A Comparative Study of 2 Screening Tools for Locomotive Syndrome (The “Loco-check” and the “GLFS-25”): An Orthopedic Outpatient-based Survey

Background: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term “locomotive syndrome” (LS) to designate a condition in high-risk groups with musculoskeletal diseases who are highly likely to require nursing care. The JOA developed two screening tools for LS: The 25-question Geriatric Locomotive Function Scale (“GLFS-25”) and the “Loco-check”. The present study represents the first comparison of these tools.

Methods: To compare the diagnostic abilities and characteristics of the two diagnostic tools, we investigated the associations of LS with clinical information including the general status, orthopedic diseases (degenerative diseases), past history (general diseases) and exercise activities using a questionnaire survey employing both diagnostic tools at Juntendo University Hospital (Tokyo, Japan) from April to June 2014.

Results: 664 of 1,027 patients answered both questionnaires. Three hundred nineteen (48.0%) and 251 (37.8%) were diagnosed with LS according to the “Loco-check” and “GLFS-25”, respectively. Our survey indicated that the “Loco-check” had a 10.2% higher detection rate than the “GLFS-25”. The correlation between the scores was investigated. The Spearman’s rank coefficient was r=0.454 and the area under the curve (AUC) value was 0.8181, which indicated a moderate correlation. We then investigated the associations between LS and the clinical factors of the patients. The results showed that female gender, advanced age, a high BMI, lumbar spondylosis and heart disease were significantly associated with a diagnosis of LS with both of the diagnostic tools.

Conclusions: We investigated the associations between the prevalence of LS and ortho-clinical information in an outpatient cohort based on both the “Loco-check” and the “GLFS-25”. These analyses are the first to report compared statistical associations between both tools. These analyses also provide critical information to help clinicians determine whether to use the “Loco-check” or “GLFS-25” in various situations.