Characteristics of Locomotive Syndrome in Japanese Patients with Chronic Pain and Results of a Path Analysis Confirming the Relevance of a Vicious Cycle Involving Locomotive Syndrome, Musculoskeletal Pain, and Its Psychological Factors

Michiko Ushio; Masahiko Sumitani; Hiroaki Abe; Kazuhito Mietani; Jun Hozumi; Reo Inoue; Rikuhei Tsuchida; Takahiro Ushida; Yoshitsugu Yamada

doi:10.31662/jmaj.2019-0009

Characteristics of Locomotive Syndrome in Japanese Patients with Chronic Pain and Results of a Path Analysis Confirming the Relevance of a Vicious Cycle Involving Locomotive Syndrome, Musculoskeletal Pain, and Its Psychological Factors

JMA J. 2019 Sep 4;2(2):184-189. doi: 10.31662/jmaj.2019-0009. Epub 2019 Aug 6.

Authors

Michiko Ushio¹, Masahiko Sumitani², Hiroaki Abe², Kazuhito Mietani¹, Jun Hozumi¹, Reo Inoue¹, Rikuhei Tsuchida¹, Takahiro Ushida³, Yoshitsugu Yamada¹

Affiliations

¹ Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
² Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
³ Multidisciplinary Pain Center, School of Medicine, Aichi Medical University, Aichi, Japan.

Abstract

Introduction: The current aging population has a major impact on public health. Locomotive syndrome (LS) is a condition that carries a high risk for developing systemic musculoskeletal disability.

Methods: Participants were patients with chronic pain (n = 415) who were examined at the Japanese multidisciplinary pain centers of the research consortium. They completed the 25-question geriatric locomotive function scale (GLFS-25; LS screening tool), an 11-point numerical rating scale (NRS) of pain intensity and its psychological distresses, health-related quality of life (HRQOL) questionnaire, and a survey of exercise habits. A multifaceted analysis of the relevance of the pain, psychological distresses, and LS were conducted using SPSS and AMOS software.

Results: 337 patients (81.2%) were found to have LS. The final model of a multifaceted analysis demonstrated good fitness for the "vicious cycle" model among the results of LS, pain intensity, impairment of self-efficacy, and depression; these parameters independently impaired HRQOL. Anxiety related to falling (GLFS-25) and exercise habits affected the model.

Conclusions: These findings indicate LS, LS-related pain, and psychological distress create a vicious cycle, resulting in the impairment of HRQOL. Treatment strategies for LS should inclusively focus on musculoskeletal disorders, pain, and pain-related psychological factors.

Keywords: locomotive syndrome; musculoskeletal pain; psychological distress; vicious cycle.