Correlation of Gastrocnemius Muscle Quality With Balance, Appendicular Skeletal Mass, and Fall Risk in Osteoporotic Women: A Musculoskeletal Sonography Assessment During Rest and Activity

Abstract

Objectives: The weakening of the musculoskeletal system in women suffering from osteoporosis often leads to an increased risk of falls. We delved into the relationship between the echo intensity (EI) of the resting and contracting medial gastrocnemius muscle (MG) and its correlation with postural sway, appendicular skeletal muscle mass index (ASMI), and the fall efficacy scale (FES) in women over 60 diagnosed with osteoporosis.

Methods: This observational-analytical study welcomed the voluntary participation of 40 women diagnosed with osteoporosis. We employed DEXA to assess ASMI, leg fat/lean-mass, and musculoskeletal sonography to measure muscle architecture and the EI of the MG muscle during both rest and activity. We determined the center of pressure sway (CoP) in the anteroposterior (AP) and mediolateral (ML) directions during the double stance position.

Results: A significant positive correlation was observed between the EI during rest and contraction with FES (r=0.527 and 0.570, respectively). An inverse correlation was noted between MG-activation EI and ASMI (r=-0.486). Interestingly, the MG-activation EI emerged as the best predictor for the sway velocity AP and ML (R²=22 % and 23 %, respectively), and sway average amplitude ML (R²=24 %).

Conclusion: It was found that gastrocnemius muscle EI during rest and activity was associated with AP/ML postural sway, ASMI, leg fat/lean-mass and FES. MG-EI, especially during activation, could be considered as a promising noninvasive marker of muscle quality with a significant association with CoP sway and fall risk in women with osteoporosis at screening.