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Low physical performance determined by chair rising test muscle mechanography is associated with prevalent fragility fractures

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Abstract

Summary

This study examined associations between physical performance assessed by chair rising test muscle mechanography and DXA T-score as well as body composition in a large patient cohort. Next to various significant interrelationships between these muscle and bone parameters, lower physical performance was associated with prevalent fragility fractures.

Purpose

Although the interaction between muscle and bone has been demonstrated in various aspects, the clinical focus in the diagnosis of musculoskeletal disorders mainly lies on the skeletal assessments. Accordingly, the association between muscle function, bone mineral density (BMD), and fragility fractures remains to be further elucidated with a feasible muscle assessment in a clinical setting.

Methods

Patient data (2076 patients, 1538 women, 538 men) were evaluated retrospectively from a large dual energy X-ray absorptiometry (DXA) database as well as from chair rising test (CRT) that was performed on a muscle mechanograph. To determine potential predictors of the CRT time and maximum force, a multivariate regression analysis was performed including age, DXA T-score, and body composition indices. Furthermore, CRT results were compared between non-fracture and fracture cases.

Results

We determined independent predictors for CRT time such as age, femoral DXA T-score, and total fat mass, whereas CRT force was only influenced by total lean mass. Both women and men with previous fragility fractures displayed a longer CRT time (women p = 0.009, men p = 0.001) and lower CRT force (women p < 0.001, men p < 0.001) than those with no fractures, while no clear differences in CRT results could be detected between normal BMD, osteopenia, and osteoporosis based on DXA T-scores.

Conclusions

Our study demonstrates that in addition to the associations between chair rising time and femoral T-score assessed by DXA, low muscle strength is associated with previous fragility fractures.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany

    Tobias Rupp, Sebastian Butscheidt, Katharina Jähn, Maciej JK Simon, Haider Mussawy, Ralf Oheim, Florian Barvencik, Michael Amling & Tim Rolvien

  2. Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Maciej JK Simon, Haider Mussawy & Tim Rolvien

Authors
  1. Tobias Rupp
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  2. Sebastian Butscheidt
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  3. Katharina Jähn
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  4. Maciej JK Simon
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  5. Haider Mussawy
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  6. Ralf Oheim
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  7. Florian Barvencik
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  8. Michael Amling
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  9. Tim Rolvien
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Contributions

Study design: MA and T Rolvien. Study conduct: T Rupp, SB, MJKS, HM, RO, FB, MA, and T Rolvien. Data analysis: T Rupp, SB, KJ, MJKS, HM, RO, FB, MA, and T Rolvien. Drafting manuscript: T Rupp and T Rolvien. Revising manuscript: T Rupp, SB, KJ, MJKS, HM, RO, FB, MA, and T Rolvien. T Rupp and T Rolvien take responsibility for the integrity of the data analysis.

Corresponding author

Correspondence to Tim Rolvien.

Ethics declarations

This study was approved by the local ethics committee (PV3874).

Conflicts of interest

None.

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Rupp, T., Butscheidt, S., Jähn, K. et al. Low physical performance determined by chair rising test muscle mechanography is associated with prevalent fragility fractures. Arch Osteoporos 13, 71 (2018). https://doi.org/10.1007/s11657-018-0490-0

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