Locomotive syndrome: history, current concepts, and future perspectives

This review outlines the concept of locomotive syndrome, as well as the current definition, diagnostic criteria, and management strategies for the condition. This paper begins by discussing the reasons behind the introduction of the concept of locomotive syndrome in Japan and its social context. This social context is characterized by Japan's population aging at the fastest rate in the world, changes in its industrial structure leading to a decrease in traumatic injuries such as workplace accidents, and a sharp increase in degenerative diseases. The prevalence of a relatively small number of musculoskeletal disorders is high among older adults, and the rate of co-morbidity is also high. Furthermore, these disorders and conditions are interlinked through a decline in motor function, such as reduced muscle strength and impaired balance. As multiple disorders and conditions often co-exist in a single older adult, their combined effect leads to a decline in mobility. The coexistence and interaction of these disorders are defining characteristics of musculoskeletal diseases in older adults and represent a major clinical challenge. The concept of locomotive syndrome was proposed precisely because it is necessary to consider such musculoskeletal problems in older adults comprehensively from the perspective of reduced mobility. Subsequently, the locomotive syndrome risk test and the locomotive syndrome stage are explained. Following this, locomotion training is introduced as a countermeasure against locomotive syndrome. Finally, this paper discusses the relationship between locomotive syndrome and other fields, such as cancer and metabolic syndrome, as well as future perspectives.