Trunk Muscle Composition 2 Months After Hip Fracture: Findings From the Baltimore Hip Studies.
Gregory E Hicks, Michelle D Shardell, Ram R Miller and 11 others
PMID 30578772WHAT IT FOUND
Two months after hip fracture, older white patients had smaller trunk muscles than older white non-fracture controls, especially side abdominal muscles.
Their muscle fat content measured by CT appeared lower, not higher.
Key findings
01After adjustment, hip fracture patients had smaller trunk muscle area in each muscle group than non-fracture controls, except the front abdominal muscle in men.
02The side abdominal muscles were approximately 29% smaller in women and 38% smaller in men with hip fracture than in controls.
03Hip fracture patients had higher muscle attenuation values, meaning lower fat inside muscle, with front abdominal muscle values 344% higher in women and 164% higher in men.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The hip fracture group became very small after exclusions: 22 women and 19 men were analysed, so findings may be unstable. Many eligible hip fracture participants refused CT scanning, so the scanned group may not represent all hip fracture patients. The sample was restricted to white participants, so it does not show what happens in other racial or ethnic groups. The study measured trunk muscles at 2 months after fracture, so it cannot show whether the differences existed before fracture or developed after it. Controls came from a different cohort and were scanned with a different scanner and software, although acquisition and analysis methods were modeled on the same approach. Muscle attenuation was validated in limb muscles, not trunk muscles, and there are no normal values for trunk muscle attenuation, making the fat-infiltration finding harder to interpret. Height, weight and body mass index were not identical between groups, especially for women, so residual differences may remain despite adjustment.
Declared interests
Research support from N.I.H. extramural and intramural programs is listed. No author conflicts of interest or commercial funding are stated in the supplied text.
The easy way to misread this
Do not conclude that hip fracture caused smaller trunk muscles or that trunk exercise will improve recovery. This was an observational comparison at the 2-month evaluation, and no treatment was tested.