The significance of tibialis anterior muscle ultrasonography for the assessment of nutritional indicators in older adults

Yuki Asada, Hiroshi Koriyama, Kei Kamide, Koichi Yamamoto, Tomohiro Minami, Ken Terashima, Masaaki Isaka, Taku Fujimoto, Hiroshi Akasaka, Yuri Onishi
Purpose:

The purpose here is show the significance of tibialis anterior muscle ultrasonography by comparing them with body composition measurements using the BIA. 

Methods:

The subjects were 130 ambulatory patients aged 65 years or older admitted to the Department of Geriatrics and Hypertension at Osaka University Hospital. In addition to basic attributes such as age, sex, height, weight, and BMI, calf circumference, grip strength, walking speed, skeletal muscle index (SMI) using the BIA, ultrasonography using the tibialis anterior muscle, and serum albumin level were measured and used to confirm their association with each item. Also, the SMI by BIA and the ultrasonographic index were compared to serum albumin level. 

Results:

The subjects were 65 men (50.0%) aged 76.9±5.9 years. Muscle thickness measured by ultrasound using the tibialis anterior muscle was correlated with BMI, calf circumference, grip strength, walking speed, and SMI. In contrast, echo intensity measured by ultrasound was associated with calf circumference, grip strength, and walking speed. On the other hand, SMI measured by BIA was correlated with BMI, calf circumference, and grip strength but not with walking speed. Serum albumin level was associated with BMI, muscle thickness measured by ultrasound, and echo intensity but not with SMI. Furthermore, multivariate analysis considering age and sex showed that muscle thickness and echo intensity measured by ultrasound were independently associated with serum albumin level. 

Conclusion(s):

The results suggest that ultrasonography assessment using the tibialis anterior muscle can simultaneously assess physical function such as grip strength and gait speed in older adults and nutritional indices. 

Implications:

Given that undernutrition and sarcopenia are deeply related, ultrasonography assessment using the tibialis anterior muscle can potentially assess skeletal muscle, and nutritional indices centrally. It may help to develop physiotherapy for physiotherapists often involved in aspects such as lower limb dysfunction and walking ability in clinical practice. 

Funding acknowledgements:
This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant Number JP22K11355).
Keywords:
Skeletal muscle mass
Ultrasonography of the tibialis anterior muscle
Sarcopenia
Primary topic:
Older people
Second topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The study protocol was approved by the Research Ethics Committee of Osaka University.
Provide the ethics approval number:
Approval No.18126-3.
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?:
No

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