Locomotive syndrome is a condition of reduced mobility due to impairment of locomotive organs. Since upright bipedal walking involves minutely controlled movement patterns, impairment of any aspect of the locomotive organs has the potential to affect it. In addition to trauma, chronic diseases of the locomotive organs, are common causes of the locomotive syndrome.
Exercise intervention is effective in improving motor function, but because the subjects are elderly people with significant degenerative diseases , caution should be taken in choosing the type and intensity of exercise.
The locomotive system is directly responsible for mobility. Locomotive Syndrome is common among individuals over 50 years because of the prevalence of chronic diseases of the locomotive organs and markedly increased requirement for surgery for chronic diseases
There are four key issues in clinical practice for locomotive organs, common to the geriatric population.
First, acute exacerbation of diseases of the locomotive organs is often accompanied by pain. Pain in the lower extremities and back being major causes of mobility disturbance.
Second, in the presence of severe osteoporosis, procedures utilizing metal screws may not provide adequate stability and may result in specific complications.
Third, treatment outcomes for the locomotive organ diseases in this patients are significantly influenced by the status of their preoperative mobility.
Fourth, there is an increase in the number of people whose return to their homes is delayed following orthopaedic operations. This is mainly because elderly patients need a longer period of postoperative physical training to restore their mobility.
Human locomotive organs have a lifespan of about 50 years, suggesting a need for additional efforts to sustain their function when used for a longer term . There is evidence supporting the view that age-related movement deficits as in sit-to-stand and gait can be improved by appropriate intervention.
Definition and Concept of Locomotive Syndrome.
Locomotive syndrome is a condition wherein mobility functions such as sit-to-stand or gait are declined due to locomotive organ impairment. Progression of this syndrome results in limiting independence in carrying out activities of daily living . In super-aged societies, most people experience the locomotive syndrome toward the end of their lives. Therefore, intervention is required to limit this syndrome and sustain locomotive organ function.
The three main components comprising the locomotive system are,
bones
️joints and intervertebral disks
️And the muscular and nervous system.
Any impairment in these organs results in,
️pain
️limited range of motion at joints or at the spine,
️muscle weakness
️and balance deficits.
All these impairments are inter-related and serve as multiple risk factors for disability. Progression of these impairments result in limitations in activities of daily living, reduction of quality of life and necessity of care support.
The Features of Locomotive Organ Diseases.
Normally, although locomotive degenerative diseases present with acute exacerbations, its progression in the initial stages is largely asymptomatic. The symptoms become apparent once pathological changes of degeneration become advanced, and further interventions are necessitated.
The risk of impairment varies between the different tissues that are affected. Insufficient loads and extreme thinness are the risk factors for osteoporosis and sarcopenia affecting bones and muscles, respectively. Excessive loading and obesity are the risk factors for deformation and impairment of joints and intervertebral disks. The load on joints tends to be concentrated on the articular cartilage and intervertebral disks . They are mobile structures that are designed to absorb impacts. Joints and intervertebral disks commonly wear out over time with aging and become painful by the middle or elderly years, because they lack direct blood supply and, thus have minimal potential to regenerate.
Physiotherapy management.
️By considering the above principles of exercise, physiotherapists recommend various exercises to improve and sustain standing and gait functions in middle and old age people.
References.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906066/
https://pubmed.ncbi.nlm.nih.gov/27375370/
Chamika harshani.
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