItaly
| | - Jamie McPhee
- Department of Sport and Exercise SciencesManchester Metropolitan UniversityManchesterUK
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly
| | | | - Kyle Mitchell
- Dorsey County Hospital NHS Foundation TrustDorchesterUK
| | | | - Elena Monti
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | | | - Philip J. Atherton
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Kenneth Smith
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Bethan Phillips
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Jonathan Lund
- Department of Surgery and University of Nottingham School of MedicineRoyal Derby HospitalDerbyUK
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly
| | - Marcello Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of GeriatricsUniversity of ParmaParmaItaly
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Marcolin G, Franchi MV, Monti E, Pizzichemi M, Sarto F, Sirago G, Paoli A, Maggio M, Zampieri S, Narici M. Active older dancers have lower C-terminal Agrin fragment concentration, better balance and gait performance than sedentary peers. Exp Gerontol 2021; 153:111469. [PMID: 34246731 DOI: 10.1016/j.exger.2021.111469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022]
Abstract
Motor neuron degeneration, denervation, neuromuscular junction (NMJ) fragmentation and loss of motor units (MUs), play a key-role in the development of sarcopenia. The aim of the present study was to investigate the beneficial effects of regular practice of dancing in physically active elders on concentration of C-terminal Agrin fragment (CAF), a marker of NMJ instability, muscle mass, strength, and physical performance in a group of 16 recreationally active older dancers (AOD; 70.1 ± 3.4 yr) compared to 15 age-matched sedentary peers (OS; 70.9 ± 6.2 yr). Circulating concentration of CAF was measured in serum, while morphology of the vastus lateralis and multifidus muscles was assessed by ultrasound imaging. In addition, the participants underwent two functional performance tests, the Timed Up and Go (TUG) and the 10-meter walk test (10-MWT), a lower and upper limb isometric strength test, a static and a dynamic balance test. Although no statistically significant differences were detected for both muscle morphology and isometric strength, higher CAF concentration (20%, p < 0.01) was found in OS. AOD showed a better performance in TUG (22%, p < 0.001), 10-MWT (17%, p < 0.001) and dynamic balance (25%, p < 0.01) than OS. Notably, CAF concentration correlated with dynamic balance performance (r = 0.3711, p < 0.05). Our results provide evidence that the regular practice of dancing in older age, together with non-structured light aerobic physical activities, is associated to lower CAF concentration and improved walking and balance performance. Our findings also suggest that NMJ instability, as indicated by elevated CAF serum concentration, seems to precede the loss of muscle size and alterations in muscle architecture normally associated with sarcopenia.
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Affiliation(s)
- Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Elena Monti
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | | | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Giuseppe Sirago
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Marcello Maggio
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sandra Zampieri
- Department of Biomedical Sciences, University of Padova, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy; Myology Center (CIR-Myo), Department of Biomedical Sciences, University of Padova, Italy.
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Feeding Your Himalayan Expedition: Nutritional Signatures and Body Composition Adaptations of Trekkers and Porters. Nutrients 2021; 13:nu13020460. [PMID: 33573243 PMCID: PMC7911656 DOI: 10.3390/nu13020460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 01/08/2023] Open
Abstract
High-altitude exposure leads to many physiological challenges, such as weight loss and dehydration. However, little attention has been posed to the role of nutrition and ethnic differences. Aiming to fulfill this gap, five Italian trekkers and seven Nepalese porters, all males, recorded their diet in diaries during a Himalayan expedition (19 days), and the average daily intake of micro and macro-nutrients were calculated. Bioimpedance analysis was performed five times during the trek; muscle ultrasound was performed before and after the expedition, only for the Italians. The Nepalese group consumed a lot of rice and only Italians consumed cheese. Water intake was slightly over 3000 g/d for both groups. Nepalese diet had a higher density of dietary fibre and lower density of riboflavin, vitamins A, K, and B12. Intake of calcium was lower than recommended levels. Body mass index, waist circumference, fat-free mass, and total body water decreased in both groups, whereas resistance (Rz) increased. Italians reactance (Xc) increased at day 9, whereas that of Nepalese occurred at days 5, 9, and 16. The cross-sectional area of the Vastus lateralis was reduced after the expedition. Specific nutritional and food-related risk factors guidance is needed for diverse expedition groups. Loss of muscle mass and balance of fluids both deserve a particular focus as concerns altitude expeditions.
