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


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.
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Yoichi
Y
Iizuka
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Haku
H
Iizuka
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan. tmieda@gunma-u.ac.jp.
Tokue
T
Mieda
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Tsuyoshi
T
Tajika
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Atsushi
A
Yamamoto
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Kenji
K
Takagishi
D015502:Absorptiometry, Photon / Q000379:methods; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology; D059350:Chronic Pain; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008124:Locomotion / Q000502:physiology*; D008297:Male; D051346:Mobility Limitation; D015999:Multivariate Analysis; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012424:Rural Population; D012720:Severity of Illness Index; D012737:Sex Factors; D013577:Syndrome; D055815:Young Adult