Abstract

The increasing elderly population has a great impact on public health, and it is important to understand the progression of musculoskeletal disorders seen in this population. To establish useful preventative methods for such locomotive disorders, we must detect early changes in these individuals and identify those at risk in order to implement early interventions. The purpose of this review was: (1) to introduce an operational definition of locomotion dysfunction to prevent a care-need condition, and to verify its validity through a prospective cohort study, and (2) to review the indication of exercise intervention for multiple musculoskeletal involvements from the preceding literature. We developed a measurement scale called the Geriatric Locomotive Function Scale (GLFS)-25, which clearly reflects the degree of functional deterioration. We used it in a prospective cohort study of 314 patients recruited from 5 clinics or nursing care facilities and investigated the relationship of the GLFS-25 with 46 variables covering various clinical manifestations. The results clearly revealed that the change in the GLFS-25 classification reflected a common pattern seen in those with locomotive dysfunction. Recently, several important movements regarding physical activity and its public promotion have been advocated by international health organizations and journal publishers. Though it has not been confirmed yet that complex musculoskeletal diseases can be treated using therapeutic exercise, the promotion of physical activity appears promising. The degree of activity limitation in aged individuals with locomotive disorders can be evaluated using this scale, which may be useful in predicting the effectiveness of future interventions.

Highlights

  • Increase in the aging population has a great impact on public health, and the proportion of elderly individuals aged C65 years in Japan was 26.0 % in 2014 [1]

  • We developed a self-completed numerical questionnaire called the Geriatric Locomotive Function Scale-25 (GLFS-25) (Table 1), the validity and reliability of which had already been assessed from the psychometric point of view [10]

  • Several orthopedic problems covered under locomotive syndrome that are mainly related to the aging process include hip and knee osteoarthritis, degenerative spondylitis, osteoporosis, and lumbar canal stenosis

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Summary

Introduction

Increase in the aging population has a great impact on public health, and the proportion of elderly individuals aged C65 years in Japan was 26.0 % in 2014 [1]. It is important to understand the progression of disorders in this population because a dramatic increase in the number of elderly requiring help from others is an urgent matter from the medical and socioeconomical points of view [2, 3]. 47 million people have at least 1 of the following 3 disorders: radiographic knee osteoarthritis, radiographic lumbar spondylosis, and osteoporosis which is diagnosed based on an assessment of the bone mineral density. An estimated 24.7 million people have 2 of the above-mentioned disorders, and 5.4 million have all 3 [5]

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