Kobayashi Takaomi, Morimoto Tadatsugu, Ono Rei, Otani Koji, Mawatari Masaaki
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
J Orthop Sci. 2023 Jul;28(4):880-885. doi: 10.1016/j.jos.2022.03.011. Epub 2022 Apr 25.
This study was conducted to investigate the relationship between grip strength and the 25-question Geriatric Locomotive Function Scale (GLFS-25) score and the diagnosis of locomotive syndrome (LS), and the usefulness of grip strength in screening for LS.
This cross-sectional study was conducted on 2251 community-dwelling residents (male, n = 1035; female, n = 1216). Subjects with GLFS-25 scores of 0-6 points, 7-15 points, 16-23 points, and 24-100 points were diagnosed with non-LS, LS-1, LS-2, and LS-3, respectively. Multivariate linear regression and multivariate logistic regression analyses were performed to assess the relationship between grip strength and the GLFS-25 score and LS after adjustment for age, sex, and body mass index. A conventional receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cutoff value of grip strength for predicting the severity of LS. The discriminative ability of the model was assessed using the area under the ROC curve (AUC).
The multivariate linear regression analysis showed that grip strength was significantly associated with the GLFS-25 score. The multivariate logistic regression analysis revealed that grip strength was significantly associated with the diagnosis of LS. The optimal cutoff values of grip strength for identifying LS-1 or more, LS-2 or more, and LS-3 or more were 36.0 kg (sensitivity 65.7%, specificity 57.1%, AUC 0.66), 35.0 kg (sensitivity 70.0%, specificity 57.5%, AUC 0.70), and 34.0 kg (sensitivity 67.2%, specificity 62.5%, AUC 0.70), respectively, in males, and 24.0 kg (sensitivity 69.1%, specificity 45.4%, AUC 0.61), 23.0 kg (sensitivity 69.5%, specificity 52.3%, AUC 0.67), and 22.0 kg (sensitivity 69.1%, specificity 61.0%, AUC 0.69) in females.
The use of grip strength in screening to predict the severity of LS may not be clinically useful. However, the results will increase our understanding of the relationship between grip strength and the GLFS-25 scores and LS.
本研究旨在探讨握力与25项老年运动功能量表(GLFS - 25)评分及运动机能不全综合征(LS)诊断之间的关系,以及握力在筛查LS中的作用。
本横断面研究纳入了2251名社区居民(男性1035名,女性1216名)。GLFS - 25评分在0 - 6分、7 - 15分、16 - 23分和24 - 100分的受试者分别被诊断为非LS、LS - 1、LS - 2和LS - 3。在对年龄、性别和体重指数进行调整后,进行多变量线性回归和多变量逻辑回归分析,以评估握力与GLFS - 25评分及LS之间的关系。采用传统的受试者工作特征(ROC)曲线分析来计算预测LS严重程度的握力最佳截断值。使用ROC曲线下面积(AUC)评估模型的判别能力。
多变量线性回归分析显示,握力与GLFS - 25评分显著相关。多变量逻辑回归分析表明,握力与LS诊断显著相关。男性中,用于识别LS - 1及以上、LS - 2及以上和LS - 3及以上的握力最佳截断值分别为36.0千克(灵敏度65.7%,特异性57.1%,AUC 0.66)、35.0千克(灵敏度70.0%,特异性57.5%,AUC 0.70)和34.0千克(灵敏度67.2%,特异性62.5%,AUC 0.70);女性中分别为24.0千克(灵敏度69.1%,特异性45.4%,AUC 0.61)、23.0千克(灵敏度69.5%,特异性52.3%,AUC 0.67)和22.0千克(灵敏度69.1%,特异性61.0%,AUC 0.69)。
利用握力筛查来预测LS的严重程度在临床上可能并无用处。然而,这些结果将增进我们对握力与GLFS - 25评分及LS之间关系的理解。