Association between dysfunction of upper extremity and locomotive syndrome in general population

Clinical characteristics of locomotive syndrome categorised by the 25-question Geriatric Locomotive Function Scale: a systematic review

OBJECTIVES

The purpose of this study was to compile the currently available evidence on the clinical characteristics of the locomotive syndrome (LS) categorised by the 25-question Geriatric Locomotive Function Scale (GLFS-25) and clarify its clinical usefulness for assessing mobility function.

DESIGN

Systematic review.

DATA SOURCES

The PubMed and Google Scholar were searched for the relevant studies on 20 March 2022.

ELIGIBILITY CRITERIA

We included relevant peer-reviewed articles, available in English language, on clinical LS characteristics categorised with the GLFS-25.

DATA EXTRACTION AND SYNTHESIS

Pooled ORs or mean differences (MDs) of the LS groups were calculated and compared with the non-LS groups for each clinical characteristic.

RESULTS

In total, 27 studies that involve 13 281 participants (LS, n=3385; non-LS, n=9896) were examined in this analysis. Older age (MD 4.71; 95% (CI) 3.97 to 5.44; p<0.00001), female gender (OR 1.54; 95% CI 1.38 to 1.71; p<0.00001), higher body mass index (MD 0.78; 95% CI 0.57 to 0.99; p<0.00001), osteoporosis (OR 1.68; 95% CI 1.32 to 2.13; p<0.0001), depression (OR 3.14; 95% CI 1.81 to 5.44; p<0.0001), lower lumbar lordosis angle (MD -7.91; 95% CI -10.08 to -5.74; p<0.00001), higher spinal inclination angle (MD 2.70; 95% CI 1.76 to 3.65; p<0.00001), lower grip strength (MD -4.04; 95% CI -5.25 to -2.83; p<0.00001), lower back muscle strength (MD -15.32; 95% CI -23.83 to -6.81; p=0.0004), lower maximum stride (MD -19.36; 95% CI -23.25 to -15.47; p<0.00001), higher timed up-and-go (MD 1.36; 95% CI 0.92 to 1.79; p<0.00001), lower one-leg standing time (MD -19.13; 95% CI -23.29 to -14.97; p<0.0001) and slower normal gait speed (MD -0.20; 95% CI -0.22 to -0.18; p<0.0001) were found to be associated with LS. No significant differences were noted in other clinical characteristics between the two groups.

CONCLUSIONS

GLFS-25 is clinically useful for assessing mobility function according to the evidence available on the clinical characteristics of LS categorised by the GLFS-25 questionnaire items until.

"Age Is Just a Number": Distal Radius Fractures in Patients Over 75

Background: Management of distal radius fractures in patients over 65 is a topic of significant study, but there are variations within this group in terms of independence and activity level. This study compares the outcomes of operative distal radius fracture treatment in patients over 75 with those aged 65 to 74, to evaluate the effects of patient demand and advanced age on outcome. Methods: A retrospective review of a single-institution distal radius fracture database was performed. All patients over age 65 were evaluated for inclusion. Patient factors including activity, independence level, and quick disabilities of the arm, shoulder and hand (QuickDASH) score were recorded. Patients were selected for open reduction and internal fixation (ORIF) based on a discussion between the patient and the treating surgeon. Outcome measures including QuickDASH were recorded at 1-year post-injury. Patients aged 65 to 74 and 75 and over were compared to evaluate for demographic, functional, and outcome differences. Results: In all, 75 patients were included in the study. Fifty-one patients were aged 65 to 74, and 24 patients were aged over 75. The majority of patients rated themselves as "completely independent" and "active," the highest levels of each. There was no difference in QuickDASH scores between those patients who rated themselves as completely partially independent, or active versus moderately active. There was no statistically significant difference in QuickDASH or range of motion parameters at final follow-up. Conclusions: This study demonstrates that, in a group of patients with high levels of independence and activity, outcomes are similar in patients aged 65 to 74 and over 75 at 1 year following distal radius ORIF.

Handgrip measurement as a useful benchmark for locomotive syndrome in patients with type 2 diabetes mellitus: A KAMOGAWA-DM cohort study

AIMS/INTRODUCTION

To carry out a cross-sectional single-center study in a Japanese hospital to determine the diagnostic value of handgrip measurement to detect locomotive syndrome (LS).

MATERIALS AND METHODS

Consecutive outpatients underwent an LS risk test, which comprised a stand-up test and a two-step test, and a handgrip measurement, along with general diabetes-related tests. We calculated the prevalence of LS, and evaluated the association between handgrip strength and LS.

