Computed tomography-based muscle attenuation and electrical impedance myography as indicators of trunk muscle strength independent of muscle size in older adults.

Objective: The aim of this study was to examine the associations of computed tomography-based x-ray attenuation and paraspinal electrical impedance myography measures of trunk muscles with absolute and relative (normalized by body weight) trunk extension strength, independent of muscle cross-sectional area.

Design: This is a cross-sectional study of mobility-limited community-dwelling older adults (34 women, 15 men; mean [SD] age, 78.2 [7.2] yrs) recruited from within an existing prospective research cohort. Trunk extension strength, computed tomography-based trunk muscle cross-sectional area and attenuation at L4 level, and paraspinal electrical impedance myography measures were collected.

Results: Attenuation was positively correlated with absolute and relative strength for multiple muscle groups (r = 0.32-0.61, P < 0.05). Paraspinal electrical impedance myography phase was positively correlated with paraspinal attenuation (r = 0.30, P = 0.039) and with relative strength (r = 0.30, P = 0.042). In multivariable linear regressions adjusting for sex and cross-sectional area, attenuations of the anterior abdominal muscles (semipartial r = 0.11, P = 0.013) and combined muscles (semipartial r = 0.07, P = 0.046) were associated with relative strength.

Conclusions: Although attenuation was associated with relative strength, small effect sizes indicate limited usefulness as clinical measures of muscle strength independent of muscle size. However, there remains a need for additional studies in larger and more diverse groups of subjects.