Era of Physiotherapy and Rehabilitation Journal (EPRJ)

IMPACT OF HEMOGLOBIN LEVEL ON FATIGUE, PHYSICAL PERFORMANCE AND QUALITY OF LIFE IN UNIVERSITY STUDENTS

Atiya Zafar — 2024-06-30

To determine the impact of hemoglobin on the physical performance, fatigue, and quality of life of university students. Methods: Descriptive correlational research was conducted from March 2023 to august 2023 in Lahore, Pakistan. A sample of 300 students from a variety of universities in Lahore was used to obtain data. The Fatigue Severity Scale and the International Physical Activity Questionnaire were implemented to assess the influence of hemoglobin levels on the quality of life, physical performance, and fatigue of university students. The Statistical Package for Social Sciences (SPSS) version 21 was employed to analyses the data. Results: Number of participants who encountered was i.e. N=300, while female were 274 (91.33%). The mean age of students was 20.73 (1.899) years. The mean weight of students was 56.75 (10.676) kg, while the mean of BMI was 22.17 (14.16) kg/m2, its means all students was in normal range. The average hemoglobin level of students was 11.61(1.55) mg/dL, that was also in normal ranges. The study concluded after analyzed the data there was statistically low positive correlation between hemoglobin level and SF-36 (r =.349) and with FSS was negative low (r=-.313) but highly significant association. The relationship between physical activity status and METs was negligible (r=-0.46) and (r=-0.60), respectively, and there was no significant association with hemoglobin levels. Conclusion: This study showed that hemoglobin had strong correlation and high association on quality of life while week or negligible correlation and highly significant association with fatigue and have negligible correlation and non-significant association with physical performance among students.

Namita N, Ranjan D. A cross-sectional study of association between hemoglobin level and body mass index among adolescent age group. National Journal of Physiology, Pharmacy and Pharmacology. 2019;9(8):746-50
Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low‐and middle‐income countries. Annals of the New York Academy of Sciences. 2019;1450(1):15-31
Butt Z, Cella D. Relationship of hemoglobin, fatigue, and quality of life in anemic cancer patients. InRecombinant human erythropoietin (rhEPO) in clinical oncology: Scientific and clinical aspects of anemia in cancer 2008 (pp. 369-391). Vienna: Springer Vienna.
Sachdev HS, Porwal A, Acharya R, Ashraf S, Ramesh S, Khan N, et al. Haemoglobin thresholds to define anaemia in a national sample of healthy children and adolescents aged 1–19 years in India: a population-based study. The Lancet Global Health. 2021;9(6): e822-e31.
Benson C, Shah A, Stanworth S, Frise C, Spiby H, Lax S, et al. The effect of iron deficiency and anaemia on women’s health. Anaesthesia. 2021; 76:84-95.
Turner J, Parsi M, Badireddy M. Anemia. StatPearls [Internet]: StatPearls Publishing; 2022.
Bhadra P, Deb A. A review on nutritional anemia. Indian Journal of Natural Sciences. 2020;10(59):18466-74.
Brownstein CG, Daguenet E, Guyotat D, Millet GY. Chronic fatigue in myelodysplastic syndromes: Looking beyond anemia. Critical Reviews in Oncology/Hematology. 2020 Oct 1; 154:103067
Sarwar S, Aleem A, Nadeem MA. Health Related Quality of Life (HRQOL) and its correlation with academic performance of medical students. Pakistan Journal of Medical Sciences. 2019;35(1):266.
Hoshino J, Muenz D, Zee J, Sukul N, Speyer E, Guedes M, et al. Associations of hemoglobin levels with health-related quality of life, physical activity, and clinical outcomes in persons with stage 3-5 nondialysis CKD. Journal of Renal Nutrition. 2020;30(5):404-14.
Corona LP, Andrade FCD, da Silva Alexandre T, de Brito TRP, Nunes DP, de Oliveira Duarte YA. Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis. BMC geriatrics. 2022;22(1):1-9.
Calbet JA, Lundby C, Koskolou M, Boushel R. Importance of hemoglobin concentration to exercise: acute manipulations. Respiratory physiology & neurobiology. 2006;151(2-3):132-40
Al Hassan NN. The prevalence of iron deficiency anemia in a Saudi University female student. Journal of microscopy and ultrastructure. 2015;3(1):25-8.
Hamali HA, Mobarki AA, Saboor M, Alfeel A, Madkhali AM, Akhter MS, et al. Prevalence of anemia among Jazan university students. International journal of general medicine. 2020:765-70
Al Hassan NN. The prevalence of iron deficiency anemia in a Saudi University female student. Journal of microscopy and ultrastructure. 2015;3(1):25-8.
Lerdal A. Fatigue severity scale. Encyclopedia of quality of life and well-being research: Springer; 2021. p. 1-5
Roser K, Mader L, Baenziger J, Sommer G, Kuehni CE, Michel G. Health-related quality of life in Switzerland: normative data for the SF-36v2 questionnaire. Quality of life research. 2019; 28:1963-77.
Lavelle G, Noorkoiv M, Theis N, Korff T, Kilbride C, Baltzopoulos V, et al. Validity of the international physical activity questionnaire short form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: A cross-sectional study. Physiotherapy. 2020; 107:209-15.
Owaidah T, Al-Numair N, Al-Suliman A, Zolaly M, Hasanato R, Al Zahrani F, et al. Iron deficiency and iron deficiency anemia are common epidemiological conditions in Saudi Arabia: report of the national epidemiological survey. Anemia. 2020;2020:1-8.
Waldman C. Determining the Correlation Between Hemoglobin Levels and the Quality of Life of Adolecents and Young Adults on Hemodialysis: A Descriptive Correlational Study.
Cella D, Kallich J, McDermott A, Xu X. The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer patients: results from five randomized clinical trials. Annals of Oncology. 2018 Jun 1;15(6):979-86.
Dimeo F, Schmittel A, Fietz T, Schwartz S, Köhler P, Böning D, Thiel E. Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment. Annals of Oncology. 2019 Aug 1;15(8):1237-42.
Simonsick EM, Patel KV, Schrack JA, Ferrucci L. Fatigability as a predictor of subclinical and clinical anemia in well‐functioning older adults. Journal of the American Geriatrics Society. 2020 Oct;68(10):2297-302
Wouters HJ, van der Klauw MM, de Witte T, Stauder R, Swinkels DW, Wolffenbuttel BH, Huls G. Association of anemia with health-related quality of life and survival: a large population-based cohort study. haematologica. 2019 Mar;104(3):468.

