Difference in physical function of older people among locomotive syndrome, frailty, and sarcopenia in orthopaedic outpatient clinic

keisuke kato, Jun iwamoto
Purpose:

We investigated the prevalence and co-existence of LS, FR, and SP among older patients in our orthopaedic outpatient clinic, and compared physical function among three conditions.

Methods:

58 male and 566 female patients (mean age: 76.0 years, range: 45–96 years), who consulted our outpatient clinic due to musculoskeletal diseases (mainly osteoporosis), took a medical checkup regarding physical function between October 2017 and February 2023. LS (stage 1 and 2) was determined using the two-step test and stand-up test proposed by the JOA. FR was diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2019. Sarcopenia was determined using the diagnostic criteria established by the J-Cardiovascular Health Study. The prevalence of and co-existence LS, FR, and SP were investigated, and crucial parameters, such as grip strength and walking speed, which are included for diagnosing FR and SP, were compared among three conditions. This study was approved by the ethics committee of Keiyu Orthopaedic Hospital.

Results:

560 (89.9%) out of 623 patients were determined to have LS, while 89 patients (14.3%) and 78 patients (12.5%) were diagnosed as having FR and SP, respectively. Of 560 patients with LS, 418 (74.6%) had neither FR nor SP. Of 89 patients with FR, 87 (97.8%) had LS, and of 78 patients with SP, 77 (98.7%) had LS. In particular, 22 (15.5%) out of 142 patients with LS together with FR or SP had three conditions. Grip strength was greater and walking speed was faster in patients without any three conditions than those with LS as well as in patients with only LS than those with LS and FR and/or SP.

Conclusion(s):

The prevalence of LS was high (89.9%) among older patients in our orthopaedic outpatient clinic, and LS co-existed among most of patients who were diagnosed as having FR and/or SP. Early identification of LS not only allows implementation of treatment strategies, but also presents an opportunity to mitigate the risk of FR and SP.

Implications:

Early prevention is considered important for extending healthy life expectancy, such as a high risk of needing long-term care when LS is applicable, and early intervention for locomotion may lead to the prevention of FR and SP.

Funding acknowledgements:
The authors declare no conflicts of interest associated with this manuscript.
Keywords:
Locomotive syndrome
Frailty
Sarcopenia
Primary topic:
Older people
Second topic:
Primary health care
Third topic:
Sustainable health
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
ethics committee of Keiyu Orthopaedic Hospital
Provide the ethics approval number:
3407
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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