Diz Osteoartriti Olan Orta Yaş Kadınlarda İntramüsküler Yağ Oranının İskelet Kası Mimari Yapısına ve Fiziksel Performansa Olan Etkisinin Araştırılması

Abstract

The aim of this study was to compare the intramuscular fat (IMF) ratio of quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (OA) and to compare with the healthy control group. Another aim of this study was to investigate the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the patients with knee OA. In this study, 31 healthy women and 31 women with knee OA, aged between 40 and 65 years were included. The participants’ demographic data (age, height, weight, body mass index), pain status and knee range of motion were recorded. Body muscle and fat mass were measured by Bioelectric Impedance Analysis and isometric muscle strength was evaluated by handheld dynamometer. Knee OA-related symptoms and knee joint functions were evaluated with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Muscle architecture (pennation angle, fiber length and thickness) of the QF and hamstring muscles evaluated with Ultrasonography (US). IMF ratio of the muscles was assessed using echo intensity (EI) measurements using gray-scale analysis in the ImageJ program. The functional performance assessments of the women were evaluated with the Five Times Sit and Stand Test, Timed Up and Go Test, and Stair Climbing Test, walking speed was evaluated with the 20 Meter Walking Test. Women with knee OA had more IMF ratio in the rectus femoris, vastus intermedius, vastus lateralis, vastus medialis, biceps femoris, semitendinosus and semimembranosus muscles compared to the healthy women (p<0.05). IMF ratio in the QF and hamstring muscles increased as the age, body mass index, and body fat mass of women with knee OA increased. As the skeletal muscle mass and skeletal muscle mass index decreased in women with knee OA, the IMF ratio of the muscles increased (p<0.05). Pennation angles of the muscles increased as the IMF ratio decreased in rectus femoris, vastus medialis, biceps femoris, and semitendinosus. (p<0.05). As the IMF ratio increased in the rectus femoris and vastus medialis muscles, the isometric extensor strength of the knee decreased, while the isometric flexor strength of the knee decreased as the IMF ratio increased in the Biceps Femoris muscle. (p<0.05). In addition, KOOS scores decreased as the IMF increased in vastus medialis and biceps femoris (p<0.05). As the IMF ratio in the QF and hamstring muscles increased, the physical performance and walking speed of women with knee OA also deteriorated (p<0.05). In middle-aged women with knee OA, the intramuscular fat ratio of the QF and hamstring muscles is higher than the healthy control group, and so exercise and treatment strategies to reduce intramuscular adipose tissue should be determined for these patients.