Funktionsdiagnostik der Sarkopenie

Zusammenfassung

Wie der Knochen, so unterliegt auch die Muskulatur kontinuierlichen Umbauund Adaptionsvorgängen, um so eine permanente Anpassung an wechselnde Einflussfaktoren und Anforderungen und damit die Funktionsfähigkeit des Bewegungsapparat zu gewährleisten. Im Alter begünstigt die verminderte körperliche Aktivität einerseits und sich ändernde metabolische und endokrinologische Rahmenbedingungen andererseits die Entwicklung einer Sarkopenie, wobei im Alltag unter diesem Begriff jenseits des reinen Muskelmasseverlustes auch die für die Patienten entscheidendere Verschlechterung der Muskelkraft und -leistung mitsubsumiert werden. Jenseits einer Quantifizierung der Muskelmasse sind daher funktionelle Untersuchungen essenzieller Bestandteil der Sarkopeniediagnostik. Die Erfassung der Kraft erfolgt meist mittels Handkraftdynamometrie. Alternativen sind die Beinpresse oder die Spirometrie. Der gängigste Test zur Evaluation der Leistung ist die Short Physical Performance Battery (SPPB) mit Erfassung der Gehgeschwindigkeit, einem Aufstehtest und einem Balance-Test, alternativ auch der Timed-upand-go-Test und der 6-Minute-Walk-Test. Eine interessante Alternative scheint die Erfassung der Sprungkraft und -leistung durch die sogenannte Mechanografie.

Summary

Muscle as well as bone underly a constant turnover and adaptation process to ensure adjustment to prevailing physical requirements in order to ensure musculoskeletal functionality. In older age, reduced physical activity as well as changing metabolic and endocrinologic conditions foster the development of sarcopenia, a term currently used not only to describe mere loss of muscle mass but rather as a generic term to summarize the entirety of age associated muscle deficits including reduced strength as well as limited physical performance. Thus functional assessment of muscle strength and physical performance are essential components of diagnosing sarcopenia, beyond mere quantification of muscle mass. Assessment of muscle strength is most commonly accomplished with hand-held dynamometry. Alternatively, lower extremity strength can be examined using a leg press measurement, or using respiratory parameters assessed via spirometry. The most common method used for investigating physical performance is the Short Physical Performance Battery (SPPB), which evaluates gait speed, balance and the ability to get in the chair rise test. Additionally, the 6 minute walk test and the Timed Up and Go test can be used to examine physical performance. New and important on a scientific approach is jumping mechanography, measuring ground reaction forces in defined jumping movements.

Schlüsselwörter

Sarkopenie - Alter - Muskel - Diagnostik

Keywords

Sarcopenia - age - muscle - diagnostics

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