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Ultrasound assessment of rectus femoris muscle in rehabilitation patients with chronic obstructive pulmonary disease screened for sarcopenia: correlation of muscle size with quadriceps strength and fat-free mass

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An Editorial to this article was published on 30 November 2018

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.

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Acknowledgements

The authors thank the study participants and other contributors, including but not limited to Joan Vila for statistical support and Elaine Lilly, PhD, for unfailing support, language revisions and suggestions.

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Authors and Affiliations

  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

    Cindry Ramírez-Fuentes, Patrícia Mínguez-Blasco, Raquel Macías, Josep M. Muniesa, Ferran Escalada & Ester Marco

  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

    Fabián Ostiz

  3. Geriatric Department, Parc de Salut Mar (Centre Fòrum Hospital del Mar), Llull 410, 08019, Barcelona, Catalonia, Spain

    Dolores Sánchez-Rodríguez

  4. Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Doctor Aiguader 88, 08033, Barcelona, Catalonia, Spain

    Dolores Sánchez-Rodríguez, Monique Messaggi-Sartor, Josep M. Muniesa, Ferran Escalada & Ester Marco

  5. School of Medicine, Universitat Autònoma de Barcelona (UAB), Doctor Aiguader 80, 08003, Barcelona, Catalonia, Spain

    Dolores Sánchez-Rodríguez, Josep M. Muniesa, Diego A. Rodríguez, Ferran Escalada & Ester Marco

  6. School of Medicine, Universitat Pompeu Fabra, Doctor Aiguader 80, 08003, Barcelona, Catalonia, Spain

    Dolores Sánchez-Rodríguez & Diego A. Rodríguez

  7. Respiratory Diseases Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Catalonia, Spain

    Diego A. Rodríguez

  8. Biostatistics, Cardiovascular Epidemiology and Genetics (EGEC), REGICOR Study Group, Hospital del Mar Medical Research Institute, CIBERESP (CIBER Epidemiologia y Salud Pública), Madrid, Spain

    Joan Vila

  9. University Center of Geriatrics, Antwerp University, Leopoldstraat 26, 2000, Antwerp, Belgium

    Stany Perkisas

Authors
  1. Cindry Ramírez-Fuentes
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  2. Patrícia Mínguez-Blasco
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  8. Diego A. Rodríguez
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  9. Joan Vila
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Corresponding author

Correspondence to Ester Marco.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ramírez-Fuentes, C., Mínguez-Blasco, P., Ostiz, F. et al. Ultrasound assessment of rectus femoris muscle in rehabilitation patients with chronic obstructive pulmonary disease screened for sarcopenia: correlation of muscle size with quadriceps strength and fat-free mass. Eur Geriatr Med 10, 89–97 (2019). https://doi.org/10.1007/s41999-018-0130-7

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