Gluteal muscle fatty infiltration, fall risk, and mobility limitation in older women with urinary incontinence: a pilot study View Full Text


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Article Info

DATE

2022-07-27

AUTHORS

Derik L. Davis, Andrew Roberts, Rodolfo Calderon, Shihyun Kim, Alice S. Ryan, Tatiana V. D. Sanses

ABSTRACT

ObjectiveGluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance.Materials and methodsProspective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged ≥ 70 years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG ≥ 12 s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed.ResultsMean age, 76.3 ± 4.8 years; no difference for age or body mass index (BMI) between the at-risk (n = 5) versus not-at-risk (n = 14) groups. SPPB score (p = 0.013) was lower for the at-risk group (6.4 ± 3.1) than for the not-at-risk group (10.2 ± 1.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2% ± 15.6% versus 19.5% ± 4.1%, p = 0.037) and bilateral gluteus maximus (33.6% ± 15.6% versus 19.7% ± 6.9%, p = 0.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p < 0.050) moderate correlation with age (rho = − 0.64), BMI (rho = 0.65), and TUG performance (rho = 0.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient, ≥ 0.892).ConclusionOlder women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling. More... »

PAGES

47-55

References to SciGraph publications

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  • 2021-03-02. Impact of fatty degeneration on the functional outcomes of 38 patients undergoing surgical repair of gluteal tendon tears in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2014-02-01. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis in BMC GERIATRICS
  • 2020-09-15. MARS MRI assessment of fatty degeneration of the gluteal muscles in patients with THA: reliability and accuracy of commonly used classification systems in SKELETAL RADIOLOGY
  • 2014-03-25. Gluteal muscle composition differentiates fallers from non-fallers in community dwelling older adults in BMC GERIATRICS
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  • 2017-05-05. The Relationship Between Urinary Incontinence, Mobility Limitations, and Disability in Older Women in CURRENT GERIATRICS REPORTS
  • 2020-06-08. Hip abductor tears in ischiofemoral impingement in SKELETAL RADIOLOGY
  • 2021-03-29. Gluteus minimus tendon: MR imaging features and patterns of tendon tearing in SKELETAL RADIOLOGY
  • 2015-08-11. Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI in SKELETAL RADIOLOGY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s00256-022-04132-3

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    https://www.ncbi.nlm.nih.gov/pubmed/35896734


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        "description": "ObjectiveGluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance.Materials and methodsProspective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged\u2009\u2265\u200970\u00a0years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG\u2009\u2265\u200912\u00a0s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed.ResultsMean age, 76.3\u2009\u00b1\u20094.8\u00a0years; no difference for age or body mass index (BMI) between the at-risk (n\u2009=\u20095) versus not-at-risk (n\u2009=\u200914) groups. SPPB score (p\u2009=\u20090.013) was lower for the at-risk group (6.4\u2009\u00b1\u20093.1) than for the not-at-risk group (10.2\u2009\u00b1\u20091.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2%\u2009\u00b1\u200915.6% versus 19.5%\u2009\u00b1\u20094.1%, p\u2009=\u20090.037) and bilateral gluteus maximus (33.6%\u2009\u00b1\u200915.6% versus 19.7%\u2009\u00b1\u20096.9%, p\u2009=\u20090.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p\u2009<\u20090.050) moderate correlation with age (rho\u2009=\u2009\u2009\u2212\u20090.64), BMI (rho\u2009=\u20090.65), and TUG performance (rho\u2009=\u20090.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient,\u2009\u2265\u20090.892).ConclusionOlder women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling.", 
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    28 schema:description ObjectiveGluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance.Materials and methodsProspective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged ≥ 70 years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG ≥ 12 s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed.ResultsMean age, 76.3 ± 4.8 years; no difference for age or body mass index (BMI) between the at-risk (n = 5) versus not-at-risk (n = 14) groups. SPPB score (p = 0.013) was lower for the at-risk group (6.4 ± 3.1) than for the not-at-risk group (10.2 ± 1.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2% ± 15.6% versus 19.5% ± 4.1%, p = 0.037) and bilateral gluteus maximus (33.6% ± 15.6% versus 19.7% ± 6.9%, p = 0.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p < 0.050) moderate correlation with age (rho =  − 0.64), BMI (rho = 0.65), and TUG performance (rho = 0.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient, ≥ 0.892).ConclusionOlder women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling.
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    34 schema:keywords ConclusionOlder women
    35 MR images
    36 MRI
    37 ResultsMean age
    38 SPPB score
    39 SPPB test
    40 T1-weighted MR images
    41 TUG
    42 TUG performance
    43 age
    44 analysis
    45 assistants
    46 axial T1-weighted MR images
    47 battery performance
    48 bilateral gluteus maximus
    49 body mass index
    50 correlation
    51 descriptive
    52 differences
    53 estimates
    54 fatty infiltration
    55 fuzzy c-means segmentation
    56 gluteus maximus
    57 gluteus medius/minimus
    58 greater levels
    59 group
    60 images
    61 incontinence
    62 index
    63 infiltration
    64 influence risk
    65 intra-observer reliability
    66 levels
    67 limitations
    68 mass index
    69 materials
    70 maximus
    71 minimus
    72 mobility limitations
    73 moderate correlation
    74 muscle fatty infiltration
    75 musculoskeletal radiologists
    76 older women
    77 participants
    78 pelvis MRI
    79 performance
    80 pilot study
    81 radiologists
    82 reliability
    83 reliability analysis
    84 research assistants
    85 risk
    86 risk groups
    87 scores
    88 segmentation
    89 student research assistants
    90 study
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