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Isaka M, Sugimoto K, Fujimoto T, Yasunobe Y, Xie K, Onishi Y, Yoshida S, Takahashi T, Kurinami H, Akasaka H, Takeya Y, Yamamoto K, Rakugi H. The utility of the ultrasonographic assessment of the lower leg muscles to evaluate sarcopenia and muscle quality in older adults. JCSM CLINICAL REPORTS 2020. [DOI: 10.1002/crt2.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Masaaki Isaka
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
- Physical Therapy Osaka Yukioka College of Health Science Osaka Ibaraki Japan
| | - Ken Sugimoto
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Taku Fujimoto
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Yukiko Yasunobe
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Keyu Xie
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Yuri Onishi
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Shino Yoshida
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | | | - Hitomi Kurinami
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Hiroshi Akasaka
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Yasushi Takeya
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Koichi Yamamoto
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
| | - Hiromi Rakugi
- Geriatric and General Medicine Osaka University Graduate School of Medicine 2‐2, Yamada‐Oka Suita Osaka 565‐0871 Japan
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Barbosa-Silva TG, Gonzalez MC, Bielemann RM, Santos LP, Costa CDS, Menezes AMB. 2 + 2 (+ 2) = 4: A new approach for appendicular muscle mass assessment by ultrasound. Nutrition 2020; 83:111056. [PMID: 33348110 DOI: 10.1016/j.nut.2020.111056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The aim of this study was to develop new appendicular lean mass (ALM) prediction models based on ultrasound and anthropometric measurements. METHODS This was a cross-sectional assessment of a subsample from a population-based study (COMO VAI?), conducted with community-dwelling individuals ≥60 y of age living in a southern Brazilian city. ALM was measured by dual-energy x-ray absorptiometry (DXA). Muscle thickness (MT) from supine participants was assessed by ultrasound on the anterior aspect of both upper and lower limbs. Such measures, along with anthropometric data, were used to develop prediction models (multivariable linear regression) through the backward stepwise method. RESULTS The study included 190 participants composed mainly of women, white, and middle-class individuals. The best ALM predictive performance was achieved by a model based on two "lengths" (height and arm length), two circumferences (dominant arm and thigh), and two ultrasound-measured MTs (dominant arm and thigh): R2 = 0.90, limits of agreement: ±2.36 kg. Closely satisfactory results were also achieved by an "abbreviated" model composed by the two aforementioned "lengths" and MTs (R2 = 0.89, limits of agreement: ±2.51 kg). ALM estimates from both equations were unbiased and similar to DXA measurements (P = 0.13 and 0.09, respectively). Bootstrap analysis favorably suggested the validity of the models. CONCLUSIONS Based on two ultrasound assessments and a few anthropometric measurements, the developed equations produced accurate and unbiased ALM estimates in the sample. Hence: 2 MTs + 2 lengths (+ 2 circumferences) = 4 limbs' muscle mass. Such models might represent promising alternatives for muscle assessment among older individuals.
