Associations of Computed Tomography-Based Trunk Muscle Size and Density With Balance and Falls in Older Adults

Anderson, Dennis E.; Quinn, Emily; Parker, Emily Anne; Allaire, Brett T.; Muir, Jesse; Rubin, Clinton T.; Magaziner, Jay; Hannan, Marian T.; Bouxsein, Mary L.; Kiel, Douglas P.

doi:10.1093/gerona/glv185

Cited by 54 publications

(44 citation statements)

References 37 publications

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“…Specifically, Woodham et al 41 reported that two young patients with chronic LBP who performed multifidi-focused exercises had reduced intramuscular fat. Given previous findings, 19,20 it is possible that older adults with LBP may also benefit from similar interventions. 42 Our work supports future research exploring longitudinal relationships between multifidi intramuscular fat and physical function among older adults with chronic LBP.…”

Section: Discussionmentioning

confidence: 75%

“…decreased intramuscular fat), has been associated with reduced postural sway and better functional performance. 20 Among older adults with and without LBP, Hicks and colleagues found greater trunk muscle (i.e. abdominals and paraspinals) intramuscular fat was predictive of poorer performance; LBP moderated this relationship.…”

mentioning

confidence: 99%

“…19 Further exploration of intramuscular fat of the lumbar multifidi (given its role in spinal health and function) as a factor that may help to explain physical function among older adults, especially those with LBP, may expand upon these prior findings. 19,20 …”

mentioning

confidence: 99%

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Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective The purpose of this study was to determine if multifidi size and/or intramuscular fat were associated with self-reported and performance-based physical function in older adults with and without chronic LBP. Design Case-control study Setting Individuals participated in a standardized evaluation in a clinical laboratory and underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility. Patient Sample A volunteer sample of 106 community-dwelling older adults, aged 60-85 years, with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis. Intervention Average right-left, L5 multifidi relative, i.e. total, cross-sectional area (rCSA); muscle-fat infiltration index (MFI), i.e. a measure of intramuscular fat; and relative muscle cross-sectional area (rmCSA), i.e. total CSA minus intramuscular fat CSA, were determined from MRIs. Linear regression modeling was performed with physical function measures as the dependent variables. Age, sex, and body mass index were entered as covariates. The main effects of L5 multifidi MFI and rmCSA, as well as their interaction with group assignment, were compared as independent variables. Main Outcome Measures Short Form-36 Health Survey Physical Functioning subscale (SF-36 PFS), Timed Up and Go (TUG), gait speed, and fast stair descent performance. Results Interaction terms between L5 multifidi MFI and group assignment were found to be significant contributors to the variance explained in all physical function measures (p≤.012). Neither the main effect, nor the interaction with group assignment for L5 multifidi rmCSA, significantly contributed to the variance explained in any of the physical function measures (p>.012). Conclusions Among older adults with chronic LBP of at least moderate intensity, L5 multifidi muscle composition, but not size, may help to explain physical function.

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Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 99%

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Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…Some investigations refer to a single vertebral level, while others report a cross section up to 11 levels between L1 and S1. Within a single level, the reported CSA can be measured at the level of the center of the intervertebral disc, at the middle of the lamina, at the superior/inferior endplate, or at the center of the vertebral body [24–28]. …”

Section: Resultsmentioning

confidence: 99%

“…Vast variability is also present in the orientation of the “slice.” Some authors adjusted the image parallel to the superior endplate/inferior endplate of the vertebral body; others used the CT reformatted image, perpendicular to the muscle mass/muscle fiber orientation [24–28]. Due to the above reasons, it is difficult to determine normal CSA values adjusted for age and gender in a healthy population and in individuals with LBP (Table 1).…”

Section: Resultsmentioning

confidence: 99%

The Association between Imaging Parameters of the Paraspinal Muscles, Spinal Degeneration, and Low Back Pain

Kalichman

Carmeli

Been

2017

BioMed Research International

193

179

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This narrative review investigated imaging parameters of the paraspinal muscles and their association with spinal degenerative features and low back pain (LBP) found in the literature. Three principal signs of muscle degeneration were detected on imaging: decreased muscle size, decreased radiographic density, and increased fat deposits. Men have a higher density of paraspinal muscles than women, younger individuals have a higher density than older ones, and lean individuals have a higher density than those with an increased body mass index. Fatty infiltration appears to be a late stage of muscular degeneration and can be measured noninvasively by an MRI scan. Fatty infiltration in the lumbar multifidus is common in adults and is strongly associated with LBP, especially in women, independent of body composition. Fatty infiltration develops in areas where most degenerative changes are found. MR spectroscopy studies have corroborated that the lumbar multifidus in LBP subjects has a significantly higher fat content than asymptomatic controls. There is a strong need for establishing uniform methods of evaluating normal parameters and degenerative changes of the paraspinal muscles. Additional imaging studies are needed to improve the understanding of the association and causal relationships between LBP, spinal degeneration, and changes in the paraspinal muscles.

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Intramuscular Fat Accumulation and Associations With Body Composition, Strength, and Physical Functioning in Patients With Rheumatoid Arthritis

Baker

Mostoufi‐Moab

Long

et al. 2018

Arthritis Care & Research

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Associations of Computed Tomography-Based Trunk Muscle Size and Density With Balance and Falls in Older Adults

Cited by 54 publications

References 37 publications

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

The Association between Imaging Parameters of the Paraspinal Muscles, Spinal Degeneration, and Low Back Pain

Intramuscular Fat Accumulation and Associations With Body Composition, Strength, and Physical Functioning in Patients With Rheumatoid Arthritis

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