RESULTS
Within the scope of the study, a total of 152 individuals; 117 patients
who were admitted to the physical therapy and rehabilitation outpatient
clinic with knee pain who were also diagnosed with knee osteoarthritis,
and 35 healthy individuals as control group were examined. Fifteen OA
patients and two of kontrol individuals were excluded. A total of 135
individuals were evaluated with the EWGSOP diagnostic criteria for the
presence of sarcopenia. Twelve (11.8%) of 102 patients with
osteoarthritis were sarcopenic. There were no sarcopenic individuals in
the control group. OA patients with sarcopenia constituted the first
group(Group 1) , non-sarcopenic OA patients constituted the second group
(Group 2) , and controls healty individuals constituted the third group
(Group 3). Distribution of some descriptive characateristics among study
groups are presented in Table 1. The weight, BMI, waist
circumference, hip circumference, upper-middle arm circumference, thigh
and leg circumference of patients group 1 were statistically lower than
the group 2 and group 3. (p <0.01-p0.001). In the
non-sarcopenic osteoarthritis group, weight and height of the patients
were lower than the control group. Biceps, triceps, and thigh extensor
surface measurements were found to be less in the group with sarcopenia
than in the other groups (p <0.001-p = 0.002). Bilateral hand
grip strength and gait speed of sarcopenic patients were found to be
statistically lower than non-sarcopenic and control groups. All of the
patients group 1 were at a low level in the physical activity assessment
questionnaire. Thirty eight of the patients with group 2 were at a low
level, 44 were at a moderate level, 8 were at a very active level.
Twenty one individuals of the group 3 were at a low level, 9 were at a
moderate level and 3 were found to be doing very active physical
activity. The metabolic equivalents (METs) values obtained from IPAQ-SF
were also calculated as min/week (Table 2). The METs values
were found to be statisticall lower in the group 1 compared to the group
2 (p = 0.017). The mean MNA score was found to be statistically
significantly lower in the group 1 compared to the other two groups (p
<0.001) (Table 2). In the CES-D evaluation, the score was
calculated as 25.58 ± 11.73 (5-52) in the sarcopenic group, 22.47 ±
14.07 (4-54) in the group 2 and 15.15 ± 10.85 (0-49) in the group 3
(Table 2).
When OA groups with and without sarcopenia were evaluated with the WOMAC
score and the WOMAC pain and stiffness values were compared, it was
found that there was no significant difference between the sarcopenic
and non-sarcopenic osteoarthritis groups (p> 0.05). When
the WOMAC physical function scores were compared, a significant
difference was found between the groups (p <0.05). The WOMAC
total scores were statistically higher in the sarcopenic group than in
the non-sarcopenic osteoarthritis group (p = 0.006).
The pain that was experienced by patients at night, on the move and at
rest were compared with VAS and no significant difference between groups
were found No statistically significant difference was found between the
group1 and 2 in the calculated sub-parameters of SF-36 used to evaluate
the quality of life (p> 0.05).
When laboratory parameters were evaluated, calcium levels of patients
group 1 were statistically lower than group 2 (p = 0.023), leptin (p =
0.720), adiponectin (p = 0.068) and vitamin D (p = 0.285) levels were
not detected as statistically significant. In the comparison between the
sarcopenic patients and the control group, vitamin D levels were found
to be statistically significantly higher in the control group (p =
0.030). Albumin levels in the control group (p = 0.035) were found to be
lower than the other two groups (Table 3).
When body composition parameters measured by DEXA, were compared in
patients with and without sarcopenic OA and the control group,
sarcopenic patients had statistically significantly lower fat masses,
lean dry weights and SMI values (p <0.001, p = 0.001, p0.001,
respectively), where as sarcopenic patients’ FMI values (p = 0.012) were
found to be lower in patients than group2 and 3. In the group 2 , it was
found that the fat percentage and LBMI values (p <0.001, p =
0.002) were higher than the other two groups (Table 4).
When the study groups were compared in terms of muscle strength measured
by the isokinetic dynamometer, average knee extension forces at 60° /
sec angular velocity for the right and left knee were lower in the
sarcopenic group when evaluated in terms of peak torque values (p
<0.001, p0.001, and the ratio of peak torque to body weight (p
= 0.007 and p = 0.031, respectively). In the group 1 , right knee
flexion forces at 180 degrees angular velocities and peak torque values
were statistically significantly lower (p = 0.038) than group 2 and 3..
Bilateral gastrocnemius medius fascicle lengths and right gastrocnemius
medius pennate angles of sarcopenic patients were found to be
statistically significantly lower than non-sarcopenic and control
groups. Right gastrocnemius medius muscle thickness was significantly
decreased in the sarcopenic group compared to the non-sarcopenic group
(p = 0.014). Left gastrocnemius medius muscle thickness was higher and
rectus abdominis muscle thickness was statistically significantly lower
in the non-sarcopenic group compared to the other study groups (p =
0.025 and p = 0.001. It was determined that there was no significant
difference between the bilateral rectus femoris subcutaneous tissue
thickness and muscle thickness between the groups (p> 0.05)