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Epidemiology of locomotive syndrome using updated clinical decision limits: 6-year follow-ups of the ROAD study

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

A Correction to this article was published on 14 June 2022

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Abstract

Introduction

Locomotive syndrome (LOCOMO) is defined by the Japanese Orthopaedic Association (JOA) as a condition requiring nursing care due to a decline in mobility resulting from musculoskeletal disorders. In 2020, the JOA announced the new definition of LOCOMO stage 3 and revision of clinical decision limits in stages of LOCOMO. However, there are few reports on the epidemiological indices of LOCOMO. This prospective cohort study aimed to investigate the prevalence, incidence, and association of poor prognosis with LOCOMO stages.

Materials and methods

The third survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study was conducted during 2012–2013, examining a population-based cohort of 1575 participants (513 men and 1062 women, mean age 65.6 years). Three LOCOMO risk tests were performed, and patients were classified into LOCOMO stages 0, 1, 2, and 3. They were followed up for 6 years, and identical examination of LOCOMO was performed in 3- and 6-year follow-ups. Data on patients’ prognoses, including disability and death, were collected.

Results

The prevalence of LOCOMO stages 1, 2, and 3 was 41.3, 14.9, and 11.6%, respectively. The incidence of LOCOMO stages 1, 2, and 3 were 83.7, 23.0, and 18.6 per 1000 person-years, respectively. Compared with LOCOMO stage 0, logistic regression analysis showed that LOCOMO stage 3 significantly increased the risk of disability and mortality. In addition, each value of LOCOMO risk tests for LOCOMO stage 3 increased the risk of poor prognosis.

Conclusion

LOCOMO stage 3 is a sensitive indicator of future disability and mortality.

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Acknowledgements

The authors wish to thank Dr. Naoki Hirabayashi of Kawakami Clinic, Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, Ms. Ikuyo Ueyama, Mrs. Michiko Mori, Mrs. Hisayo Sugimoto, and other members of the public office in Hidakagawa Town; and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji, and other members of the public office in Taiji Town for their assistance in locating and scheduling the participants for examinations. We would also like to thank Mrs. Kyoko Hattori, Mrs. Saeko Sahara, and Mr. Noriyuki Oe for their assistance with data reduction and administration.

Funding

This work was supported by a Grant-in-Aid funding from the Ministry of Health, Labour and Welfare: H17-Men-eki-009 (Director, Kozo Nakamura), H20-Choujyu-009 (Director, Noriko Yoshimura), H23-Choujyu-002 (Director, Toru Akune), H25-Choujyu-007 (Director, Noriko Yoshimura), and H25-Nanchitou (Men)-005 (Director, Sakae Tanaka), 19FA1401 (Director, Sakae Tanaka), 19FA0701 (Director, Hiroyuki Oka), and 19FA1901 (Director, Estuo Chosa). The study was also supported by Scientific Research grants B19H03895, B26293139, B23390172, and B20390182, and Challenging Exploratory Research grants 21K19631, 18K18447, 15K15219, and 24659317 to Noriko Yoshimura; Challenging Exploratory Research grants 21K19291 to Kanae Mure, Scientific Research grants B26293331, B23390356, and C20591774 and Challenging Exploratory Research grants 26670307 and 23659580 to Shigeyuki Muraki; Challenging Exploratory Research grants 24659666 and 21659349 and Young Scientists A18689031 to Hiroyuki Oka; Scientific Research grants B26293329, B23390357, and C20591737 and Challenging Exploratory Research grant 25670293 to Toru Akune; Scientific Research grant S50282661 to Sakae Tanaka; and by Collaborating Research with NSF from the Ministry of Education, Culture, Sports, Science and Technology in Japan 08033011-00262 (Director, Noriko Yoshimura). The study was partly supported by grants from the Japan Agency for Medical Research and Development (17dk0110028h0001, Director, Noriko Yoshimura; 17gk0210007h0003, and 19gk0210018h0002, Director, Sakae Tanaka). Further, the study was partly supported by grants from the Japan Osteoporosis Society (Noriko Yoshimura, Shigeyuki Muraki, Hiroyuki Oka, and Toru Akune) and Japan Osteoporosis Foundation (2015, Noriko Yoshimura) and research aids from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006-1 and 2010-2, Director, Hiroshi Kawaguchi; and 2014-1, Director, Kozo Nakamura), the Japanese Society for Musculoskeletal Medicine (2015, Director, Shigeyuki Muraki; and 2017, Director, Noriko Yoshimura), Mitsui Sumitomo Insurance Welfare Foundation (2016, Director, Noriko Yoshimura), and Japan Dairy Association (2017, Director, Noriko Yoshimura).

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Authors and Affiliations

  1. Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    Noriko Yoshimura, Toshiko Iidaka & Shigeyuki Muraki

  2. Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan

    Chiaki Horii & Sakae Tanaka

  3. Department of Public Health, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8510, Japan

    Kanae Mure

  4. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 113-8655, Japan

    Hiroyuki Oka

  5. Tokyo Neurological Center, Tokyo, 105-0001, Japan

    Hiroshi Kawaguchi

  6. National Rehabilitation Center for Persons With Disabilities, Saitama, 359-0042, Japan

    Toru Akune

  7. Department of Orthopedic Surgery, Ina Hospital, Saitama, 362-0806, Japan

    Hideaki Ishibashi

  8. NTT Medical Center Tokyo, Tokyo, 141-8625, Japan

    Takashi Ohe

  9. Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan

    Hiroshi Hashizume, Hiroshi Yamada & Munehito Yoshida

  10. Towa Hospital, Tokyo, 120-0003, Japan

    Kozo Nakamura

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  1. Noriko Yoshimura
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Corresponding author

Correspondence to Noriko Yoshimura.

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Conflict of interest

All authors have no conflicts of interest.

Ethical approval

The study was conducted with the approval of the ethics committees of the University of Tokyo (No. 1264 and No. 1326), and the University of Wakayama Medical University (No. 373).

Consent to participate

All participants provided written informed consent.

Consent for publication

All participants provided informed consent for publication of the results of the ROAD study, without any personal information.

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The original online version of this article was revised as there are some mistakes identified under the section “Association of LOCOMO stages with the occurrence of disability and mortality” and corrected in this version.

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Yoshimura, N., Iidaka, T., Horii, C. et al. Epidemiology of locomotive syndrome using updated clinical decision limits: 6-year follow-ups of the ROAD study. J Bone Miner Metab 40, 623–635 (2022). https://doi.org/10.1007/s00774-022-01324-8

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  • DOI: https://doi.org/10.1007/s00774-022-01324-8

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