Targeting Sarcopenia as an Objective Clinical Outcome in the Care of Children with Spinal Cord-Related Paralysis: A Clinician's View

Muscle Mass as a Biomarker for Health Status and Function in Pediatric Individuals with Neuromuscular Disabilities: A Systematic Review

This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.

Secondary Sarcopenia and Spinal Cord Injury: Clinical Associations and Health Outcomes

Background: Sarcopenia and spinal cord injury (SCI) often coexist, but little is known about the associations. This study aimed to assess the impact of SCI on muscle and bone mass and the correlations between the clinical characteristics of SCI patients and sarcopenia. Methods: A total of 136 patients with SCI admitted to rehabilitation hospital were included in this study. The type and severity of injury (AIS), level of spasticity (MAS), bone mineral density and Appendicular Lean Muscle Mass (ALM) were assessed. Sarcopenia was diagnosed according to EWGSOP2 cut-off points for ALM. Results: Subjects were divided into two groups: Group S-SCI (N = 66, sarcopenia group) and Group NS-SCI (N = 70, without sarcopenia). Mean ALM values in the two groups were 0.49 and 0.65, respectively. A total of 75% of women and 42.9% of men developed sarcopenia. The mean age was 35.8 years in the sarcopenic patients and 41.5 in the non-sarcopenia group. Over 55% of AIS Grades A and B cases, 69.7% of MAS level 0 cases and 51.6% of the patients with osteoporosis had sarcopenia. The mean number of comorbidities was 2.7 in the sarcopenia group. Conclusions: Gender, type of injury, presence of multiple comorbidities and age were directly associated with sarcopenia; meanwhile, surprisingly, spasticity level and the presence of immobilization osteoporosis were not.