INCIDENCE OF DYSPHAGIA IN INDIVIDUALS WITH CLEFT PALATE

Ezwah Khalid — 2024-06-30

Analyzing the prevalence of digestive disorders in individuals with cleft palates is the objective of this investigation. Methods: A cross-sectional study was conducted in Department of Speech and Language Pathology, The Children's Hospital in Lahore for a period of three months. The study encompassed approximately 30 infants with variable degrees of untreated cleft lip and palate. Parental interviews and a swallowing protocol were implemented to evaluate each of these instances. Swallowing disorders are examined in this investigation to determine their prevalence in individuals with cleft palates. Results: Out of 30, 28 cases had swallowing disorder in some form while 2 cases were not diagnosed with any form of swallowing disorder. Cough during feeding was present in 10 cases, noisy breath sounds in 11 cases; a history of chest infection was present in 16 cases, drooling was reported in17 cases, regurgitation in 15 cases, choking during feeding was present in 23 cases while 28 of the 30 cases were unable suck during breast feeding. Conclusion: This study found that cleft palate predominantly affects males and isn't usually linked to family history. Symptoms such as swallowing difficulties, coughing, drooling, and feeding issues, particularly chest infections, were more prevalent in cases with both cleft lip and palate, while saliva was most prevalent in cases with cleft palate only.

Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Physical medicine and rehabilitation clinics of North America. 2008 Nov 1;19(4):691-707
Candotto V, Oberti L, Gabrione F, Greco G, Rossi D, Romano M, Mummolo S. Current concepts on cleft lip and palate etiology. Journal of biological regulators and homeostatic agents. 2019 May 1;33(3 Suppl. 1):145-51.
Martinelli M, Palmieri A, Carinci F, Scapoli L. Non-syndromic cleft palate: an overview on human genetic and environmental risk factors. Frontiers in cell and developmental biology. 2020 Oct 20; 8:592271.
Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of lip and palate: A review. Journal of family medicine and primary care. 2020 Jun 1;9(6):2621-5.
Kaufman FL. Managing the cleft lip and palate patient. Pediatric Clinics of North America. 1991 Oct 1;38(5):1127-47.
Felix-Schollaart B, Hoeksma JB, Prahl-Andersen B. Growth comparison between children with cleft lip and/or palate and controls. The Cleft palate-craniofacial journal. 1992 Sep;29(5):475-80.
Lindner A. Measurement of intra-oral negative air pressure during dummy sucking in human newborn. The European Journal of Orthodontics. 1991 Aug 1;13(4):317-21.
Nassar E, Marques IL, Trindade Jr AS, Bettiol H. Feeding-facilitating techniques for the nursing infant with Robin sequence. The Cleft palate-craniofacial journal. 2006 Jan;43(1):55-60.
Trenouth MJ, Campbell AN. Questionnaire evaluation of feeding methods for cleft lip and palate neonates. International Journal of Paediatric Dentistry. 1996 Dec;6(4):241-4.
Clarren SK, Anderson B, Wolf LS. Feeding infants with cleft lip, cleft palate, or cleft lip and palate. The Cleft palate journal. 1987 Jul 1;24(3):244-9.
Arvedson JC, Brodsky L, Arvedson JC, Brodsky LB. Feeding with craniofacial anomalies. Pediatric Swallowing and Feeding: Assessment and Management, 2nd ed. Singular Publishing Group, Albany, NY. 2002:527-61.
Delaney KA. Cleft lip and palate: Breastfeeding your baby. Feeding and Nutrition for the Child with Special Needs. 1994:381-4.
Dalben GD, Costa B, Gomide MR, Neves LT. Breast-feeding and sugar intake in babies with cleft lip and palate. The Cleft palate-craniofacial journal. 2003 Jan;40(1):84-7.
Masarei AG, Wade A, Mars M, Sommerlad BC, Sell D. A randomized control trial investigating the effect of presurgical orthopedics on feeding in infants with cleft lip and/or palate. The Cleft palate-craniofacial journal. 2007 Mar;44(2):182-93.
Mizuno K, Ueda A, Kani K, Kawamura H. Feeding behaviour of infants with cleft lip and palate. Acta Paediatrica. 2002 Nov;91(11):1227-32.
Reid J, Reilly S, Kilpatrick N. Sucking performance of babies with cleft conditions. The Cleft palate-craniofacial journal. 2007 May;44(3):312-20.
Shkoukani MA, Lawrence LA, Liebertz DJ, Svider PF. Cleft palate: a clinical review. Birth Defects Research Part C: Embryo Today: Reviews. 2014 Dec;102(4):333-42.
De Vries IA, Breugem CC, Van der Heul AM, Eijkemans MJ, Kon M, van der Molen AM. Prevalence of feeding disorders in children with cleft palate only: a retrospective study. Clinical oral investigations. 2014 Jun; 18:1507-15.x

LEVEL OF DEPRESSION, STRESS, QUALITY OF LIFE AND FUNCTIONAL INDEPENDENCE IN PATIENTS WITH SPINAL CORD INJURY

Iqra Shabbir — 2024-06-30

The primary goal of the survey was to determine the level of depression, stress, quality of life, and functional independence in patients with spinal cord injury (SCI). Additionally, the study aimed to determine the correlation between the psychological factors with the severity of the injury, and to compare the differences in male and female patients with SCI. Methods: In this cross-sectional survey 100 patients with SCI were recruited through non- non-probability convenience sampling technique. Male and Female SCI patients 25 to 50 years of age, SCI level C5 and above, patients on ASIA scale A, B, C with complete and incomplete SCI, acute and chronic SCI patients, were included in the study. The outcome measures used to assess their depression stress and quality of life were the Perceived Quality of Life Scale, Functional Independence Measure, Perceived Stress Scale, and Beck Depression Inventory Scale. The analysis was done through the SPSS version. 23. Results: Descriptive analysis showed that among the calculated, 54% were males 46% were females, 53% were married and 47% were unmarried. 48% of individuals experienced mild mood disturbances, 85% were in moderate stress, 98% were dissatisfied individuals and those who showed moderate functional independence were 74%. Moreover, depression, stress, and functional independence have a high association and significant p-value<0.05 with the level of injury according to the ASIA scale. Conclusion: The current study's findings indicate that patients with spinal cord injuries are significantly agitated and depressed, and their quality of life is relatively low.