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Affiliation(s)
- Thiago G Barbosa-Silva
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Pennington Biomedical Research Center, Louisiana State University. Baton Rouge, Louisiana, United States
| | - Renata M Bielemann
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil; Nutrition College, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Caroline Dos S Costa
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ana Maria B Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
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Muscle Hypertrophy and Architectural Changes in Response to Eight-Week Neuromuscular Electrical Stimulation Training in Healthy Older People. Life (Basel) 2020; 10:life10090184. [PMID: 32911678 PMCID: PMC7554879 DOI: 10.3390/life10090184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/25/2022] Open
Abstract
Loss of muscle mass of the lower limbs and of the spine extensors markedly impairs locomotor ability and spine stability in old age. In this study, we investigated whether 8 w of neuromuscular electrical stimulation (NMES) improves size and architecture of the lumbar multifidus (LM) and vastus lateralis (VL) along with locomotor ability in healthy older individuals. Eight volunteers (aged 65 ≥ years) performed NMES 3 times/week. Eight sex- and age-matched individuals served as controls. Functional tests (Timed Up and Go test (TUG) and Five Times Sit-to-Stand Test (FTSST)), VL muscle architecture (muscle thickness (MT), pennation angle (PA), and fiber length (FL)), along with VL cross-sectional area (CSA) and both sides of LM were measured before and after by ultrasound. By the end of the training period, MT and CSA of VL increased by 8.6% and 11.4%, respectively. No significant increases were observed in FL and PA. LM CSA increased by 5.6% (left) and 7.1% (right). Interestingly, all VL architectural parameters significantly decreased in the control group. The combined NMES had a large significant effect on TUG (r = 0.50, p = 0.046). These results extend previous findings on the hypertrophic effects of NMES training, suggesting to be a useful mean for combating age-related sarcopenia.
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Jandova T, Bondi D, Verratti V, Narici M, Steffl M, Pietrangelo T. The importance of sonographic evaluation of muscle depth and thickness prior to the 'tiny percutaneous needle biopsy'. Eur J Transl Myol 2020; 30:8851. [PMID: 32499889 PMCID: PMC7254425 DOI: 10.4081/ejtm.2019.8851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 01/24/2023] Open
Abstract
Biopsy of human skeletal muscle tissue is a widely used method in many research studies, where ‘the tiny percutaneous needle biopsy’ (TPNB) is one of the relatively simplest and safest procedures currently available. By using and contrasting ultrasound images of vastus lateralis of young and elderly subjects, this work highlights further the safety aspects of TPNB and stresses the importance of prior ultrasound evaluation of muscle depth and thickness in order to prevent wrong muscle group or tissue sampling in subsequent laboratory analyses.
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Affiliation(s)
- Tereza Jandova
- Department of Neuroscience, Imaging and Clinical Sciences, University" G. d'Annunzio" of Chieti Pescara, Italy
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University" G. d'Annunzio" of Chieti Pescara, Italy
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti Pescara, Italy
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Italy
| | - Michal Steffl
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University" G. d'Annunzio" of Chieti Pescara, Italy
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Morat M, Faude O, Hanssen H, Ludyga S, Zacher J, Eibl A, Albracht K, Donath L. Agility Training to Integratively Promote Neuromuscular, Cognitive, Cardiovascular and Psychosocial Function in Healthy Older Adults: A Study Protocol of a One-Year Randomized-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1853. [PMID: 32178430 PMCID: PMC7143005 DOI: 10.3390/ijerph17061853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/01/2020] [Accepted: 03/05/2020] [Indexed: 12/24/2022]
Abstract
Exercise training effectively mitigates aging-induced health and fitness impairments. Traditional training recommendations for the elderly focus separately on relevant physiological fitness domains, such as balance, flexibility, strength and endurance. Thus, a more holistic and functional training framework is needed. The proposed agility training concept integratively tackles spatial orientation, stop and go, balance and strength. The presented protocol aims at introducing a two-armed, one-year randomized controlled trial, evaluating the effects of this concept on neuromuscular, cardiovascular, cognitive and psychosocial health outcomes in healthy older adults. Eighty-five participants were enrolled in this ongoing trial. Seventy-nine participants completed baseline testing and were block-randomized to the agility training group or the inactive control group. All participants undergo pre- and post-testing with interim assessment after six months. The intervention group currently receives supervised, group-based agility training twice a week over one year, with progressively demanding perceptual, cognitive and physical exercises. Knee extension strength, reactive balance, dual task gait speed and the Agility Challenge for the Elderly (ACE) serve as primary endpoints and neuromuscular, cognitive, cardiovascular, and psychosocial meassures serve as surrogate secondary outcomes. Our protocol promotes a comprehensive exercise training concept for older adults, that might facilitate stakeholders in health and exercise to stimulate relevant health outcomes without relying on excessively time-consuming physical activity recommendations.
