Combined Exercise and Nutrition Intervention for Spinal Sarcopenia: a Pilot Study
试验速览
- 阶段
- 不适用
- 入组人数
- 35
- 主要终点
- Isometric back extensor strength
研究概览
简要总结
Sarcopenia in the lumbar paraspinal muscles is receiving renewed attention as a cause of spinal degeneration. However, there were few studies on the precise concept and diagnostic criteria for spinal sarcopenia. We have already developed the concept of spinal sarcopenia in community-dwelling older adults and investigated the association between conventional sarcopenic indices and spinal sarcopenia. However, intervention studies on spinal sarcopenia have not been conducted until now. Here, we aim a pilot study to evaluate the effectiveness of the combined exercise and nutrition intervention for spinal sarcopenia.
This is a prospective study with 35 community-dwelling older women who were diagnosed as spinal sarcopenia in our previous cohort study. Combined intervention will consist of back extensor strengthening exercise and nutritional supplementation for 12 weeks. The primary outcome of this study is isometric back extensor strength after 12 weeks' intervention. All functional outcomes will be measured at 0, 12, and 24 weeks after intervention. The data will be analysed using the intention-to-treat principle.
详细描述
Both the atrophy and fatty change of paraspinal muscles originated from sarcopenia on lumbar paraspinal are also known to be associated with functional disorders and chronic back pain. We want to suggest classifying this phenomenon as "spinal sarcopenia." While feasible, inexpensive, and less radiation-exposed tools such as dual energy X-ray absorptiometry have been used to measure appendicular skeletal muscle mass, paraspinal muscle assessment is still needed using spinal CT or MRI. In addition, spinal extensor strength measurement is necessary to confirm the function of lumbar paraspinal muscle, but isokinetic exercise equipment for accurate measurement is not as feasible as a dynamometer for hand grip strength to evaluate sarcopenia. Furthermore, many elderly people may experience pain during the measurement of spinal extension strength. Therefore, it is necessary to develop a simple, accessible, and clinically meaningful measurement index to confirm the myofunction of spinal extension. The main two axes of treatment and prevention of conventional sarcopenia are muscle strengthening exercises and high protein nutritional supplements. Therefore, it is necessary to confirm the clinical effect by intervention for spinal extension exercise and nutritional supplementation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 90 Years（Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Older women (≥ 65 years old)
- •Community-dwellers
- •Able to walk with or without assistive devices for more than 100 meters
排除标准
- •Low back pain with moderate severity (numeric rating scale 5 and over)
- •History of any types of lumbar spine surgery
- •History of hip fracture surgery and arthroplasty of hip or knee
- •Contraindications for MRI (such as cardiac pacemaker, implanted metallic objects, and claustrophobia)
- •Disorders in central nervous system (such as stroke, parkinsonism, spinal cord injury)
- •Cognitive dysfunction (Mini Mental State Examination score < 24)
- •Communication disorder (such as severe hearing loss)
- •Musculoskeletal condition affecting physical function (such as amputation of limb)
- •Long-term use of corticosteroids due to inflammatory disease
- •Malignancy requiring treatment within 5 years
- •Other medical conditions which need active treatment
- •Subjects who refuse to participate in a study
结局指标
主要结局
Isometric back extensor strength
时间窗: 12 weeks after intervention
Isometric back muscle strength test using a handheld dynamometer (PowerTrack II; JTECH Medical, Salt Lake City, UT, USA)
次要结局
- Spinal sagittal balance parameters(24 weeks after intervention)
- Isokinetic back extensor strength(24 weeks after intervention)
- Lumbar paraspinal muscle volume(12 weeks after intervention)
- Isometric back extensor strength(24 weeks after intervention)
- Short physical performance battery (SPPB)(24 weeks after intervention)
研究者
Sang Yoon Lee
Clinical Associate Professor
Seoul National University Hospital