The First Study on Locomotive Syndrome in Lower Amputees in Japan
Kei Sano
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Yoshiyuki Suehara *
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Yu Tanabe
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Taketo Okubo
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Youngji Kim
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Midori Ishii
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Takayuki Kawasaki
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Atsuhiko Terakado
The Prosthetic and Orthotic Care Center of the Tetsudo Kosaikai Foundation, Tokyo, Japan.
Keisuke Akaike
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Kenta Mukaihara
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Daisuke Kubota
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Naoko Okubo
Faculty of Health and Sports Science, Juntendo University, Japan.
Yuichiro Maruyama
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
Tsuyoshi Saito
Department of Human Pathology, Juntendo University School of Medicine, Japan.
Kazuo Kaneko
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
*Author to whom correspondence should be addressed.
Abstract
Background: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term "Locomotive syndrome" (LS) to describe a condition in high-risk patients with musculoskeletal disease. So far, there are many studies that are designed for non-handicapped people. However, the study using a cohort of handicapped people are limited. In this study, we therefore conducted a study on LS in lower amputees.
Methods and Participants: We surveyed 47 lower amputees. A questionnaire that included the 25-question Geriatric Locomotive Function Scale (GLFS-25) and the Loco-check was distributed to the participants.
Results: According to GLFS-25, the classifications of the amputee patients were as follows: no locomotive dysfunction, n=21 (44.7%); grade I locomotive syndrome, n=17 (36.2%); and grade II locomotive syndrome, n=9 (19.1%). The mean GLFS-25 was 10.4. According to the Loco-check, 43 (91.5%) patients were at risk of LS.
Conclusion: We have surveyed the GLFS-25 and Loco-check to investigate the risk of LS in lower limb amputees. We found that lower limb amputees had unique risk factors for LS, including amputation level, phantom pain, stump wound and frequency of wheelchair use. Both non-handicapped people and lower limb amputees need to be considered in studies on LS and more specific countermeasures are required for LS in lower limb amputees.
Keywords: Lower amputees, locomotive syndrome, GLFS-25 and Locomotor function