The locomotive syndrome

This syndrome was first described in 2007 by the Japanese Orthopedic Association in order to define a new concept causing gait disorders in a considerable number of very elderly patients. This is the locomotive that doesn’t pushes the train forward. The neurologist often meets these patients.
The locomotive syndrome is the consequence of pathologies on 3 levels: bone (osteoporosis), articulations and vertebral discs (spondylosis and spondyloarthritis at the cervical and lumbar level, shoulders, hips and knee arthritis), muscles and peripheral nerves. Finally the locomotive syndrome brings together several pathologies that are related to each other. The symptoms are pain, limitation of mobility, difficulties of balance and walking.
The consequence of this syndrome is a decrease of the functional autonomy for the activities of daily living, a decrease in social life and quality of life. There is a 25-item questionnaire (Geriatric Locomotive Function Scale – GLFS-25) that can help to establish the diagnosis. Other measures can be used to better define the functional state such as the handgrip strength, the on one leg time standing, and the 6 m walking time The syndrome is common for elderly patients. While the term « frailty syndrome » is intended in case several organs are typo-functioning (cognition dysfunction is included), the term locomotive syndrome applies to multiple inter related musculoskeletal problems.
Osteoporosis is an important component of the locomotive syndrome and its prevention is fundamental. Finally, to prevent the locomotive syndrome of the geriatric age, the most important thing to do is to let patients moving. Favor mobility by all means. Assessment and treatments are provided by a multidisciplinary team. Thus, do not forget the neurologist.

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