Arbex Maria Carolyna Fonseca Batista, Okazaki Jane Erika Frazão, Tavares Daniela Regina Brandão, Figueiredo Bersani Ana Laura, Santos Fania Cristina
Federal University of São Paulo (UNIFESP), Discipline of Geriatrics and Gerontology, Pain and Osteoarticular Diseases Group, Address 105, St Professor Francisco de Castro, CEP 04020-050, Sao Paulo, SP, Brazil; University of Araraquara (UNIARA), Discipline of Geriatrics and Gerontology, Sao Paulo, SP, Brazil.
Federal University of São Paulo (UNIFESP), Discipline of Geriatrics and Gerontology, Pain and Osteoarticular Diseases Group, Address 105, St Professor Francisco de Castro, CEP 04020-050, Sao Paulo, SP, Brazil.
J Orthop Sci. 2021 Jan;26(1):162-166. doi: 10.1016/j.jos.2020.02.007. Epub 2020 Mar 12.
In 2007, the Japanese Orthopedic Association established the term "Locomotive Syndrome" (LS) for the concept of locomotor organ dysfunction with potential loss of independence. The purpose of this study was to identify characteristics of LS and establish a diagnostic cut-off for the Geriatric Locomotive Function Scale (GLFS 25-p) for the Brazilian population.
A cross-sectional observational study of the LOCOMOV Project cohort of independent outpatients aged ≥80 years was conducted. Questionnaires on functional status in Basic and Instrumental Activities of Daily Living (Katz and Lawton, respectively) and quality of life (WHOQOL-Bref) were applied, together with the Geriatric Locomotive Function Scale (GLFS 25-p) to identify individuals with LS. Mobility was assessed using the five-times sit-to-stand test, 4-m gait speed, two-step test, one-leg standing time with eyes open and hand-grip test. The data were analyzed using Student's t-test, the Chi-Square test, and multiple logistic regression (stepwise). The significance level was set at 0.05 (5%).
A sample of 102 individuals with mean age of 87.3 (±4.2) years and predominantly female (73.5%) was assessed. We determined a cut-off score of 19 (sensitivity of 0.86 and specificity of 0.67) for diagnosis of LS, as assessed by the GLFS 25-p, and a high prevalence (55%) of the syndrome was found in the sample. In the multiple regression analysis, LS was directly associated with chronic pain (OR 22.24, 95%CI 3.13-157.87), use of a walking device (OR 17.121, 95%CI 1.94-150.49), and inversely associated with gait speed ≥0.8 m/s (OR 0.42, 95%CI 0.006-0.278), perception of good health (OR 0.153, 95%CI 0.029-0.799) and male gender (OR 0.086, 95%CI 0.0105-0.714).
The LS in the oldest old proved a very common condition in this survey, especially in women, and was strongly associated with chronic pain, worse performance on physical tests and poor quality of life.
2007年，日本矫形外科学会确立了“机体功能障碍综合征”（LS）这一术语，用于描述具有潜在独立能力丧失风险的运动器官功能障碍概念。本研究的目的是确定LS的特征，并为巴西人群建立老年机体功能量表（GLFS 25项）的诊断临界值。
对LOCOMOV项目队列中年龄≥80岁的独立门诊患者进行横断面观察研究。应用了关于基本日常生活活动和工具性日常生活活动（分别为Katz量表和Lawton量表）中的功能状态问卷以及生活质量问卷（WHOQOL-Bref），同时使用老年机体功能量表（GLFS 25项）来识别患有LS的个体。通过五次坐立试验、4米步速测试、两步试验、睁眼单腿站立时间和握力测试来评估活动能力。使用学生t检验、卡方检验和多元逻辑回归（逐步法）对数据进行分析。显著性水平设定为0.05（5%）。
对102名平均年龄为87.3（±4.2）岁且以女性为主（73.5%）的个体进行了评估。我们确定通过GLFS 25项评估诊断LS的临界值为19分（敏感性为0.86，特异性为0.67），并且在样本中发现该综合征的患病率很高（55%）。在多元回归分析中，LS与慢性疼痛直接相关（比值比22.24，95%置信区间3.13 - 157.87）、使用助行器（比值比17.121，95%置信区间1.94 - 150.49），与步速≥0.8米/秒呈负相关（比值比0.42，95%置信区间0.006 - 0.278）、自我感觉健康良好（比值比为0.153，95%置信区间0.029 - 0.799）以及男性性别呈负相关（比值比0.086，95%置信区间0.0105 - 0.714）。
在本次调查中，最年长老人中的LS被证明是一种非常常见的情况，尤其是在女性中，并且与慢性疼痛、身体测试表现较差以及生活质量差密切相关。
