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  1. Nakamura, Misa PhD
  2. Hashizume, Hiroshi MD, PhD
  3. Oka, Hiroyuki MD, PhD
  4. Okada, Morihiro MD, PhD
  5. Takakura, Rie DPT
  6. Hisari, Ayako PT
  7. Yoshida, Munehito MD, PhD
  8. Utsunomiya, Hirotoshi DVM, PhD


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.


Purpose: 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 (6MWT). Variables were compared between LS and non-LS groups.


Results: Fourteen participants (11.1%) were classed as having LS. Unipedal stance time, normal 6MWT, and fast 6MWT were significantly different between the 2 groups. The LS group had a shorter unipedal stance time and a longer normal and fast 6MWT 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 6MWT and 3.6 s for fast 6MWT. 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).


Conclusion: 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.