Assessment of core and lower limb muscles for static/dynamic balance in the older people: An ultrasonographic study

Abstract

Background: sufficient research has not been conducted to determine the role of core and lower limb muscles in providing balance in older people. Objective: to investigate the relationships between the thickness of core/lower limb muscles and static/dynamic balance in older people. Methods: the study included a total of 68 older people (≥ 65 years) and 68 gender-matched young subjects, aged 20-40 years. Balance, knee proprioception sense, regional and total muscle measurements and grip strength were assessed using a force platform system, isokinetic dynamometer, ultrasound imaging, bioelectrical impedance analysis and Jamar dynamometer, respectively. Results: all the static (postural sway) parameters were higher and all the dynamic (limits of stability) parameters were lower in the older adults compared to the young adults (all P<0.05). The diaphragm was thicker and all the other muscles (except for multifidus and tibialis anterior) were thinner in the older group (all P<0.05). A higher error of knee proprioception sense was determined at 45 and 70 degrees in the older subjects (both P<0.001). According to the multivariate analyses, significant predictors for balance were age, gender, height, and rectus femoris, vastus intermedius and diaphragm muscle thicknesses in the older group, and age, gender, height, grip strength, and rectus abdominis, internal oblique, longissimus, tibialis anterior and soleus muscle thicknesses in the young group (all P<0.05). Conclusions: the thickness of core/lower limb muscles are important determinants of balance in both older and young adults. These findings could provide a strong rationale for strengthening specific (abdominal and quadriceps) muscles to prevent falls and regional sarcopenia, and to improve posture/balance in the older population. Clinical trial registration number: NCT03791047 Ethics committee approval: Hacettepe University Non-interventional Clinical Research Ethics Board. Decision number:GO 18/506-39