Cripps RA, Lee BB, Wing P, Weerts E, Mackay J, Brown D. A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention. Spinal cord. 2011;49(4):493-501.
Ho CH, Wuermser L-A, Priebe MM, Chiodo AE, Scelza WM, Kirshblum SC. Spinal cord injury medicine. 1. Epidemiology and classification. Archives of physical Medicine and Rehabilitation. 2007;88(3):S49-S54.
Pollock K, Dorstyn D, Butt L, Prentice S. Posttraumatic stress following spinal cord injury: a systematic review of risk and vulnerability factors. Spinal cord. 2017;55(9):800-11.
Lim S-W, Shiue Y-L, Ho C-H, Yu S-C, Kao P-H, Wang J-J, et al. Anxiety and depression in patients with traumatic spinal cord injury: a nationwide population-based cohort study. PloS one. 2017;12(1):e0169623.
Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following traumatic spinal cord injury. Neuroepidemiology. 2005;25(2):55-61.
Lude P, Kennedy P, Elfström M, Ballert C. Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study. Topics in spinal cord injury rehabilitation. 2014;20(3):197-207.
Pagliacci M, Franceschini M, Di Clemente B, Agosti M, Spizzichino L. A multicentre follow-up of clinical aspects of traumatic spinal cord injury. Spinal Cord. 2007;45(6):404-10.
Jackson-Koku G. Beck depression inventory. Occupational medicine. 2016;66(2):174-5.
Scale PS. Perceived Stress Scale. PSS; 1983.
George LK. Perceived quality of life. Handbook of aging and the social sciences: Elsevier; 2006. p. 320-36.
Mackintosh S. The Functional Independence Measure: Australian Physiotherapy Association; 2009.
Robinson-Whelen S, Taylor H, Hughes R, Wenzel L, Nosek M. Depression and depression treatment in women with spinal cord injury. Topics in spinal cord injury rehabilitation. 2014;20(1):23-31.
Khazaeipour Z, Taheri-Otaghsara S-M, Naghdi M. Depression following spinal cord injury: its relationship to demographic and socioeconomic indicators. Topics in spinal cord injury rehabilitation. 2015;21(2):149-55.

RELATIONSHIP OF HAND GRIP STRENGTH AND HAND DIMENSIONS IN FEMALE STUDENTS

Areeba Hassan — 2024-06-30

Handgrip strength is a quantitative evaluation of generally speaking actual capacity and an assessment of the usefulness of the upper appendages. Hand grasp strength can be evaluated by estimating how much consistent power that the hand can apply on a dynamometer. Methods: This study was directed on an example of 68 female college understudies matured somewhere in the range of 18 and 25 years, utilizing a non-likelihood helpful testing method. This study rejects guys and females who are more seasoned and have work related populace. The information was gathered by a survey that included individual data like age, level, weight, BMI, way of life, as well as hand aspects estimated utilizing anthropometric procedures, and hand strength estimated utilizing a dynamometer. The information was dissected utilizing SPSS 21. Results: The mean age of female students was 21.6±1.98 years, with a basal age of 19 years and a maximum age of 25 years. The mean level and weight were 157.29±5.06cm and 52.75±8.463kg individually. The mean hand grasp strength of female understudies was 12.21±2.875 kg. Out of 68 female understudies, the BMI of 9(13.2%) was underweight, 48(70.6%) was typical and 11(16.2%) was overweight. Out of 68 female understudies, 55 (80.9%) had a functioning way of life that included activity, while 13 (19.1%) had an inactive way of life. The mean of FS1, FS2, FS3, FS4 and FS5 were 10.98±1.82, 14.32±1.75, 15.77±1.96, 16.96±2.00 and 26.63±3.66 individually. The mean of TL, IFL, MFL, RFL AND LFL were 13.10±0.89, 15.94±3.42, 17.65±1.27, 16.71±1.29 and 14.45±0.55 separately. The mean of P1, P2, P3, P4 and P5 were 39.95±2.98, 44.66±2.59, 43.89±3.02, 43.99±3.57 and 54.27±4.22 separately. Conclusion: The ongoing review found a vigorous and measurably huge connection between hand aspects (in particular finger range, finger length, and hand edge) and hand hold strength in female understudies at the College of Lahore. Customary actual work and ordinary activity add to expanded hand grasp strength in understudies.

