Ide Koichiro, Yamato Yu, Hasegawa Tomohiko, Yoshida Go, Hanada Mitsuru, Banno Tomohiro, Arima Hideyuki, Oe Shin, Yamada Tomohiro, Watanabe Yuh, Kurosu Kenta, Hoshino Hironobu, Niwa Haruo, Togawa Daisuke, Matsuyama Yukihiro
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan.
Department of Orthopaedic Surgery, Fujieda Municipal General Hospital, 4-1, Surugadai, Fujieda, Shizuoka, 426-0077, Japan.
Osteoporos Sarcopenia. 2024 Jun;10(2):89-94. doi: 10.1016/j.afos.2024.05.001. Epub 2024 May 31.
Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship.
A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018.
Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan-Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451-3.447).
Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a high-risk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.
最近确定的运动机能不全综合征3期（LS3）可能比运动机能不全综合征0期（LS0）、运动机能不全综合征1期（LS1）和运动机能不全综合征2期（LS2）需要更多的护理。LS3与日本长期护理之间的关系尚不清楚。因此，本研究旨在探讨这种关系。
2012年共有531例未被归类为需要长期护理且接受了肌肉骨骼检查的患者（314名女性和217名男性；平均年龄75岁），根据其运动机能不全综合征阶段进行分组。L组包括LS3患者，N组包括LS0、LS1和LS2患者。我们根据2013年至2018年的流行病学结果和长期护理需求对这些组进行了比较。
59例患者（11.1%）被诊断为LS3。L组需要长期护理的患者（50.8%）比N组（17.8%）更多（P<0.001）。L组椎体骨折和膝骨关节炎患者也比N组更多（分别为33.9%对19.5%[P=0.011]和78%对56.4%[P<0.001]）。Cox比例风险模型和Kaplan-Meier分析显示，L组和N组在护理需求方面存在显著差异（对数秩检验，P<0.001；风险比，2.236；95%置信区间，1.451-3.447）。
在2012年至2018年期间，50%的LS3患者需要护理。因此，LS3是一种需要干预的高危情况。治疗椎体骨折和膝骨关节炎的方法可能是关键。
