Introduction
In recent years, “locomotive syndrome (locomo)” has become an important issue in maintaining the health of older adults. Locomo refers to a condition in which a decline in musculoskeletal function due to aging or disease leads to reduced mobility and an increased risk of requiring nursing care. The Ministry of Health, Labour and Welfare and the Japanese Orthopaedic Association emphasize the importance of early prevention. This article provides a simple, evidence-based explanation of the definition, causes, diagnosis, and prevention of locomo.
What Is Locomotive Syndrome?
Locomotive syndrome, proposed by the Japanese Orthopaedic Association in 2007, refers to a state in which mobility is impaired due to disorders of the musculoskeletal system, leading to a higher risk of becoming dependent on care. The main causes include decreased function of bones, joints, muscles, and the nervous system.
Major Causes of Locomo
1. Sarcopenia (Loss of Muscle Mass)
With age, muscle mass decreases and strength declines, making walking or standing up difficult.
Studies report that the prevalence of sarcopenia among people over 65 years old ranges from 10% to 30% (Cruz-Jentoft et al., 2019).
2. Osteoporosis (Bone Fragility)
Decreased bone density increases the risk of fractures, leading to difficulty walking or a higher chance of falling. Hip fractures due to osteoporosis are one of the leading causes of long-term bedridden conditions.
3. Osteoarthritis (Joint Degeneration)
Degeneration of joint cartilage—especially in the knees or hips—causes pain and movement restriction.
In Japan, knee osteoarthritis is particularly common, especially among women (Muraki et al., 2014).
Diagnosis of Locomo
The “Locomo Degree Test,” developed by the Japanese Orthopaedic Association, is used to assess locomotive syndrome.
1. Stand-Up Test (Locomo Degree 1)
Participants attempt to stand up from chairs of 40 cm, 30 cm, and 20 cm using one or both legs.
Inability to stand up from a 20 cm chair with both legs indicates Locomo Degree 1.
2. Two-Step Test (Locomo Degree 2)
Measures the distance covered in two maximum steps from a standing position.
If the ratio “2-step distance (cm) ÷ height (cm)” is less than 1.1, Locomo Degree 2 is diagnosed.
3. Locomo 25 Questionnaire (Locomo Degree 3)
A 25-item questionnaire assessing mobility-related daily activities.
A total score of 16 or higher indicates Locomo Degree 3.
Prevention and Improvement Strategies
Locomo can be prevented and improved through appropriate exercise and nutrition management.
1. Exercise Therapy
・Squats: Strengthen lower limb muscles.
・One-leg standing: Improve balance.
・Walking: Enhance endurance.
2. Nutrition Management
・Protein: Maintain muscle mass.
・Calcium and Vitamin D: Support bone density.
・Antioxidants: Help reduce joint inflammation.
Summary
Locomotive syndrome is a condition in which decline of the musculoskeletal system reduces mobility and increases the risk of needing care. The “Locomo Degree Test” is useful for diagnosis, and prevention through regular exercise and proper nutrition is highly effective.
