Trunk muscle composition 2 months after hip fracture: Findings from the Baltimore Hip Studies

Publication date: Available online 19 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Gregory E. Hicks, Michelle D. Shardell, Ram R. Miller, Marty Eastlack, Denise L. Orwig, Bret H. Goodpaster, Peter J. Chomentowski, Marc C. Hochberg, Alan M. Rathbun, Jane A. Cauley, Tamara Harris, Suzanne Satterfield, Anne L. Schafer, Jay Magaziner

Abstract

Objective

To determine if hip fracture patients would have smaller cross-sectional area (CSA) and lower radiological attenuation (suggesting greater fat infiltration) in all trunk muscles as compared to healthy older adults.

Design

Cross-sectional analysis of computed tomography scans.

Setting

Clinical imaging facility.

Participants

Forty-one white participants (19 men, 22 women) from the Baltimore Hip Studies 7^th cohort (BHS-7) at 2-months post-fracture were compared to 693 white participants (424 men, 269 women) from the Health, Aging and Body Composition Study (Health ABC) at the year 6 visit.

Intervention

Not applicable.

Main Outcome Measures

Trunk muscle CSA and attenuation values were obtained from a single 10 mm, axial computed tomography (CT) scan completed at the L4-L5 disc space in each participant.

Results

The hip fracture cohort had significantly smaller CSA for all trunk muscles (range: 12.1 to 38 % smaller) compared to the Health ABC cohort (p<.01), with the exception of the rectus abdominus muscle in men (p=.12). But, hip fracture patients, particularly female patients, had higher attenuation levels (lower intramuscular fat) in all trunk muscles (p<.0001).

Conclusions

Findings are consistent with atrophy of the trunk muscles in the hip fracture population without a high level of intramuscular fat. Future work should evaluate the role of trunk muscle composition in the functional recovery of older adults following hip fracture.

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