Tanaka Satoshi, Ando Kei, Kobayashi Kazuyoshi, Hida Tetsuro, Seki Taisuke, Hamada Takashi, Ito Kenyu, Tsushima Mikito, Morozumi Masayoshi, Machino Masaaki, Ota Kyotaro, Ishiguro Naoki, Hasegawa Yukiharu, Imagama Shiro
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
J Orthop Sci. 2019 Sep;24(5):912-917. doi: 10.1016/j.jos.2019.01.011. Epub 2019 Feb 14.
Locomotive syndrome risk level has been recently proposed to evaluate physical ability. Impaired balance control is one of the most important risk factors for falls. However, the relationship between locomotive syndrome risk and postural sway according to the balance test is unclear. This study aimed to investigate the relationship between locomotive syndrome risk and balance test results, including muscle mass and physical function, in a large-scale prospective general health checkup.
We enrolled 292 participants who underwent a basic health checkup and conducted a two-step test, stand-up test, evaluation using a 25-question geriatric locomotive function scale for the locomotive syndrome risk test, balance test, appendicular skeletal muscle mass measurement by bioelectrical impedance analysis, evaluation of physical function by the timed-up-and-go test, and back muscle and grip strength evaluation. A statistical comparative study was then conducted between normal and locomotive syndrome risk groups. Subsequently, significant factors for locomotive syndrome risk were investigated by multivariate analysis.
The comparative study was conducted by adjusting age and sex using a generalized linear model. No significant difference in muscle mass existed, but postural sway in the balance test significantly increased in the people at locomotive syndrome risk. Among the four posturographic variables by balance test, increase in back-and-forth sway was the most remarkable variable associated with locomotive syndrome risk together with back muscle strength, body mass index, and the timed-up-and-go test by logistic regression analysis. This posturographic variable was significantly related to the timed-up-and-go test and leg skeletal muscle mass by multiple regression analysis.
A relationship was recognized between locomotive syndrome risk and postural sway. In particular, increase in back-and-forth sway was an important factor for locomotive syndrome risk. If the balance test shows an increase in back-and-forth sway, attention should be paid to locomotive syndrome risk for possible intervention and early treatment.
最近提出了机车综合征风险水平来评估身体能力。平衡控制受损是跌倒的最重要风险因素之一。然而,根据平衡测试,机车综合征风险与姿势摆动之间的关系尚不清楚。本研究旨在调查大规模前瞻性一般健康检查中机车综合征风险与平衡测试结果(包括肌肉质量和身体功能)之间的关系。
我们招募了292名接受基本健康检查的参与者,进行了两步测试、起立测试、使用25个问题的老年机车功能量表进行机车综合征风险测试评估、平衡测试、通过生物电阻抗分析测量四肢骨骼肌质量、通过定时起立行走测试评估身体功能以及背部肌肉和握力评估。然后在正常组和机车综合征风险组之间进行统计比较研究。随后,通过多变量分析研究机车综合征风险的显著因素。
使用广义线性模型对年龄和性别进行调整后进行比较研究。肌肉质量没有显著差异,但平衡测试中的姿势摆动在机车综合征风险人群中显著增加。在平衡测试的四个姿势描记变量中,前后摆动的增加是与机车综合征风险相关的最显著变量,与背部肌肉力量、体重指数和逻辑回归分析中的定时起立行走测试一起。通过多元回归分析,这个姿势描记变量与定时起立行走测试和腿部骨骼肌质量显著相关。
认识到机车综合征风险与姿势摆动之间的关系。特别是,前后摆动的增加是机车综合征风险的一个重要因素。如果平衡测试显示前后摆动增加,应注意机车综合征风险,以便进行可能的干预和早期治疗。