Cindry Ramírez-Fuentes1, Patrícia Mínguez-Blasco1, Fabián Ostiz2, Dolores Sánchez-Rodríguez3,4,5,6, Monique Messaggi-Sartor4, Raquel Macías1, Josep M Muniesa1,4,5, Diego A Rodríguez5,6,7, Joan Vila8, Stany Perkisas9, Ferran Escalada1,4,5, Ester Marco10,11,12. 1. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança), Sant Josep de la Muntanya 12, 08024, Barcelona, Catalonia, Spain. 2. Physical Medicine and Rehabilitation Department, Centre d'Atenció Primària Sant Andreu, Institut Català de la Salut, Avinguda de la Meridiana 428, 08030, Barcelona, Catalonia, Spain. 3. Geriatric Department, Parc de Salut Mar (Centre Fòrum Hospital del Mar), Llull 410, 08019, Barcelona, Catalonia, Spain. 4. Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Doctor Aiguader 88, 08033, Barcelona, Catalonia, Spain. 5. School of Medicine, Universitat Autònoma de Barcelona (UAB), Doctor Aiguader 80, 08003, Barcelona, Catalonia, Spain. 6. School of Medicine, Universitat Pompeu Fabra, Doctor Aiguader 80, 08003, Barcelona, Catalonia, Spain. 7. Respiratory Diseases Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Catalonia, Spain. 8. Biostatistics, Cardiovascular Epidemiology and Genetics (EGEC), REGICOR Study Group, Hospital del Mar Medical Research Institute, CIBERESP (CIBER Epidemiologia y Salud Pública), Madrid, Spain. 9. University Center of Geriatrics, Antwerp University, Leopoldstraat 26, 2000, Antwerp, Belgium. 10. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança), Sant Josep de la Muntanya 12, 08024, Barcelona, Catalonia, Spain. emarco@parcdesalutmar.cat. 11. Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Doctor Aiguader 88, 08033, Barcelona, Catalonia, Spain. emarco@parcdesalutmar.cat. 12. School of Medicine, Universitat Autònoma de Barcelona (UAB), Doctor Aiguader 80, 08003, Barcelona, Catalonia, Spain. emarco@parcdesalutmar.cat.
Abstract
PURPOSE: To determine the relationship of the size of the rectus femoris muscle, assessed by ultrasonography, with parameters of muscle strength and body composition that are commonly used in the case-finding of sarcopenia in rehabilitation patients with chronic obstructive pulmonary disease (COPD). METHODS: Cross-sectional pilot study of 18 men with severe COPD and 17 healthy controls. MAIN OUTCOME VARIABLES: cross-sectional area, thickness, and width of the non-dominant rectus femoris muscle obtained by ultrasound, muscle strength determined by voluntary maximum isometric contraction of the quadriceps muscle, and fat-free mass assessed by bioimpedance analysis. RESULTS: Ultrasounds detected differences in the size of the rectus femoris muscle: cross-sectional area was 4.3 (SD 1.05) cm2 in patients, compared to 5.6 (SD 1.25) cm2 in controls; patients also presented lower quadriceps strength, and fat-free mass index. Cross-sectional area of the rectus femoris muscle showed a moderate correlation with quadriceps strength (R = 0.497, p = 0.036) and fat-free mass (R = 0.584, p = 0.011). In a multivariate linear model adjusted for age, body mass index, fat-free mass and muscle size, muscle strength was 7.44 kg lower (p value = 0.014) in patients, compared to controls. CONCLUSIONS: A causal relationship was observed between the cross-sectional area of the rectus femoris muscle, assessed with ultrasonography, and maximum isometric strength of knee extension in COPD rehabilitation patients. Reduced cross-sectional area was also associated with loss of fat-free mass. Muscle ultrasound and bioimpedance analysis provide complementary and relevant information that could be useful in the case-finding of sarcopenia in COPD patients.
PURPOSE: To determine the relationship of the size of the rectus femoris muscle, assessed by ultrasonography, with parameters of muscle strength and body composition that are commonly used in the case-finding of sarcopenia in rehabilitation patients with chronic obstructive pulmonary disease (COPD). METHODS: Cross-sectional pilot study of 18 men with severe COPD and 17 healthy controls. MAIN OUTCOME VARIABLES: cross-sectional area, thickness, and width of the non-dominant rectus femoris muscle obtained by ultrasound, muscle strength determined by voluntary maximum isometric contraction of the quadriceps muscle, and fat-free mass assessed by bioimpedance analysis. RESULTS: Ultrasounds detected differences in the size of the rectus femoris muscle: cross-sectional area was 4.3 (SD 1.05) cm2 in patients, compared to 5.6 (SD 1.25) cm2 in controls; patients also presented lower quadriceps strength, and fat-free mass index. Cross-sectional area of the rectus femoris muscle showed a moderate correlation with quadriceps strength (R = 0.497, p = 0.036) and fat-free mass (R = 0.584, p = 0.011). In a multivariate linear model adjusted for age, body mass index, fat-free mass and muscle size, muscle strength was 7.44 kg lower (p value = 0.014) in patients, compared to controls. CONCLUSIONS: A causal relationship was observed between the cross-sectional area of the rectus femoris muscle, assessed with ultrasonography, and maximum isometric strength of knee extension in COPD rehabilitation patients. Reduced cross-sectional area was also associated with loss of fat-free mass. Muscle ultrasound and bioimpedance analysis provide complementary and relevant information that could be useful in the case-finding of sarcopenia in COPDpatients.
Authors: Jaber S Alqahtani; Tope Oyelade; Jithin Sreedharan; Abdulelah M Aldhahir; Saeed M Alghamdi; Ahmed M Alrajeh; Abdullah S Alqahtani; Abdullah Alsulayyim; Yousef S Aldabayan; Nowaf Y Alobaidi; Mohammed D AlAhmari Journal: BMJ Open Respir Res Date: 2020-09