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Original Article| Volume 24, ISSUE 6, P1094-1104, November 2019

A nationwide observational study of locomotive syndrome in Japan using the ResearchKit: The Locomonitor study

  • Yusuke Yoshimura
    Affiliations
    Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Muneaki Ishijima
    Correspondence
    Corresponding author. Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: +81 3 3813-3428.
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Sportology Center, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Masayoshi Ishibashi
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Liz Liu
    Affiliations
    Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Sportology Center, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Eri Arikawa-Hirasawa
    Affiliations
    Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Shuichi Machida
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Graduate School of Health and Sports Science, Juntendo University, Hiraka-gakuenndai 1-1, Inzai-shi, Chiba 270-1965 Japan
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  • Hisashi Naito
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Graduate School of Health and Sports Science, Juntendo University, Hiraka-gakuenndai 1-1, Inzai-shi, Chiba 270-1965 Japan
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  • Chieko Hamada
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Juntendo Advanced Research Institute for Health Science (JARIHES), Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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  • Eiki Kominami
    Affiliations
    Center of Innovation (COI) Program, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan

    Juntendo University Faculty of International Liberal Arts, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421 Japan
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Published:September 03, 2019DOI:https://doi.org/10.1016/j.jos.2019.08.009

      Abstract

      Background

      We developed the Locomonitor application (app), the world's first iOS app to study locomotive syndrome, using the ResearchKit and examined the prevalence and risk factors for locomotive syndrome in Japanese general individuals 20–69 years old in a nationwide cross-sectional observational study.

      Methods

      The participants were recruited from February to August 2016. The outcome measures for the locomotive function were evaluated by locomotive syndrome risk tests (LSRTs) using the Locomonitor app. The chi-squared test, a linear-by-linear association trend analysis, and Spearman's correlation test were performed as statistical analyses.

      Results

      A total of 2177 subjects from all prefectures in Japan were included (average 42.2 years old). The Locomo25 and Stand-Up test scores in female participants and the Two-Step test scores in male participants showed age-dependent deterioration. In the overall population, the incidence of Locomo stage 1 and 2, as evaluated by the Locomo25, Stand-Up test or Two-Step test, was 30.2% and 29.2%, respectively. In subjects without locomotive syndrome (40.5%), LSRT scores showed age-dependent deterioration in both sexes. Locomotive syndrome in participants with a body mass index (BMI) of ≥25 kg/m2 was more frequent than in those with a BMI of <25 kg/m2 (age- and gender-adjusted odds ratio [OR] 1.344 [95% confidence interval {CI} 1.03–1.75, p = 0.027]). Locomotive syndrome in participants with an exercise habit was less frequent than in those without an exercise habit (age- and gender-adjusted OR 0.499 [95% CI 0.33–0.755, p < 0.0001]).

      Conclusions

      The Locomonitor app, a newly developed remote platform, revealed that approximately 20%–30% of Japanese individuals 20–69 years old in the general population met the definition of locomotive syndrome. Locomotive syndrome in participants with obesity was more frequent than those without obesity, while locomotive syndrome in participants with an exercise habit was less frequent than those without an exercise habit.
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