Quadriceps muscle characteristics and subcutaneous fat assessed by ultrasound and relationship with function in patients with knee osteoarthritis awaiting knee arthroplasty

M Núñez, E Nuñez, J M Moreno, V Segura, L Lozano, N M Maurits, J M Segur, S Sastre, M Núñez, E Nuñez, J M Moreno, V Segura, L Lozano, N M Maurits, J M Segur, S Sastre

Abstract

Background: Patients with severe knee osteoarthritis are evaluated for total knee replacement (TKR), whose main indications are persistent pain and severe functional limitations substantially affecting mobility. However, evaluation of pain intensity and functional disability is difficult to standardize.

Objective: To evaluate the relationship between quadriceps muscle thickness (QMT) and quality; the QMT and subcutaneous fat thickness (SFT) and QMT and function in patients with knee OA on a waiting list for TKR.

Methods: Cross-sectional study in consecutively-enrolled patients. Variables: SFT, QMT and rectus femoris muscle quality, assessed by echointensity (EI). Function by the Timed Up & Go Test (TUG); sociodemographic and clinical variables and physical activity were determined. Karl Pearson correlations and multiple linear regression were used.

Results: 61 patients (45 female, mean age 69.7 years [SD 7.2], mean BMI 33.0 [SD 5.7], mean comorbidities 3.3 [SD 2.0], 52.5% regular physical activity) were studied. Mean TUG was 15.1 (SD 6.1). Variables retained in the regression model explained 36% of variability in the TUG. Greater muscle content (percentage) (r = -0,291) was associated with better TUG scores (p = 0.001). Greater muscle EI was negatively (r = -0,364) associated with function (p = 0.006). Older age was associated with worse TUG scores while regular physical activity was associated with better TUG scores (p = 0.001 and p = 0.008, respectively).

Conclusions: A higher percentage of quadriceps muscle and better muscle quality (lower EI) was associated with better function. Age and exercise levels influenced function. Ultrasound may provide.

Keywords: Knee osteoarthritis; Muscle ecography; Muscular; TKR.

References

    1. Núñez M., Lozano L., Núñez E., Segur J.M., Sastre S. Factors influencing health related quality of life after TKR in patients who are obese. Clin Orthop Relat Res. 2011;469(4):1148–1153.
    1. McKay C., Badley E.M., Jaglal S.B., Sale J., Davis A.M. We're all looking for solutions: a qualitative study of the management of knee symptoms. Arthr Care Res (Hoboken) 2014;66(7):1033–1040.
    1. Vennu V., Bindawas S.M. Relationship between falls, knee osteoarthritis, and health-related quality of life: data from the Osteoarthritis Initiative study. Clin Interv Aging. 2014;9:793–800.
    1. De Miguel Mendieta E. 2005. Relevancia De Los Hallazgos Clínicos Y Radiológicos En La Artrosis. Available from:
    1. Lozano L., Núñez M., Sastre S., Popescu D. Total knee arthroplasty in the context of severe and morbid obesity in adults. Open Obesity J. 2012;4:1–10.
    1. Koca I., Boyaci A., Tutoglu A., Boyaci N., Ozkur A. The relationship between quadriceps thickness, radiological staging, and clinical parameters in knee osteoarthritis. J Phys Ther Sci. 2014;26(6):931–936.
    1. Núñez M., Nuñez E., Segur J.M. Health-related quality of life and prioritization strategies in waiting lists: spanish aspects. In: Preedy V.R., Watson R.R., editors. Handbook of Disease Burdens and Quality of Life Measures. Springer; New York: 2009. [1811–24 ISBN: 978–0-387–78664-3 (Print) 978–0-387–78665-0 (Online)2010.
    1. Carr A.J., Robertsson O., Graves S. Knee replacement. Lancet. 2012;379(9823):1331–1340.
    1. Villareal D.T., Banks M., Siener C., Sinacore D.R., Klein S. Physical frailty and body composition in obese elderly men and women. Obes Res. 2004;12:913–920.
    1. Watanabe Y., Yamada Y., Fukumoto Y. Echo intensity obtained from ultrasonography images reflecting muscle strength in elderly men. Clin Interv Aging. 2013;8:993–998.
    1. Seene T., Priit Kaasik P., Riso Lusa E.M. Review on aging, unloading and reloading: changes in skeletal muscle quantity and quality. Arch Gerontol Geriatr. 2012;54(2):374–380.
    1. Möller I., Bong D., Naredo E. Ultrasound in the study and monitoring of osteoarthritis. Osteoarthr Cartil. 2008;16(3):S4–S7.
    1. Keen Wakefield R.J., Conaghan P.G. A systematic review of ultrasonography in osteoarthritis. Ann Rheum Dis. 2009;68(5):611–619. Review.
    1. Bruyn G.A.W., Naredo E., Damjanov N. An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment. Ann Rheum Dis. 2015;0:1–5.
    1. Podsiadlo D., Richardson S. The Timed Up & Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148.
    1. Kellgren J.H., Lawrence J.S. Vol. 2. Blackwell Scientific Publications.; Oxford: 1963. (Atlas Standard radiographs: the epidemiology of chronic rheumatism).
    1. Maurits N.M., Bollen A.E., Windhausen A., De Jager A.E., Van Der Hoeven J.H. Muscle ultrasound analysis: normal values and differentiation between myopathies and neuropathies. Ultrasound Med Biol. 2003;29(2):215–225.
    1. Rech A., Radaelli R., Goltz F.R., da Rosa L.H., Schneider C.D., Pinto R.S. Echo intensity is negatively associated with functional capacity in older women. Age (Dordr) 2014;36(5):9708.
    1. Abizanda P., Lopez-Torres J., Romero L., Sánchez-Jurado P.M., García-Noguera I., Esquinas J.L. Normal data of functional assessment tools of the elderly in Spain: the FRADEA Study. Aten Primaria. 2012;44(3):162–171.
    1. Dunlop D.D., Song J., Semanik P.A., Sharma L., Chang R.W. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Arthr. Rheum. 2011;63(1):127–136.
    1. Brown C.J., Flood K.L. Mobility limitation in the older patient: a clinical review. JAMA. 2013;310(11):1168–1177.
    1. Bennell K.L., Hinman R.S. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14(1):4–9.
    1. Arts I.M., Pillen S., Schelhaas H.J., Overeem S., Zwarts M.J. Normal values for quantitative muscle ultrasonography in adults. Muscle Nerve. 2010;41(1):32–41.
    1. Cadore E.L., Izquierdo M., Conceição M. Echo intensity is associated with skeletal muscle power and cardiovascular performance in elderly men. Exp Gerontol. 2012;47(6):473–478.
    1. Fukumoto Y., Ikezoe T., Yamada Y. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012;112(4):1519–1525.
    1. Whittaker J.L., Emery C.A. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014;44(8):627–632.
    1. Brown D.W., Balluz L.S., Heath G.W. Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med. 2003;37(5):520–528.
    1. McLean R.R. The weakness link: can muscle impairment Be identified as a cause of disability in rheumatology patients? Arthr Care Res (Hoboken) 2015;67(1):1–3.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir