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Population-based study of the association of osteoporosis and chronic musculoskeletal pain and locomotive syndrome: the Katashina study

  • Original Article
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Journal of Orthopaedic Science

Abstract

Background

“Locomotive syndrome”, a concept proposed by the Japanese Orthopaedic Association (JOA), refers to risk conditions among the elderly population that may lead to the need for nursing care services. The association between osteoporosis (OP) or chronic musculoskeletal pain (CMSP) and the screening results of locomotive dysfunction identified by the GLFS-25 (a 25-question geriatric locomotive function scale) has not yet been adequately investigated.

Materials and Methods

Two hundred eighty-seven Japanese subjects were evaluated for locomotive dysfunction using the GLFS-25 and were also evaluated for their bone status by a quantitative ultrasound (QUS) assessment of the bone status (i.e., the measurement of the speed of sound (SOS) of the calcaneus). Furthermore, a questionnaire survey concerning CMSP persisting for 3 months or longer was given to those subjects. Statistical analyses were conducted to clarify the association between the bone status or CMSP and the screening results for locomotive dysfunction.

Results

The % young adult mean (%YAM) of the SOS was significantly lower among the 43 subjects with locomotive dysfunction identified by the GLFS-25 than in the 244 subjects without locomotive dysfunction (p < 0.001). Moreover, low back pain (p < 0.01), shoulder pain (p < 0.05) and knee pain (p < 0.001) were significantly more frequently observed in the 43 subjects with locomotive dysfunction than the 244 subjects without locomotive dysfunction. The screening results of the  %YAM of the SOS was significantly associated with the population demonstrating locomotive dysfunction screened by the GLFS-25 based on the age-, gender- and BMI-adjusted analysis (OR 0.95, 95 % CI 0.91–0.98). Furthermore, the %YAM of SOS correlated with the GLFS-25 score (β = -0.212, p = 0.001). Furthermore, low back pain (OR 2.60, 95 % CI 1.29–5.24), shoulder pain (OR 2.16, 95 % CI 1.00–4.66), and knee pain (OR 2.97, 95 % CI 1.41–6.28) were found to be associated with locomotive dysfunction based on the results of the age-, gender- and a BMI-adjusted analysis.

Conclusions

The %YAM of the SOS was associated with the population demonstrating locomotive dysfunction which was identified using the GLFS-25, and the severity of locomotive dysfunction evaluated by the GLFS-25 was found to correlate with the %YAM of the SOS. Furthermore, low back pain, shoulder pain and knee pain were found to be associated with the screening results for locomotive dysfunction by the GLFS-25.

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References

  1. Nakamura K. The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. J orthop Sci. 2011;16(5):489–91.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Nakamura K. A “super-aged” society and the “locomotive syndrome”. J Orthop Sci. 2008;13(1):1–2.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Nakamura K. Locomotive syndrome: disability-free life expectancy and locomotive organ health in a “super-aged” society. J Orthop Sci. 2009;14(1):1–2.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T. Prevalence of knee osteoarthritis, lumbar spondylosis and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 2009;27(5):620–8.

    Article  PubMed  Google Scholar 

  5. Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N. The influence of locomotive syndrome on health-related quality of life in a community-living population. Mod Rheumatol. 2013;23(5):939–44.

    Article  PubMed  Google Scholar 

  6. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41(5):778–99.

    Article  CAS  PubMed  Google Scholar 

  7. Ohtori S, Ito T, Yamashita M, Murata Y, Morinaga T, Hirayama J, Kinoshita T, Ataka H, Koshi T, Sekikawa T, Miyagi M, Tanno T, Suzuki M, Aoki Y, Aihara T, Nakamura S, Yamaguchi K, Tauchi T, Hatakeyama K, Takata K, Sameda H, Ozawa T, Hanaoka E, Suzuki H, Akazawa T, Suseki K, Arai H, Kurokawa M, Eguchi Y, Suzuki M, Okamoto Y, Miyagi J, Yamagata M, Toyone T, Takahashi K. Evaluation of low back pain using the Japanese orthopaedic association back pain evaluation questionnaire for lumbar spinal disease in a multicenter study: differences in scores based on age, sex, and type of disease. J Orthop Sci. 2010;15(1):86–91.

