Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Selection
2.2. Inclusion and Exclusion Criteria
2.3. Risk of Bias Assessment
3. Results
3.1. Included Studies
3.2. The Diagnosis of Sarcopenia in Patients Affected by Hip Fracture
3.3. Treatment of Sarcopenia in Patients Affected by Hip Fracture
3.4. Prevention of Sarcopenia in Patients Affected by Hip Fracture
4. Discussion
4.1. General Considerations and Key Findings
4.2. Sarcopenia Diagnosis in Hip-Fractured Patients
4.3. Sarcopenia Treatment in Hip-Fractured Patients
4.4. Sarcopenia Prevention in Hip-Fractured Patients
4.5. Limits of the Study
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Author | Sample | Intervention | Outcome Measures | Results | Limits of the Study |
---|---|---|---|---|---|
Kramer et al., 2017 | 15 HYW (age: 20.3 ± 0.4 years), 15 HEW (age: 78.8 ± 1.7 years), and 15 FEW (age: 82.3 ± 1.5 years) | Muscle biopsies and immunohistochemistry | Muscle fibre type distribution, myonuclear and satellite cell content | FEW resulted in atrophy of muscle fibres Type I and II, associated to a general deterioration in muscle fibres Type II size. Atrophy of Type II muscle fibre in these subjects is associated to a decrease in myonuclear content of Type II muscle fibre. | No measures of muscle mass and/or strength. No data about men |
Hansen et al., 2007 | 30 patients over 60 years old with hip fractures affected in community living patients (not nursing houses, no dementia, no terminally ill) | DEXA-derived midthigh slice has been found to be reasonably accurate in comparison with a single-slice CT technique | Muscle mass and composition | Superior accessibility and simplicity of DEXA utilize. DEXA errors inherent suggest that it should be used to studying groups of patients rather than individuals and in longitudinal trials. | Patients with non-traumatic neck hip fracture |
Villani et al., 2012 | 79 Patients with hip fracture, free in the community. | BIS; DEXA | FFM and SMM, and CAMA | BIS demonstrated sufficient agreement against DXA. | Predictive power and Repeatability |
Flodin et al., 2015 | 79 patients divided in 3 groups: Group N (26 patients); Group B (28 patients); Group C (25 patients) | Group N: 40 g of protein and 600 kcal combined with risedronate and calcium 1 g and vit D 800 IE; Group B: Same of Group N + bisphosphonates alone once weekly for 12 months; Group C: Control. All groups received conventional rehabilitation | Body composition; HGS; HRQoL at 0, 6 and 12 months postoperatively | No considerable variation in baseline attributes was observed between the groups. There was a positive correlation between FFMI and aLMI, r = 0.92, p < 0.01. | Small number of study subjects. The use of different devices of DXA measurements inflict uncertainties on the validity of the results |
Invernizzi et al., 2018 | 32 patients over 65 years old divided in two groups: Sarcopenic and non-sarcopenic. | Physical exercise rehabilitative programme and received a dietetic counselling. One group was supplemented with two sachets of 4 g/day of essential amino acids. | HGS, TUG, ILOA, Nutritional assessment, HRQoL baseline (T0) and after 2 months of treatment (T1) | At T1 follow-up, statistically significant differences in all the outcomes (p < 0.017) in sarcopenic patient who received AA supplementation. | Small size, the use of BIA to calculate the SMI. |
Malafarina et al., 2017 | 107 patients: Group control (CG), Group intervention (IG) | CG: standard diet (1500 kcal); IG: CG+oral nutritional supplementation (CaHMB 0.7 g/100 mL, 25(OH)D 227 IU/100 mL and 227 mg/100 mL of calcium). All patients received Physical therapy | Body composition, HGS, MNA-SF, BI, FAC | BMI and lean mass were constant in IG patients, while reduced in the CG. The vitamin D and proteins and concentration had improved more in the IG than in the CG. ADL recovery of was more frequent in the IG (68%) than in the CG (59%) (p = 0.261) | Patients received physiotherapy 5 days por week. No follow-up after discharge. Diagnostic criteria for sarcopenia. |
Chan et al., 2018 | 110 participants divided in Integrated group (IG) and Low extremity group (LEG) | IC: 15 min warm-up + Resistance training (30 min) + Balance training (10 min) at least once a week for 12 weeks. LEG: 12-week machine based lower extremity resistance exercise twice per week (30 min each). All participants had received a lecture on prevention of osteoporosis, sarcopenia and fall-related injury | Body composition; Gait speed (m/s), chair stand test and timed up-and-go test. Hip and L-spine BMD. | Decrease in weight (p < 0.01) and limb fat (p < 0.001) were noted in IC group. Im LLE group, Significant variations were detected in limb mass (p < 0.01). No variation in the cohorts regarding change on body composition. Significant enhancement in muscle strength in both the cohorts. After 3 months, significant improvement for leg strength but higher gain in LEE on leg curl performance (p = 0.001). BMD of L-spine improved but similar after 3 months. | BMD tests were not strictly performed on all participants. |
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Testa, G.; Vescio, A.; Zuccalà, D.; Petrantoni, V.; Amico, M.; Russo, G.I.; Sessa, G.; Pavone, V. Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review. J. Clin. Med. 2020, 9, 2997. https://doi.org/10.3390/jcm9092997
Testa G, Vescio A, Zuccalà D, Petrantoni V, Amico M, Russo GI, Sessa G, Pavone V. Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review. Journal of Clinical Medicine. 2020; 9(9):2997. https://doi.org/10.3390/jcm9092997
Chicago/Turabian StyleTesta, Gianluca, Andrea Vescio, Danilo Zuccalà, Vincenzo Petrantoni, Mirko Amico, Giorgio Ivan Russo, Giuseppe Sessa, and Vito Pavone. 2020. "Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review" Journal of Clinical Medicine 9, no. 9: 2997. https://doi.org/10.3390/jcm9092997