Abstract
BackgroundThe Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). It has been reported that the Two-Step test score has a good correlation with one’s walking ability; however, its association with the gait pattern of older people during normal walking is still unknown. Therefore, this study aims to clarify the associations between the gait patterns of older people observed during normal walking and their Two-Step test scores.MethodsWe analyzed the whole waveforms obtained from the lower-extremity joint angles and joint moments of 26 older people in various stages of locomotive syndrome using principal component analysis (PCA). The PCA was conducted using a 260 × 2424 input matrix constructed from the participants’ time-normalized pelvic and right-lower-limb-joint angles along three axes (ten trials of 26 participants, 101 time points, 4 angles, 3 axes, and 2 variable types per trial).ResultsThe Pearson product-moment correlation coefficient between the scores of the principal component vectors (PCVs) and the scores of the Two-Step test revealed that only one PCV (PCV 2) among the 61 obtained relevant PCVs is significantly related to the score of the Two-Step test.ConclusionsWe therefore concluded that the joint angles and joint moments related to PCV 2—ankle plantar-flexion, ankle plantar-flexor moments during the late stance phase, ranges of motion and moments on the hip, knee, and ankle joints in the sagittal plane during the entire stance phase—are the motions associated with the Two-Step test.
Highlights
The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome
This study focused on the first 19 of these Principal component vector (PCV), each of which explained more than 1% of the total variance of the 260 gait samples
We provide a stick figure animation of the lower limb movements showing the gaits for PCV 2, to help understand how this PCV affects the joint angles and joint moments
Summary
The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). The JOA prescribed three official tests for assessing the individual risk level of suffering from locomotive syndrome based on the evidence provided in previous studies [5,6,7] to detect the symptoms of locomotive syndrome in its early stage.: 1) the stand-up test to assess leg strength, 2) the Two-Step test to assess maximal stride length, and 3) a 25-question risk assessment questionnaire to assess the individual’s physical conditions and difficulties in daily life. Despite the feasibility of the Two-Step test as a measure of mobility in locomotive syndrome, it is unknown which factors in gait pattern contribute to the score of the test Revealing those factors, especially for relatively young older people, may provide novel insights for understanding the mechanisms underlying the declining mobility in the early stage of aging. The characterization of gait patterns of those who score low values in the Two-Step test will lead to the establishment of effective instruction to improve their gait performance in the early stage of locomotive syndrome
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