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Affiliation(s)
- Mareike Morat
- Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany;
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (O.F.); (H.H.); (S.L.)
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (O.F.); (H.H.); (S.L.)
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland; (O.F.); (H.H.); (S.L.)
| | - Jonas Zacher
- Institute of Cardiology and Sports Medicine, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany; (J.Z.); (A.E.)
| | - Angi Eibl
- Institute of Cardiology and Sports Medicine, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany; (J.Z.); (A.E.)
| | - Kirsten Albracht
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany;
| | - Lars Donath
- Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany;
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Meza-Valderrama D, Marco E, Duarte E. [Assessment of muscle mass in rehabilitation settings]. Rehabilitacion (Madr) 2020; 54:1-2. [PMID: 32007176 DOI: 10.1016/j.rh.2020.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/02/2020] [Indexed: 12/14/2022]
Affiliation(s)
- D Meza-Valderrama
- Grupo de Investigación en Rehabilitación, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Cataluña, España; Servicio de Medicina Física y Rehabilitación, Instituto Nacional de Medicina Física y Rehabilitación (INFRE), Panamá, Panamá; Servicio de Medicina Física y Rehabilitación, PMMV-Caja de Seguro Social, Panamá, Panamá.
| | - E Marco
- Grupo de Investigación en Rehabilitación, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Cataluña, España; Servicio de Medicina Física y Rehabilitación, Parc Salut Mar (Hospital del Mar-Hospital de la Esperanza), Barcelona, Cataluña, España; Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Cataluña, España
| | - E Duarte
- Grupo de Investigación en Rehabilitación, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Cataluña, España; Servicio de Medicina Física y Rehabilitación, Parc Salut Mar (Hospital del Mar-Hospital de la Esperanza), Barcelona, Cataluña, España
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Lo Buglio A, Bellanti F, Serviddio G, Vendemiale G. Impact of Nutritional Status on Muscle Architecture in Elerly Patients Hospitalized in Internal Medicine Wards. J Nutr Health Aging 2020; 24:717-722. [PMID: 32744567 DOI: 10.1007/s12603-020-1407-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Nutritional alterations are highly prevalent in older rather than adult hospitalized patients. In these subjects, a loss of physical performance is dependent on the impairment of muscle architecture. This study aimed to investigate the association between the nutritional status and muscle architecture in elderly patients hospitalized in internal medicine wards. 68 aged patients admitted in internal medicine wards were consecutively enrolled and stratified in three groups based on the Mini Nutritional Assessment (MNA) score: well-fed (WF), at risk of malnutrition (RM), and malnourished (M). Biochemical indices and anthropometric parameters were sampled at hospital admission. Furthermore, all patients were assessed at admission and after 7 days of hospitalization for muscle strength (hand-grip test), mass (bioimpedentiometry), and architecture (ultrasonography of vastus lateralis). At hospital admission, M patients showed lower percentage of fat free mass and muscle mass with respect to WF and RM. Furthermore, M group presented with lower muscle thickness and pennation angle, as compared to WF and RM. At admission, the MNA score was positively related to the pennation angle and muscle strength. Multivariate linear regression analysis showed that the nutritional status at admission was the only significant factor influencing pennation angle. Finally, during the first 7 days of hospitalization, a decrease of pennation angle occurred in all the groups studied. We conclude that malnutrition at admission is associated with impaired muscle architecture in elderly patients hospitalized in internal medicine wards. Moreover, muscle architecture is impacted by early hospitalization, irrespective of nutritional status.
