title: Lumbar spondylosis, lumbar spinal stenosis, knee pain, back muscle strength are associated with the locomotive syndrome: Rural population study in Japan.
abstract: OBJECTIVE
  To comprehensively investigate the clinical and physical factors associating with locomotive syndrome (Loc-S); the locomotorium-disability for daily life.
  
  
  METHODS
  647 volunteers participated (247 males, 400 females, Age: 58.4 ± 11.0, BMI: 22.5 ± 3.3). Three self-assessment questionnaires were administered: 1) "25-question Geriatric Locomotive Function Scale" (GFLS-25) for evaluating Loc-S (GLFS-25 ≥ 16 defined as Loc-S); 2) "diagnostic support tool for LSS" (LSS-DST) for evaluating the prevalence of lumbar spinal stenosis (LSS); 3) Knee injury and Osteoarthritis Outcome Score (KOOS). Plain radiographs of the bilateral knees and lumbar spine were evaluated, and the severity of lumbar spondylosis (LS) and knee osteoarthritis (KOA) defined by Kellgren-Lawrence grade. Bone status was evaluated by using the osteo-sono assessment index (OSI) at the calcaneus. Isometric muscle strength of trunk and leg (Nm/kg, both extension and flexion) were evaluated. Linear regression analysis was performed to elucidate the factors concerned with GFLS-25 including age, sex, and BMI.
  
  
  RESULTS
  Thirty-nine subjects (6.0%, 13 males, 26 females) were defined as having Loc-S. Single regression model showed that age, height, BMI, skeletal muscle mass, OSI, LSS, KOOS, the severity of LS and KOA, and trunk- and leg-muscle strength were correlated with the degree of GLFS-25. Stepwise multiple regression model showed that sex, height, LSS, KOOS, the severity of LS, and back muscle strength were significantly correlated with that of GLFS-25.
  
  
  CONCLUSIONS
  In this cross-sectional study, pain status associated with LSS and knee joint, structural severity for LS, and back muscle strength primarily affected the degree of GFLS-25. For managing Loc-S, we must pay more intensive attention to these factors.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: dachiba@hirosaki-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Chiba
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tsuda
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Kanichiro
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Gentaro
authors.initials: G
authors.lastname: Kumagai
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Sasaki
authors.affiliation: Medical Engineering Laboratory, Alcare Co., Ltd, Kyojima, Sumida-ku, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nawata
authors.affiliation: Medical Engineering Laboratory, Alcare Co., Ltd, Kyojima, Sumida-ku, Tokyo, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Nakagomi
authors.affiliation: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nakaji
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ishibashi
mesh_terms: D017677:Age Distribution; D000368:Aged; D000375:Aging / Q000502:physiology; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology*; D064131:Back Muscles / Q000502:physiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan; D007719:Knee Joint / Q000503:physiopathology; D016014:Linear Models; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology*; D011788:Quality of Life; D012424:Rural Population; D012720:Severity of Illness Index; D017678:Sex Distribution; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013577:Syndrome