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Relationship between physician-judged functioning level and self-reported disabilities in elderly people with locomotive disorders

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Abstracts

Purpose

Locomotive disorders due to musculoskeletal involvement are one of the main causes requiring long-term care services in aging Japan. “Locomotive syndrome (LoS)” is a concept referring to the condition under which people require assistance from others or at risk in future. The object of this study is to examine the relationship between self-reported measure and physician-judged degrees on ADL disability in elder people with locomotive disorders.

Methods

In a cross-sectional study, 711 patients who were aged 65 years old or more were recruited from 49 outpatient clinics and hospitals. We investigated ADL disabilities by self-reported questionnaire (Geriatric Locomotive Function Scale-25: GLFS-25) and physician-judged grading (Locomotive Dysfunction Grade: LDG) and examined the relationship between these two.

Results

We classified the severity of locomotive disability by clinical phenotype into six grades: LDG Grade 1 (N = 77), Grade 2 (213), Grade 3 (139), Grade 4 (162), Grade 5 (78), and Grade 6 (42). The mean of GLFS-25 was 25.9. The mean of GLFS-25 was 5.68 for Grade 1, 14.33 for Grade 2, 22.34 for Grade 3, 35.40 for Grade 4, 43.25 for Grade 5, and 60.24 for Grade 6. Significant differences of GLFS-25 scores were found between adjacent LDGs.

Conclusions

Physician-judged grade of locomotive dysfunction was significantly related to self-reported assessment scale on ADL disability. Physician-judged dysfunction grade is readily administered scale and useful to assess the severity of locomotive dysfunction. Self-reported scale provides precise information on ADL disabilities due to locomotive organ dysfunction and is useful to develop intervention programs.

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Abbreviations

LoS:

Locomotive syndrome

LTCI:

Long-term care insurance

GLFS-25:

Geriatric Locomotive Function Scale-25

LDG:

Locomotive Dysfunction Grade

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Acknowledgments

We wish to thank Kozo Nakamura, Hiromoto Itoh, Keiji Fujino, Noriko Yoshimura, and Kunihiko Hayashi for their advice and Noriko Kojima for her secretarial work. This study was conducted with the support of the Japanese Clinical Orthopaedic Association. We are also grateful to all of the orthopedic surgeons, their staff members, and those who willingly participated in this study (49 study sites): Matsuzaki Orthopaedics, Yamashita Orthopaedic Clinic, Nasu Orthopaedic Clinic, Hyakutake Orthopaedic Hospital, Morishita Orthopaedic and Rheumatism Clinic, Mori Orthopaedics, Nakagaki Orthopaedics, Takaoka Clinic, Tatsuya Orthopaedic Clinic, Shimizu Orthopaedic Clinic, Mistukaichi Orthopaedics, Nagakura Orthopaedics, Himeno Hospital, Cosmopia Kumamoto Institution for the Elderly, Mukaiyama Clinic, Yoro Orthopaedics, Idota Orthopaedics, Kiyoshi Orthopaedics, Kumamoto Kino Hospital, Sakata Orthopaedics, Minamiakita Orthopaedics, Aomori Jikeikai Hospital, Oyumino Orthopaedic Clinic, Tanikake Hatano Orthopaedic and Rehabilitation Clinic, Matsuo Orthopaedics, Konagai Orthopaedics, Suzuki Orthopaedics, Sugiyama Orthopaedic and Rehabilitation Clinic, Hirose Orthopaedics, Nozomi Orthopaedics, Mizoguchi Orthopaedics, Shiba Orthopaedics, Morifuku Orthopaedics, Yoshimura Orthopaedics, Tomono Orthopaedic Clinic, Horii Orthopaedics, Matsuki Orthopaedics, Yamanaka Orthopaedics, Mochizuki Orthopaedics, Oya Orthopaedic Clinic, Miyake Orthopaedics, Koganei Chuo Hospital, Shimotsuga General Hospital, Haga Red Cross Hospital, Imaichi Hospital, Sano Clinic, and Shiobara National Towa Clinic, Saigo Hospital.

Author contributions

TI conceived and designed the study. AS, YO, and TO performed the study and collected the data. TD, TI, and MA performed statistical analysis of the data and interpreted the results. TI and MA wrote the article.

Funding

This study was supported by a Sciences Research Grant (H20-Choju-G-002) from the Ministry of Health, Labor, and Welfare, Japan. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subjects of this article.

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Authors and Affiliations

  1. Nagano University of Health and Medicine, 11-1 Imaihara, Kawanakajima-chou, Nagano, 381-2227, Japan

    Tsutomu Iwaya

  2. Geriatric Care Facility Excellent Care Shizu, 1316-1 Kami-Shizu, Sakura, Chiba, 285-0846, Japan

    Tokuhide Doi

  3. Mitsui Memorial Hospital, 1 Kanda-Izumi-chou, Chiyoda-ku, Tokyo, 101-0024, Japan

    Atsushi Seichi

  4. Tochigi Rehabilitation Center, 3337-1 Komanyu-machi, Utsunomiya, Tochigi, 320-8503, Japan

    Yuichi Hoshino

  5. National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan

    Toru Ogata

  6. Graduate School, International University of Health and Welfare, 4F, Aoyama 1-Chome Tower, 1-3-3 Minami-Aoyama, Minato-ku, Tokyo, 107-0062, Japan

    Masami Akai

Authors
  1. Tsutomu Iwaya
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  2. Tokuhide Doi
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  3. Atsushi Seichi
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  4. Yuichi Hoshino
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  5. Toru Ogata
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  6. Masami Akai
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Corresponding author

Correspondence to Masami Akai.

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The authors declare that they have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Iwaya, T., Doi, T., Seichi, A. et al. Relationship between physician-judged functioning level and self-reported disabilities in elderly people with locomotive disorders. Qual Life Res 26, 35–43 (2017). https://doi.org/10.1007/s11136-016-1377-4

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