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Affiliation(s)
- A Lo Buglio
- Francesco Bellanti, MD, PhD, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71121 Foggia, Italy, Ph: +39 0881 732167,
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Bellanti F, Buglio AL, Stasio ED, Bello GD, Tamborra R, Dobrakowski M, Kasperczyk A, Kasperczyk S, Vendemiale G. An open-label, single-center pilot study to test the effects of an amino acid mixture in older patients admitted to internal medicine wards. Nutrition 2020; 69:110588. [PMID: 31629306 DOI: 10.1016/j.nut.2019.110588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Older patients are frequently subjected to prolonged hospitalization and extended bed rest, with a negative effect on physical activity and caloric intake. This results in a consistent loss of muscle mass and function, which is associated with functional decline and high mortality. The aim of this study was to investigate the effect of 1 wk of oral amino acid (AA) supplementation in older patients subjected to low mobility during hospitalization. METHODS Hospitalized older patients (69-87) were included in the control group (n = 50) or were administered 25 g of AA mixture (n = 44) twice daily throughout 7 d of low mobility. We collected data related to length of stay as primary outcome measure. In-hospital mortality, 90-d postdischarge mortality, 90-d postdischarge rehospitalization, and falls also were considered. Moreover, variations of anthropometric measures, body composition and muscle architecture/strength, circulating interleukins, and oxidative stress markers between the beginning and the end of the supplementation period were analyzed as secondary outcomes. RESULTS Similar values were reported between the two groups regarding age (76.6 ± 6.8 versus 79 ± 7.2 y old), body weight (61.5 ± 14.3 versus 62.1 ± 16.1 kg), and body mass index (28.7 ± 4.15 versus 28.1 ± 3.62 kg/m2). Although no difference in terms of in-hospital, 90-d postdischarge, or overall mortality rate was observed between the two groups, a reduction in length of stay, 90-d postdischarge hospitalization, and falls was observed in the AA supplementation group rather than in controls. Furthermore, the AA mixture limited muscle architecture/strength impairment and circulating oxidative stress, which occurred during hospitalization-related bed rest. The latter data was associated with increased circulating levels of anti-inflammatory cytokines interleukin-4 and -10. CONCLUSIONS These results suggest that the AA mixture limits several alterations associated with low mobility in older hospitalized patients, such as length of stay, 90-d postdischarge hospitalization, and falls, preventing the loss of muscle function, as well as the increase of circulating interleukins and oxidative stress markers.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Elena Di Stasio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giorgia di Bello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Tamborra
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Michał Dobrakowski
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Sławomir Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Aubertin-Leheudre M, Martel D, Narici M, Bonnefoy M. The usefulness of muscle architecture assessed with ultrasound to identify hospitalized older adults with physical decline. Exp Gerontol 2019; 125:110678. [PMID: 31376472 DOI: 10.1016/j.exger.2019.110678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Muscle mass and strength decline are known to be key factors in the development of physical incapacities in later life. These structural and functional declines are even more significant in older people during hospitalizations, increasing risk of falls, fractures, and loss of quality of life. In clinical daily practice, functional and muscular decline are assessed using the validated Short Physical Performance Battery (SPPB). Nevertheless, psychological conditions (pain, demotivation, depression) and temporary physical incapacities (e.g: hip fracture) during hospitalization can be significant barriers to evaluate these patients. Skeletal muscle ultrasound assessment could be an alternative in clinical daily practice since muscle architecture (MA) is related to poor muscle function. However, this potential objective and clinical tool is not yet implemented in geriatric setting during hospitalization. Our study aimed at: 1) comparing MA, muscle mass