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Funao H, Igawa T, Matsuzawa M, Isogai N, Ishii K. Comparative Study of Anticipatory Postural Adjustments between Normal and Cervical Myelopathy Patients. J Clin Med 2023; 12:jcm12103584. [PMID: 37240690 DOI: 10.3390/jcm12103584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Patients with cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament have been considered to be prone to falls due to lower extremity dysfunction and gait instability. Anticipatory postural adjustments (APAs) are unconscious muscular activities to counterbalance perturbation. To date, there are no reports on APAs in cervical myelopathy patients, and quantification of postural control remains difficult. Thirty participants were enrolled, of which 15 were cervical myelopathy patients and 15 were normal age- and sex-matched controls. A three-dimensional motion capture system with force plates was used, and the APA phase was defined as the time between start of movement at the center of pressure and heel-off of the step leg. The APA phase (0.47 vs. 0.39 s, p < 0.05) and turning time (2.27 vs. 1.83 s, p < 0.01) were significantly longer, whereas step length tended to be shorter (305.18 vs. 361.04 mm, p = 0.06) in cervical myelopathy patients. There was a significant correlation between Japanese Orthopaedic Association lower extremity motor dysfunction scores and step length (p < 0.01). Cervical myelopathy patients are prone to falls due to longer APA phases with shorter step lengths. Analysis of the APA phase aids the visualization and quantification of postural control during initial gait in cervical myelopathy patients.
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Affiliation(s)
- Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Chiba 286-0124, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan
| | - Masaru Matsuzawa
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
- Society for Minimally Invasive Spinal Treatment (MIST), Tokyo 101-0063, Japan
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Terai H, Tamai K, Takahashi S, Katsuda H, Shimada N, Hori Y, Kobayashi Y, Nakamura H. Development of locomotive syndrome in elderly population after COVID-19 outbreak: A population-based cross-sectional study with over 12,000 participants. J Orthop Sci 2022:S0949-2658(22)00132-4. [PMID: 35718602 PMCID: PMC9167829 DOI: 10.1016/j.jos.2022.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/24/2022] [Accepted: 05/23/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Restrictions during the coronavirus disease 2019 (COVID-19) pandemic have decreased physical activity levels, which may result in locomotive syndrome. This study evaluated the change in locomotive syndrome prevalence and associated risk factors among an elderly population before and after a coronavirus outbreak. METHODS This written self-administered cross-sectional survey was conducted in conjunction with the coronavirus disease vaccination program in Habikino City, Japan. Participants who were aged ≥65 years completed the five-question Geriatric Locomotive Function Scale before and during the pandemic. The diagnosis of locomotive syndrome and its stage was based on the Geriatric Locomotive Function Scale score: stage 1 (2-3 points), 2 (4-5 points), and 3 (≥6 points). Data on lifestyle changes, including regular exercise, during the pandemic were collected. RESULTS This study included 12,197 participants (36.7% of the city's total elderly residents). The prevalence of locomotive syndrome increased from 41.3% to 47.1% after the outbreak. In total, 765 (6.3% of overall population) and 295 (9.5% of the participants who had stages 1-2 before the pandemic) participants developed locomotive syndrome and stage 3 locomotive syndrome, respectively. The multivariate logistic regression analysis indicated that a decrease in exercise was significantly associated with the onset of locomotive syndrome (all stages) (odds ratio = 2.5, p < 0.001) and locomotive syndrome stage 3 (odds ratio = 2.6, p < 0.001). CONCLUSIONS Extrapolation of the study's findings to the entire population of Japan suggests that approximately 2 million elderly individuals might develop locomotive syndrome after the coronavirus outbreak. Additionally, 10% of the participants with mild-moderate locomotive syndrome before the pandemic may develop severe locomotive syndrome after the outbreak. The greatest risk factor for new-onset or worsening locomotive syndrome was a decrease in daily exercise. Thus, there is an urgent need for adequate exercise guidelines during the coronavirus pandemic, especially for the elderly population.
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Affiliation(s)
- Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan
| | - Koji Tamai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan,Corresponding author. Fax: +81 6 6645 6260
| | - Shinji Takahashi
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan
| | - Hiroshi Katsuda
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1, Kashiyama, Habikino City, Osaka, 583-0875, Japan
| | - Nagakazu Shimada
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1, Kashiyama, Habikino City, Osaka, 583-0875, Japan
| | - Yusuke Hori
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan
| | - Yuto Kobayashi
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-5-7, Asahimachi, Abenoku, Osaka City, Osaka, 545-8585, Japan
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Nakamura M, Imaoka M, Nakao H, Hida M, Tazaki F, Imai R, Utsunomiya H, Hashizume H. Association between subjective oral dysfunction and locomotive syndrome in community-dwelling older adults. Sci Rep 2021; 11:12591. [PMID: 34131252 PMCID: PMC8206075 DOI: 10.1038/s41598-021-92153-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/07/2021] [Indexed: 12/17/2022] Open
Abstract
The need for support and care is a major problem facing societies around the world. Locomotive syndrome (LS) refers to a condition in which people require healthcare services because of problems associated with locomotion. Oral dysfunction is also associated with various long-term care factors including activities of daily living. The purpose of this study was to determine the association between oral dysfunction and LS. The study participants were 407 elderly people living in a rural area in Japan. Evaluation of oral dysfunction was based on subjective judgment by each participant. LS was assessed using Locomo-25, which is a self-administered questionnaire and was defined by a Locomo-25 score ≥ 7 points. Those with a “decline in masticatory function” and “difficulty swallowing” had higher odds of LS than those without these dysfunctions (odds ratio (OR) = 2.134, 2.007, respectively). Furthermore, participants with a Locomo-25 score ≥ 11 had higher odds of a “decline in masticatory function” (OR = 2.657) than those with a Locomo-25 score < 11, and those with a Locomo-25 score ≥ 9 had higher odds of “difficulty swallowing” (OR = 2.411) than those with a Locomo-25 score < 9. These findings suggest that a strong relationship exists between oral dysfunction and LS.
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Affiliation(s)
- Misa Nakamura
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan. .,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.
| | - Masakazu Imaoka
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Hidetoshi Nakao
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Mitsumasa Hida
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Fumie Tazaki
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Ryota Imai
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Hirotoshi Utsunomiya
- Department of Strategic Surveillance for Functional Food andComprehensive Traditional Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.,School of Health and Nursing Science, Wakayama Medical University, Wakayama, Wakayama, Japan
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