    Article  PubMed  Google Scholar 

  8. Sasaki E, Ishibashi Y, Tsuda E, Ono A, Yamamoto Y, Inoue R, Takahashi I, Umeda T, Nakaji S. Evaluation of locomotive disability using loco-check: a cross-sectional study in the Japanese general population. J Orthop Sci. 2013;18(1):121–9.

    Article  PubMed  Google Scholar 

  9. Kitahara H, Ye Z, Aoyagi K, Ross PD, Abe Y, Honda S, Kanagae M, Mizukami S, Kusano Y, Tomita M, Shindo H, Osaki M. Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study. Osteoporos Int. 2013;24(3):907–15.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Muraki S, Akune T, Nagata K, Ishimoto Y, Yoshida M, Tokimura F, Tanaka S, Oka H, Kawaguchi H, Nakamura K, Yoshimura N. Association of knee osteoarthritis with onset and resolution of pain and physical functional disability: the ROAD study. Mod Rheumatol. 2014;24(6):966–73.

    Article  PubMed  Google Scholar 

  11. Muraki S, Oka H, Akune T, Mabuchi A, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Prevalence of radiographic lumbar spondylosis and its association with low back pain in elderly subjects of population-based cohorts: the ROAD study. Ann Rheum Dis. 2009;68(9):1401–6.

    Article  CAS  PubMed  Google Scholar 

  12. Nemoto O, Kitada A, Naitou S, Tsuda Y, Matsukawa K, Ukegawa Y. A longitudinal study of low back pain and radiological changes of lumbar spine in asymptomatic Japanese military young adults. Eur Spine J. 2013;22(2):453–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Yoshimura N, Akune T, Fujiwara S, Shimizu Y, Yoshida H, Omori G, Sudo A, Nishiwaki Y, Yoshida M, Shimokata H, Suzuki T, Muraki S, Oka H, Nakamura K. Prevalence of knee pain, lumbar pain and its coexistence in Japanese men and women: the longitudinal cohorts of motor system organ (LOCOMO) study. J Bone Miner Metab. 2014;32(5):524–32.

    Article  PubMed  Google Scholar 

  14. Graphical Review of Japanese Household: From Comprehensive survey of living conditions 2013. Tokyo: Statistics and Information Department, Minister’s Secretariat, Ministry of Health, Labour and Welfare; 2014.

  15. Nakamura M, Nishiwaki Y, Ushida T, Toyama Y. Prevalence and characteristics of chronic musculoskeletal pain in Japan. J Orthop Sci. 2011;16(4):424–32.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Nakamura M, Nishiwaki Y, Ushida T, Toyama Y. Prevalence and characteristics of chronic musculoskeletal pain in Japan: a second survey of people with or without chronic pain. J Orthop Sci. 2014;19:339–50.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N. Impact of low back pain, knee pain, and timed up-and-go test on quality of life in community-living people. J Orthop Sci. 2014;19(1):164–71.

    Article  PubMed  Google Scholar 

  18. Kanis JA on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health care level. Sheffield: WHO Collaborating Center for Metabolic Bone Disease; 2007.

  19. Ministry of Health, Labour and Welfare. Outline of the results of National Livelihood Survey 2010. http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/4-2.html.

  20. Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study. Osteoarthr Cartil. 2010;18(9):1227–34.

    Article  CAS  PubMed  Google Scholar 

  21. Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Impact of knee and low back pain on health-related quality of life in Japanese women: the research on osteoarthritis against disability (ROAD). Mod Rheumatol. 2010;20(5):444–51.

    Article  PubMed  Google Scholar 

  22. Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Health-related quality of life in subjects with low back pain in a population-based cohort study of Japanese men: the Research on Osteoarthritis Against Disability study. Spine. 2011;36(16):1312–9.

    Article  PubMed  Google Scholar 

  23. Muraki S, Oka H, Akune T, En-yo Y, Yoshida M, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Independent association of joint space narrowing and osteophyte formation at the knee with health-related quality of life in Japan: a cross-sectional study. Arthritis Rheum. 2011;63(12):3859–64.