and strength measurements in hospitalized older adults with different functional levels, 2) evaluating the association between these measurements. METHODS Forty-four hospitalized older adults were divided in 2 groups: 21 Pre-Disabled (PDis (SPPBscore: 6-9): 81 ± 7 years old, SPPBscore:7.6 ± 1.1) and 23 Disabled (Dis (SPPBscore:<6): 83 ± 7 years old, SPPBscore:3.6 ± 1.6). SPPB, body mass (BM) and composition (bio-impedance), handgrip strength (HS, dynamometer) and MA (Pennation angle (PA), muscle thickness (MT); ultrasound) were evaluated. RESULTS Relative muscle strength (HS/BM: 0.28 ± 0.08 vs 0.34 ± 0.09 kg/kg), PA (10.6 ± 1.8 vs 12.3 ± 1.9°), and MT (16.4 ± 0.4 vs 19.2 0.4 mm) but not lean body mass were significantly different between Dis and PDis, respectively. Significant associations between PA and the SPPBscore (r2 = 0.37) or walking speed (r2 = 0.38); between SCF and walking speed (r2 = -0.36); as well as between MT and SPPBscore (r2 = 0.29), walking speed (r2 = 0.30), LBM (r2 = 0.382) or MMI (r2 = 0.361) were observed. CONCLUSION Muscle architecture (proxy of muscle quality) and functional capacities/status of hospitalized older adults are related. Thus, ultrasound seems to be a potential useful and objective screening tool for clinicians to assess/prevent physical decline during hospitalization. Larger and/or longitudinal studies are needed to confirm our findings from a pilot pragmatic study.
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Affiliation(s)
- Mylène Aubertin-Leheudre
- Département des Sciences de l'activité physique, Université du Québec à Montréal (UQÀM), Montréal, Québec, Canada; Groupe de recherche en activité physique adaptée, Université du Québec à Montréal (UQÀM), Montréal, Québec, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada.
| | - Dominic Martel
- Département des Sciences de l'activité physique, Université du Québec à Montréal (UQÀM), Montréal, Québec, Canada; Groupe de recherche en activité physique adaptée, Université du Québec à Montréal (UQÀM), Montréal, Québec, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Marc Bonnefoy
- Centre Hospitalier Universitaire de Lyon Sud, Lyon, France; Université Claude Bernard Lyon1, Faculté Lyon Sud, Inserm U 1060, France
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Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48:16-31. [PMID: 30312372 PMCID: PMC6322506 DOI: 10.1093/ageing/afy169] [Citation(s) in RCA: 6286] [Impact Index Per Article: 1257.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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Affiliation(s)
| | - Gülistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Jürgen Bauer
- Center for Geriatric Medicine, University Heidelberg, Agaplesion Bethanien Krankenhaus, Heidelberg, Germany
| | - Yves Boirie
- Research Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, and Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton; Southampton, UK; and Department of Epidemiology, University of Oxford, OX, UK
| | - Francesco Landi
- Instituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Yves Rolland
- Department of Geriatrics, Hospital and University of Toulouse, Toulouse, France
| | - Avan Aihie Sayer
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Stéphane M Schneider
- Department of Gastroenterology and Clinical Nutrition, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Cornel C Sieber
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine and Ageing, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - Maurits Vandewoude
- Department Geriatrics, University of Antwerp, Ziekenhuisnetwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam; and the Amsterdam Public Health Research Institute; Amsterdam, The Netherlands
| | - Mauro Zamboni
- Department of Medicine, Geriatric section, University of Verona, Verona, Italy
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Application of ultrasound for muscle assessment in sarcopenia: the challenge of implementing protocols for clinical practice. Eur Geriatr Med 2018; 10:155-156. [DOI: 10.1007/s41999-018-0126-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 10/27/2022]
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Application of ultrasound for muscle assessment in sarcopenia: towards standardized measurements. Eur Geriatr Med 2018; 9:739-757. [DOI: 10.1007/s41999-018-0104-9] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022]
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