Impact of sarcopenia on gait independence in musculoskeletal disorders: A comparison of two diagnostic algorithms

Yuki Morikawa, Kotoha Kuroda, Naoki Nakayama, Naho Terada, Niina Misuzu, Daisuke Matsumoto, Taiki Ikemoto, Mitsunori Tokuda
Purpose:

This study aimed to compare the impact of sarcopenia on gait recovery in older patients with musculoskeletal disorders using the ISarcoPRM and the AWGS2019 algorithms.

Methods:

This prospective observational study enrolled 153 patients hospitalized with musculoskeletal disorders (women: 78.4%, average age: 79.3±6.7 years, and average length of stay 51.0±25.9 days). Sarcopenia was defined using the ISarcoPRM and AWGS2019 algorithms at admission. Gait independence was assessed using the Functional Ambulation Categories (FAC) before admission and at discharge. The patients whose FAC was maintained or improved at discharge compared to that before admission were classified as the improved-gait group; those whose FAC had worsened were classified as the worsened-gait group. Statistical analysis was performed to compare the improved and worsened-gait groups. The impact of sarcopenia on worsened gait independence at discharge was evaluated using multivariate logistic regression analysis.

Results:

Sarcopenia prevalence was 56.2% (ISarcoPRM) and 36.6% (AWGS2019). At discharge, 26.8% of patients exhibited a worsened in gait independence. The worsened-gait group was significantly older and had a higher sarcopenia prevalence based on the ISarcoPRM algorithm (p0.001), with significantly lower FAC at discharge (p0.001) compared to the improved-gait group. Sarcopenia based on the ISarcoPRM algorithm was significantly associated with worsened gait independence (odds ratio [OR]: 3.94, 95% confidence interval [CI]: 0.42–2.33, p=0.005), unlike sarcopenia based on AWGS2019 OR: 1.08, 95% CI: -0.88 to 1.03, p=0.88).

Conclusion(s):

Our findings indicated that Sarcopenia assessed using the ISarcoPRM algorithm was associated with worsened gait independence at discharge in older patients with musculoskeletal disorders, but not AWGS 2019.

Implications:

Sarcopenia assessed using the ISarcoPRM algorithm was associated with mobility limitation at discharge and could, therefore, be used as a prognostic indicator of gait independence. Moreover, muscle thickness assessment using ultrasound images could be a useful alternative to BIA-assessed ASMI, particularly in older patients with musculoskeletal disorders during acute hospitalization.

Funding acknowledgements:
None
Keywords:
sarcopenia
gait independence
musculoskeletal disorders
Primary topic:
Musculoskeletal: lower limb
Second topic:
Musculoskeletal
Third topic:
Orthopaedics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Institution: Heisei Memorial Hospital Ethics committee: Ethics committee of Heisei Memorial Hospital
Provide the ethics approval number:
22-1
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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