title: Physical Performance Measures Associated With Locomotive Syndrome in Middle-Aged and Older Japanese Women.
abstract: BACKGROUND
  The Japanese Orthopaedic Association proposed a concept called locomotive syndrome (LS) to identify middle-aged and older adults at high risk of requiring health care services because of problems with locomotion. It is important to identify factors associated with the development of LS. Physical performance measures such as walking speed and standing balance are highly predictive of subsequent disability and mortality in older adults. However, there is little evidence about the relationship between physical performance measures and LS.
  
  
  OBJECTIVE
  To determine the physical performance measures associated with LS, the threshold values for discriminating individuals with and without LS, and the odds ratio of LS according to performance greater than or less than these thresholds in middle-aged and older Japanese women.
  
  
  METHODS
  Participants were 126 Japanese women (mean age = 61.8 years). Locomotive syndrome was defined as a score of 16 or more on the 25-question Geriatric Locomotive Function Scale. Physical performance was evaluated using grip strength, unipedal stance time with eyes open, seated toe-touch, and normal and fast 6-m walk time (6 MWT). Variables were compared between LS and non-LS groups.
  
  
  RESULTS
  Fourteen participants (11.1%) were classed as having LS. Unipedal stance time, normal 6 MWT, and fast 6 MWT were significantly different between the 2 groups. The LS group had a shorter unipedal stance time and a longer normal and fast 6 MWT than the non-LS group. For these 3 variables, the area under the receiver operating characteristic curve was greater than 0.7, and the threshold for discriminating the non-LS and LS groups was 15 s for unipedal stance time, 4.8 s for normal 6 MWT and 3.6 s for fast 6 MWT. These variables were entered into a multiple logistic regression analysis, which indicated that unipedal stance time less than 15 s was significantly related to LS (odds ratio = 8.46; P < .01).
  
  
  CONCLUSIONS
  Unipedal stance time was the physical performance measure that was most strongly associated with LS. This measure may be useful for early detection of LS.
authors.affiliation: 1Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan. 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan. 3Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan. 4Department of Strategic Surveillance for Functional Food and Comprehensive Traditional Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Misa
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hashizume
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Oka
authors.forename: Morihiro
authors.initials: M
authors.lastname: Okada
authors.forename: Rie
authors.initials: R
authors.lastname: Takakura
authors.forename: Ayako
authors.initials: A
authors.lastname: Hisari
authors.forename: Munehito
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Utsunomiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D019540:Area Under Curve; D015331:Cohort Studies; D004185:Disability Evaluation; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007564:Japan; D008124:Locomotion / Q000502:physiology*; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology; D004856:Postural Balance / Q000502:physiology*; D012372:ROC Curve; D013577:Syndrome