Static one-leg standing balance test as a screening tool for low muscle mass in healthy elderly women

Abstract

Background Identification of simple screening tools for detecting lower skeletal muscle mass may be beneficial for planning effective interventions in the elderly. Aims We aimed to (1) establish a threshold for one-leg standing balance test (OLST) time for low muscle mass, and (2) test the ability of that threshold to assess muscular impairments in a poor balance group. Methods Eyes-open OLST (maximum duration 30 s) was performed with right and left legs in 291 women (age 71 ± 6 years). OLST time was calculated as the sum of the OLST time of right and left legs. Fat-free mass (FFM), skeletal muscle mass (SMM), fat mass, biceps brachii and vastus lateralis sizes; handgrip strength (HGS), elbow flexion maximum torque (MVCEF) and knee extension maximum torque (MVCKE) were measured. Muscle quality was calculated as MVCKE/FFM and physical activity was assessed by questionnaire. Low muscle mass was defined as SMMrelative of 22.1%, a previously established threshold for pre-sarcopenia. Results The OLST threshold time to detect low muscle mass was 55 s (sensitivity: 0.63; specificity: 0.60). The poor balance group (OLST < 55 s) had higher fat mass (3.0%, p < 0.001), larger VL thickness (5.1%, p = 0.016), and lower HGS (− 10.2%, p < 0.001), MVCEF (− 8.2%, p = 0.003), MVCKE (− 9.5%, p = 0.012), MVCKE/FFM (− 11.0%, p = 0.004) and physical activity (− 8.0%, p = 0.024) compared to the normal balance group. While after adjusting age, the differences exist for HGS, fat mass and VL thickness only. Discussion An OLST threshold of 55 s calculated as the summed score from both legs discriminated pre-sarcopenic characteristics among active, community-dwelling older women with limited potential (sensitivity 0.63, specificity 0.60). Conclusion OLST, which can be performed easily in community settings without the need for more complex muscle mass measurement, may help identify women at risk of developing sarcopenia.

Dietary Protein Requirement Threshold and Micronutrients Profile in Healthy Older Women Based on Relative Skeletal Muscle Mass

“…In addition to above, the recent literature emphasizes the use of SMI (skeletal muscle mass adjusted with height squared) instead of SMM r for evaluating individual’s muscle mass level. Although variable differences in prevalence of low muscle mass could be anticipated with SMI and SMM r thresholds [ 38 ] and thus the possible outcome measures in investigation, the authors present the findings in relation to relevance of relative skeletal muscle mass for physical independence and clinical conditions in older population [ 14 , 32 , 33 , 34 , 35 ]. PASE is a valid and reliable assessment tool for the classification of physical activity in the older population [ 74 ], with approximation to quantitative methods of assessment [ 75 ].…”

“…There remains an ongoing debate on the preferred method of reporting skeletal muscle mass normalised for body mass for identifying lower levels in the older population [ 41 , 42 ]. The 22.1% SMM r in the present study has previously been used for identifying risk of disability [ 14 ], the gene variants associated with lower muscle mass (sarcopenia)[ 38 ] and balance impairments in the elderly [ 32 ]. For the purposes of group comparisons, and to be consistent with the established terminology [ 42 ], those participants with a SMM r < 22.1% will be termed “low relative skeletal muscle mass”, those with a SMM r ≥ 22.1% will be termed “high relative skeletal muscle mass” [ 14 ].…”

“…An identification of the dietary protein requirement for the older population based on the threshold of relative skeletal muscle mass is important as it could influence individual physical independence, and progression to sarcopenia. For example, a lower muscle mass has been linked with a decline in parameters related to physical independence such as functional impairment (walking and chair stands) [ 14 ], balance [ 32 ] and respiratory strength [ 33 ] and other conditions such as development of metabolic syndrome [ 34 ], incidence of hypertension [ 35 ] and likelihood of physical disability [ 14 ].…”

Sarcopenia and Endocrine Ageing: Are They Related?

“…The one leg standing balance test is also known as the single leg stance time test. Postural balance, a key metric in explaining muscular health, represents a person's capability to sustain postural control in a position, physical movement, and responsiveness to external perturbations without falling [ 14 ]. The subject should stand unsupported solely on a single leg and is timed in seconds from when the foot is flexed off the ground to when the standing leg leaves the hips.…”

The Relationship between Postural Control and Muscle Quality in Older Adults

“…Postural control requires accurate neuromuscular output to maintain stability. This suggests that low muscle quality could cause poor postural control as the performance of the output of the postural control system is attenuated and may thus explain why low muscle quality increases the risk of falling (Gadelha et al, 2018;Khanal et al, 2021).…”