RESULTS

We enrolled 234 patients in this study. The prevalence of LS in the stand-up and two-step tests was 51.5 and 79.0%, respectively. The prevalence of LS in the stand-up or two-step tests increased with age both in men and women. Using the stand-up and two-step tests, 107 patients (46.7%) were diagnosed with LS. The area under the receiver operating characteristic curve, used to assess our identification of LS in terms of grip strength in men and women, showed 95% confidence intervals of 0.703 (0.563-0.813) and 0.698 (0.500-0.842), respectively. The odds ratios of grip strength for LS were 0.90 (95% confidence interval 0.83-0.97) and 0.87 (95% confidence interval 0.76-0.98) in men and women, respectively.

CONCLUSIONS

Our findings showed that handgrip measurement was useful in detecting LS, and LS should be considered when evaluating patients with type 2 diabetes mellitus.

Verification of phycological factors related to health-related quality of life in elderly knee osteoarthritis: A prospective cohort study

BACKGROUND

In recent years, locomotive syndrome, which is a condition requiring nursing care due to musculoskeletal disease, has been reported, and interest in knee osteoarthritis has been increasing. Several studies have reported the physical factors influencing the relationship between knee osteoarthritis and health-related quality of life (HRQOL), but there have been no reports verifying the changes over time in the relationship between psychosocial factors and HRQOL. This study aimed to investigate the influence of psychosocial factors on HRQOL in elderly patients with knee osteoarthritis.

METHODS

Evaluations were conducted at four time points: before exercise therapy intervention, 1 month into intervention, 3 months into intervention, and 1 month after completion of intervention. The items investigated were (1) Japanese Orthopedic Association (JOA) score, (2) Kellgren-Lawrence (K-L) grading system, (3) Fall Efficacy Scale (FES), (4) Frenchay Activities Index (FAI), (5) Geriatric Depression Scale (GDS), and (6) Short Form-8 (SF-8).

RESULTS

No significant differences were seen between each time point of exercise therapy intervention in depression and HRQOL scale but a significant improvement was seen in instrumental ADL and fear of falling at 3 months into intervention. On multiple regression analysis with SF-8 subscales, fear of falling and degree of depression were determined as significant factors affecting physical and mental summary scores.

CONCLUSION

Elderly patients with knee osteoarthritis require not only intervention for knee function, but also psychological intervention to address decreased activity and depression to improve their HRQOL.

Evaluation of the association between locomotive syndrome and metabolic syndrome

BACKGROUND

Locomotive syndrome (LS) includes disorders of the musculoskeletal system and is a high-risk condition that requires nursing care. We included an examination of locomotive function in specific health checkups to investigate the relationship between LS risk and the muscle strengths. The purpose of this study was to determine the distribution of LS and the relationship between LS and metabolic syndrome (MetS).

METHODS

Among 2695 participants who undertook a specific health checkup, 790 received a locomotive examination (302 men and 488 women; mean age, 65.9 years). Data for MetS components were measured in the specific health checkup. Data about the locomotive examination were obtained from five tests: the two-step test, stand-up test, 25-question Geriatric Locomotive Function Scale, and measurement of lower limb muscular strength and grip strength.

RESULTS

The MetS components did not differ according to LS risk level in men. In women, body weight, body mass index, and abdominal circumference were significantly lower in the non-LS group than in the LS risk level 1 or 2 groups. The ratio of lower limb muscular strength to body weight differed significantly between all risk groups in men and women. In women, lower limb muscular strength was significantly higher in those at risk of both LS and MetS (double-risk group) than in the LS-only group. In women, the ratio of lower limb muscular strength to body weight was significantly lower in the double-risk group than in the LS-only group.

CONCLUSIONS

Adding a locomotive examination to the specific health checkup may be useful for identifying people at risk of LS or MetS. The prevalence rates of LS and MetS correlate positively in women. The ratio of lower limb muscular strength to body weight might be a better index of locomotor dysfunction than lower limb muscular strength alone.

The prevalence of elbow osteoarthritis in Japanese middle-aged and elderly populations: the relationship between risk factors and function

BACKGROUND

The aim was to investigate the prevalence of elbow osteoarthritis (OA) in populations aged 40 years or older and to clarify the risk factors and their relationship with elbow function.

METHODS

The respondents were 354 residents of a single village who underwent general medical examinations in April 2016. The mean age was 67.2 years (range, 40-93 years), and 222 respondents (62.7%) were women. Anteroposterior radiographs of the bilateral elbow joints were obtained, and the subjects were classified into 4 groups (non-OA, mild OA, moderate OA, and severe OA) according to the modified Kellgren-Lawrence scale. With respect to risk factors for elbow OA, a logistic regression analysis was performed.