    Article  PubMed  Google Scholar 

  24. Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, Ohta H, Shiraki M, Sugimoto T, Suzuki T, Soen S, Nishizawa Y, Hagino H, Fukunaga M, Fujiwara S. Japanese 2011 guidelines for prevention and treatment of osteoporosis executive summary. Arch Osteoporos. 2012;7(1–2):3–20.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Iwaya T. Development of a screening tool for risk of locomotive syndrome in the elderly: the 25-question geriatric locomotive function scale. J Orthop Sci. 2012;17(2):163–72.

    Article  PubMed  Google Scholar 

  26. Gluer CC. Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. J Bone Miner Res. 1997;12(8):1280–8.

    Article  CAS  PubMed  Google Scholar 

  27. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Harold Merskey and Nikolai Bogduk (eds). Prepared by the international association for the study of pain, Subcommittee on Taxonomy. Pain Supplement.1986, 3:S1-226.

  28. Iizuka Y, Iizuka H, Mieda T, Tajika T, Yamamoto A, Takagishi K. Association between “loco-check” and EuroQol, a comprehensive instrument for assessing health-related quality of life: a study of the Japanese general population. J Orthop Sci. 2014;19(5):786–91.

    Article  PubMed  Google Scholar 

  29. Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993;8(5):567–73.

    Article  CAS  PubMed  Google Scholar 

  30. Yoshimura N, Oka H, Muraki S, Akune T, Hirabayashi N, Matsuda S, Nojiri T, Hatanaka K, Ishimoto Y, Nagata K, Yoshida M, Tokimura F, Kawaguchi H, Nakamura K. Reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices for locomotive syndrome and associated disability: the second survey of the ROAD study. J Orthop Sci. 2011;16(6):768–77.

    Article  PubMed  Google Scholar 

  31. Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 17:1–45.

  32. Oka H, Yoshimura N, Kinoshita H, Saiga A, Kawaguchi H, Nakamura K. Decreased activities of daily living and associations with bone loss among aged residents in a rural Japanese community:the Miyama Study. J Bone Miner Metab. 2006;24(4):307–13.

    Article  PubMed  Google Scholar 

  33. Muramoto A, Imagama S, Ito Z, Hirano K, Ishiguro N, Hasegawa Y. Physical performance tests are useful for evaluating and monitoring the severity of locomotive syndrome. J Orthop Sci. 2012;17(6):782–8.

    Article  PubMed  Google Scholar 

  34. Muramoto A, Imagama S, Ito Z, Hirano K, Tauchi R, Ishiguro N, Hasegawa Y. Threshold values of physical performance tests for locomotive syndrome. J Orthop Sci. 2013;18(4):618–26.

    Article  PubMed  Google Scholar 

  35. Ministry of Health, Labour and Welfare. Outline of the National Health and Nutrition Survey Japan 2012. http://www.mhlw.go.jp/bunya/kenkou/eiyou/h24-houkoku.html.

  36. Laugier P. An overview of bone sonometry. Int Congr Ser. 2004;1274:23–32.

    Article  Google Scholar 

  37. Collinge CA, Lebus G, Gardner MJ, Gehrig L. A comparison of quantitative ultrasound of the calcaneus with dual-energy x-ray absorptiometry in hospitalized orthopaedic trauma patients. J Orthop Trauma. 2010;24(3):176–80.

    Article  PubMed  Google Scholar 

  38. Trimpou P, Bosaeus I, Bengtsson BA, Landin-Wilhelmsen K. High correlation between quantitative ultrasound and DXA during 7 years of follow up. Eur J Radiol. 2010;73(2):360–4.

    Article  PubMed  Google Scholar 

  39. Fujiwara S, Sone T, Yamazaki K, Yoshimura N, Nakatsuka K, Masunari N, Fujita S, Kushida K, Fukunaga M. Heel bone ultrasound predicts non-spine fracture in Japanese men and women. Osteoporos Int. 2005;16(12):2107–12.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Tokue Mieda.

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Iizuka, Y., Iizuka, H., Mieda, T. et al. Population-based study of the association of osteoporosis and chronic musculoskeletal pain and locomotive syndrome: the Katashina study. J Orthop Sci 20, 1085–1089 (2015). https://doi.org/10.1007/s00776-015-0774-9

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  • DOI: https://doi.org/10.1007/s00776-015-0774-9

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