Non-Invasive Biomarkers of Musculoskeletal Health with High Discriminant Ability for Age and Gender

A novel approach to ageing studies assessed the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and thigh composition (ultrasound imaging) to classify healthy individuals according to age and gender. The cross-sectional study included 138 community-dwelling, self-reported healthy males and females (65 young, mean age ± SD = 25.7 ± 4.8 years; 73 older, 74.9 ± 5.9 years). Handgrip strength; quadriceps strength; respiratory peak flow; timed up and go; stair climbing time; anterior thigh tissue thickness; muscle stiffness, tone, elasticity (Myoton technology), and self-reported health related quality of life (SF36) were assessed. Stepwise feature selection using cross-validation with linear discriminant analysis was used to classify cases based on criterion variable derived from known effects of age on physical function. A model was trained and features selected using 126 cases with 0.92 accuracy (95% CI = 0.86–0.96; Kappa = 0.89). The final model included five features (peak flow, timed up and go, biceps brachii elasticity, anterior thigh muscle thickness, and percentage thigh muscle) with high sensitivity (0.82–0.96) and specificity (0.94–0.99). The most sensitive novel biomarkers require no volition, highlighting potentially useful tests for screening and monitoring effects of interventions on musculoskeletal health for vulnerable older people with pain or cognitive impairment.

Psoas Major Muscle Volume Does Not Affect the Postoperative Thigh Symptoms in XLIF Surgery

Background: Extreme lateral interbody fusion (XLIF) is a minimally invasive surgery that accesses the lumbar spine through the psoas muscle. This study aimed to evaluate the correlation between the psoas major muscle volume and anterior thigh symptoms after XLIF. Methods: Eighty-one patients (mean age 63 years) with degenerative spine diseases underwent XLIF (total = 94 levels). Thirty-eight patients were female (46.9%), and 24 patients (29.6%) had a history of lumbar surgery. Supplemental pedicle screws were used in 48 patients, and lateral plates were used in 28 patients. Neuromonitoring devices were used in all cases. The patients were classified into two groups (presence of thigh symptoms and no thigh symptoms after the surgery). The psoas major volumes were measured and calculated by CT (computed tomography) scan and compared between the two patient groups. Results: In the first 24 h after surgery, 32 patients (39.5%) had thigh symptoms (20 reported pain, 9 reported numbness, and 18 reported weakness). At one year postoperatively, only 3 of 32 patients (9.4%) had persistent symptoms. Conclusions: As a final observation, no statistically significant difference in the mean psoas major volume was found between the group of patients with new postoperative anterior thigh symptoms and those with no thigh symptoms. Preoperative psoas major muscle volume seems not to correlate with postoperative anterior thigh symptoms after XLIF.

Predictive Ability of Body Fat Percentage and Thigh Anthropometrics on Tissue Cooling during Cold Water Immersion

Context: Cold water immersion (CWI) is a common aid in exercise recovery. CWI effectiveness depends on the magnitude of muscle and core cooling. Individual cooling responses to CWI are variable and likely influenced by CWI dose and individual physiological characteristics. Objective: Evaluate body fat percentage and thigh anthropometrics as predictors of intramuscular and skin cooling responses to CWI. Design: Interrupted time-series. Setting: Sports medicine research center. Participants: Sixteen young adults (8 male, 8 female, age=24.3±1.84 years, height=176.4±12.7 cm, mass=86.6±29.4 kg). Intervention: Body fat percentage was measured using a three site skinfold. Thigh length, thigh circumference, anterior thigh adipose thickness, anterior thigh muscle thickness, and thigh volume were estimated using manual and ultrasound methods. Using sterile techniques, thermocouple probes were approximated in the belly of the rectus femoris (2 cm deep to sub-adipose tissue) and on the anterior mid-thigh surface. Participants cycled on an ergometer for 30 minutes at a target heart rate between 130 and 150 beats per minute. Post-exercise, participants were placed in CWI (immersion depth: iliac crest; 10°C) until intramuscular temperature was 7°C below pre-exercise baseline temperature, with a maximum immersion duration of 30 minutes. Main Outcome Measure(s): Intramuscular rectus femoris and thigh skin temperatures measured post exercise, after 10 and 15 minutes of CWI, and post-CWI. Results: Body fat percentage significantly predicted rectus femoris cooling magnitude and rate after 10 minutes of CWI, 15 minutes of CWI, and post-CWI (p <0.001; R2 = 0.58–0.64). Thigh anthropometrics significantly predicted thigh skin cooling rate post-CWI (p = 0.049; R2 = 0.46). Conclusions: A simple three site skinfold assessment may improve the efficacious prescription of CWI through estimation of the dose required for minimal muscle tissue cooling.