RESULTS

Elbow OA was detected in 55.0% of the elbows. The prevalence of symptomatic elbow OA was 22.6%, and no correlation between elbow OA and daily function was observed. The risk of elbow OA increased according to age, with odds ratios for those in their 50s, 60s, 70s, and 80s or older against those in their 40s of 12.99, 11.26, 14.45, and 26.85, respectively. In addition, male sex and a history of elbow trauma were significant risk factors, with odds ratios of 2.57 and 9.26, respectively.

CONCLUSIONS

The prevalence of elbow OA was 55.0%; the prevalence of symptomatic elbow OA was 22.6%; and the risk factors for elbow OA were older age, male sex, and a history of elbow trauma.

Locomotive syndrome: clinical perspectives

The deterioration of locomotive components, which comprise bones, joints, and intervertebral discs, and muscles and nerves, can lead to symptoms such as pain, limitations in the range of joint mobility, malalignment, impaired balance, and difficulty walking. Locomotive syndrome (LoS) was proposed by the Japanese Orthopedic Association in 2007 as a concept for people who are at a high risk of developing a musculoskeletal ambulation disability attributed to locomotor organs. Although many international articles related to LoS have been published, an international consensus of this concept seems to be lacking. This review article on LoS introduces the concept, the related assessment methods, and the condition's prevalence based on the most up-to-date literature, and discusses discrimination from frailty and sarcopenia, relevance to musculoskeletal problems, management plan, and future directions. Familiarity with recent evidence would be useful for the health care providers in an aging society to educate individuals with LoS or pre-LoS and to maintain their well-being and prevent them from requiring long-term care.

The impact of musculoskeletal diseases on the presence of locomotive syndrome

OBJECTIVES

We assessed the impact of musculoskeletal diseases, depressive mental state, and hypertension on locomotive syndrome, a condition of reduced mobility requiring nursing care. Since locomotive syndrome is a major public health issue that needs attention, its relationship with functional inconvenience in performing daily activities was also investigated.

METHODS

We conducted a cross-sectional study using an Internet panel survey, comprising 747 persons aged 30-90 years. Demographics, personal medical history, and daily activity data were assessed. The 25-question Geriatric Locomotive Function Scale was used to diagnose locomotive syndrome. Stepwise linear regression analysis and logistic regression analysis were conducted to evaluate the association between locomotive syndrome, musculoskeletal diseases, and functional inconvenience.

RESULTS

Aging, osteoporosis, and low back pain significantly increased the risk of locomotive syndrome, followed by knee osteoarthritis and lumbar spinal stenosis. Locomotive syndrome was significantly related to depressive mental state and hypertension, and led to functional inconvenience in Seiza sitting, cleaning, shopping, and strolling.

CONCLUSION

Locomotive syndrome was associated with functional inconvenience in performing common daily activities involving the lower extremities and spine. Osteoporosis and aging were significantly associated with locomotive syndrome. The risk of locomotive syndrome may be decreased by treating comorbid osteoporosis and instituting exercise and diet-related modifications.

Locomotive function and quality of life among older people in Liaoning, China: Falls efficacy as mediator or moderator?

OBJECTIVES

This study aimed to examine the role of falls efficacy in the relationship between the locomotive function and quality of life.

METHODS

From March to May in 2016, we conducted a cross-sectional survey among 830 community residents aged ≥60 years from Jinzhou,China.GLFS-25 (25-question Geriatric Locomotive Function Scale), FES-I(International edition of Falls Efficacy Scale),and SF-12 (12-item Short Form Health Survey) were used to estimate locomotive function, falls efficacy and quality of life, respectively. The higher score of GLFS-25, the worse the locomotive function.

RESULTS

Median age was 68.69 years (ranges 60-88). Locomotive function, falls efficacy and quality of life all presented a linear relationship within each other, locomotive function score was negatively correlated with falls efficacy score (-0.461, P < 0.01). locomotive function score was negatively correlated with quality of life score (-0.523, P < 0.01).Falls efficacy score was positively correlated with quality of life score (0.415, P < 0.01).Falls efficacy exerted both a mediating and moderating role between locomotive function and quality of life, and the mediation effect accounted for 45.5% of the total effect.

CONCLUSIONS

Poorer locomotive function was associated with poorer quality of life, and greater falls efficacy was associated with better quality of life. In addition, falls efficacy was demonstrated to be both a mediator and moderator variable in the linkage between locomotive function and quality of life. Aged care professional practitioners and our policy makers should strengthen the awareness of the psychological role of the elderly falls efficacy.