Abstract

Trunk muscle weakness and imbalance are risk factors for postural instability, low back pain, and poor postoperative outcomes. The association between trunk muscle strength and aging is poorly understood, and establishing normal reference values is difficult. We aimed to establish the validity of a novel portable trunk muscle torque measurement instrument (PTMI). We then estimated reference data for healthy young adults and elucidated age-related weakness in trunk muscle strength. Twenty-four university students were enrolled to validate values for PTMI, and 816 volunteers from the general population who were recruited to the Iwaki Health Promotion Project were included to estimate reference data for trunk muscle strength. Trunk flexion and extension torque were measured with PTMI and KinCom, and interclass correlation coefficients (ICC) were estimated to evaluate the reliability of PTMI values. Furthermore, from the young adult reference, the age-related reduction in trunk muscle torque and the prevalence of sarcopenia among age-sex groups were estimated. The ICC in flexion and extension torque were 0.807 (p<0.001) and 0.789 (p<0.001), respectively. The prevalence of sarcopenia increased with age, and the prevalence due to flexion torque was double that of extension torque. Flexion torque decreased significantly after 60 years of age, and extension torque decreased after 70 years of age. In males over age 80, trunk muscle torque decreased to 49.1% in flexion and 63.5% in extension. In females over age 80, trunk muscle torque decreased to 60.7% in flexion and 68.4% in extension. The validity of PTMI was confirmed by correlation with KinCom. PTMI produced reference data for healthy young adults, and demonstrated age-related reduction in trunk muscle torque. Trunk sarcopenia progressed with aging, and the loss of flexion torque began earlier than extension torque. At age 80, trunk muscle torque had decreased 60% compared with healthy young adults.

Highlights

  • Trunk stability plays an important role in low back pain, falls, and locomotive ability [1,2,3,4]

  • A validation study showed that the strength of agreement in flexion torque was almost perfect based on the interclass correlation coefficients (ICC) (2,1) being 0.807 (p

  • The strength of agreement for extension torque was substantial in that ICC (2,1) was 0.789 (p

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Summary

Introduction

Trunk stability plays an important role in low back pain, falls, and locomotive ability [1,2,3,4]. In the elderly, weakness and imbalance of trunk muscle strength are strongly correlated with low back pain [5,6,7,8,9], which is the most common complaint in Japan [10], and one that can have a major socioeconomic impact. There have been reports that wounds caused by invasive surgery cause numerous complications that lead to unsatisfactory outcomes [12]. It must be recognized that sarcopenia of the trunk muscles leads to dysfunction and affects clinical outcomes, including postoperative rehabilitation [13,14]. The contribution of age to decreases in trunk muscle strength is unclear, as reference data in young adults, as well as changes associated with age, have not been investigated in large cohort studies using validated instruments

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