Relationship between quadriceps thickness and 60-second sit-to-stand test in patients with chronic kidney disease

Abstract

Background: This study aimed to evaluate the relationship between quadriceps muscle thickness and functional performance on the 60s sit-to-stand test (60s-STS), the six-minute walk test (6MWT), and handgrip strength in non-dialytic stage 4 and 5 chronic kidney disease (CKD) patients. Methods: This was a cross-sectional study that evaluated 40 CKD patients aged between 30-70 years. Participants were submitted to an assessment that included quadriceps muscle thickness evaluated by a portable ultrasound. Functional performance tests included the 60s-STS, distance walked in the 6MWT, and handgrip strength. Also, body composition evaluated using electrical bioimpedance analysis and physical activity level through the short version of International Physical Activity were measured. Multiple linear regression was used to investigate the relationship between the quadriceps thickness and functional performance. Results: Quadriceps muscle thickness was correlated to 60s-STS (R2 = 43.6%; 95% CI = 0.022 - 0.665; β = 0.34; p = 0.037). Also, a moderate correlation between this muscle thickness and appendicular skeletal muscle (ALM) was found in CKD patients (r = 0.603, p <0.001). No relationship was found between quadriceps muscle thickness with the 6MWT and handgrip strength. Conclusion: Quadriceps muscle thickness is associated to 60s-STS, thus our results demonstrate the repercussions of the disease on the musculoskeletal system.

Is there an association between quadriceps thickness and functional capacity in patients with chronic kidney disease?

“…On the other hand, some studies have shown that there is an association between the 60s STS test result and distance in the 6MWT; and have also described that the 60s STS test may represent an alternative to determine functional capacity, especially if space and time are limited 2 - 5 . Thus, we believe that the results found by Costa et al 1 are actually more associated with the characteristics of the 60s STS test in assessing muscle endurance than the relationship with the functional capacity in patients with CKD. Basically, ultrasonography enabled us to analyze muscle “volume” rather than muscle “quality” by determining fiber types in the quadriceps.…”

“…Although the results by Costa et al 1 showed that the ultrasonography-assessed quadriceps muscle thickness was associated with performance in the 60s STS test, this relationship was not seen with distance in the 6MWT. On the other hand, some studies have shown that there is an association between the 60s STS test result and distance in the 6MWT; and have also described that the 60s STS test may represent an alternative to determine functional capacity, especially if space and time are limited 2 - 5 .…”

“…However, quadriceps thickness was not associated with the distance covered in the six-minute walk test (6MWT) and with handgrip strength 1 . Therefore, this letter aims to discuss some findings of the study by Costa et al 1 , considering our experience with the STS test and the partial results of a project that we are carrying out to evaluate the association of different STS test protocols with the quadriceps muscle torque in patients with CKD on hemodialysis.…”

“…In a recently published paper, Costa et al 1 demonstrated the association between ultrasound-assessed quadriceps muscle thickness and the number of repetitions in the 60s sit-to-stand (STS) test (R 2 = 0.436; p = 0.037) in patients with pre-dialysis chronic kidney disease (CKD). However, quadriceps thickness was not associated with the distance covered in the six-minute walk test (6MWT) and with handgrip strength 1 .…”

“…In a recently published paper, Costa et al 1 demonstrated the association between ultrasound-assessed quadriceps muscle thickness and the number of repetitions in the 60s sit-to-stand (STS) test (R 2 = 0.436; p = 0.037) in patients with pre-dialysis chronic kidney disease (CKD). However, quadriceps thickness was not associated with the distance covered in the six-minute walk test (6MWT) and with handgrip strength 1 . Therefore, this letter aims to discuss some findings of the study by Costa et al 1 , considering our experience with the STS test and the partial results of a project that we are carrying out to evaluate the association of different STS test protocols with the quadriceps muscle torque in patients with CKD on hemodialysis.…”