Marzvanyan A, Alhawaj AF. Physiology, sensory receptors. 2019.
Rostamzadeh S, Saremi M, Fereshteh T. Maximum handgrip strength as a function of type of work and hand-forearm dimensions. Work. 2020;65(3):679-87.
McGrath R, Robinson-Lane SG, Cook S, Clark BC, Herrmann S, O’Connor ML, et al. Handgrip strength is associated with poorer cognitive functioning in aging Americans. Journal of Alzheimer's Disease. 2019;70(4):1187-96.
Soysal P, Hurst C, Demurtas J, Firth J, Howden R, Yang L, et al. Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies. Journal of sport and health science. 2021;10(3):290-5.
McGrath RP, Kraemer WJ, Snih SA, Peterson MD. Handgrip strength and health in aging adults. Sports medicine. 2018;48:1993-2000.
Wilkinson DJ, Piasecki M, Atherton PJ. The age-related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing research reviews. 2018;47:123-32.
Alonso AC, Ribeiro SM, Luna NMS, Peterson MD, Bocalini DS, Serra MM, et al. Association between handgrip strength, balance, and knee flexion/extension strength in older adults. PLoS One. 2018;13(6):e0198185.
McGrath R, Johnson N, Klawitter L, Mahoney S, Trautman K, Carlson C, et al. What are the association patterns between handgrip strength and adverse health conditions? A topical review. SAGE open medicine. 2020;8:2050312120910358.
Kim KH, Park SK, Lee DR, Lee J. The relationship between handgrip strength and cognitive function in elderly Koreans over 8 years: a prospective population-based study using Korean longitudinal study of ageing. Korean journal of family medicine. 2019;40(1):9.
Zaccagni L, Toselli S, Bramanti B, Gualdi-Russo E, Mongillo J, Rinaldo N. Handgrip strength in young adults: Association with anthropometric variables and laterality. International journal of environmental research and public health. 2020;17(12):4273.
Jäkel B, Kedor C, Grabowski P, Wittke K, Thiel S, Scherbakov N, et al. Hand grip strength and fatigability: correlation with clinical parameters and diagnostic suitability in ME/CFS. Journal of translational medicine. 2021;19(1):1-12.
Neidenbach RC, Oberhoffer R, Pieper L, Freilinger S, Ewert P, Kaemmerer H, et al. The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease. Cardiovascular Diagnosis and Therapy. 2019;9(Suppl 2):S187.
Buckner SL, Dankel SJ, Bell ZW, Abe T, Loenneke JP. The association of handgrip strength and mortality: what does it tell us and what can we do with it? Rejuvenation research. 2019;22(3):230-4.
Vanishri P, Sheikh NA. Anthropometric measurements of hand length and breadth for estimation of stature in South Indians. Indian Journal of Forensic Medicine and Pathology. 2019;12(2):124.
Alahmari K, Kakaraparthi V, Reddy RS, Silvian PS, Ahmad I, Rengaramanujam K. Percentage difference of hand dimensions and their correlation with hand grip and pinch strength among schoolchildren in Saudi Arabia. Nigerian Journal of Clinical Practice. 2019;22(10):1356-64.
Ji C, Zheng L, Zhang R, Wu Q, Zhao Y. Handgrip strength is positively related to blood pressure and hypertension risk: results from the National Health and nutrition examination survey. Lipids in health and disease. 2018;17(1):1-7.
Shaheen AAM, Omar MTA, Ali OI. Normative values of handgrip and pinch strengths in healthy female college students in Riyadh, Saudi Arabia: a cross-sectional study. Bulletin of Faculty of Physical Therapy. 2021;26(1):1-7.

FREQUENCY OF LOCOMOTIVE SYNDROME IN ELDERLY WOMEN- A CROSS-SECTIONAL SURVEY

Soha Malik — 2024-06-30

To ascertain to learn the commonness of train disorder in older ladies. Methods: A cross-sectional study was conducted with non-probability convenience Sampling technique was used. This study included 171 elderly females having the age of 65 or above. Data was collected from ULTH (University of Lahore Teaching Hospital) and Chaudhry Muhammad Akram Teaching Hospital. Results: Out of 171 participants 69.6% females were 65-75, 24.6% were 76-86 and 5.8% were 87-97 of age Scoring of GLFS-25 shows that 1.17% (n=2) had no locomotive syndrome ,7.61% (n=13) had grade 1 LS, 12.28%(n=21) had grade 2 LS whereas 78.94(n=135) had grade 3 LS. Overall, out of total 171 participants 98.83% (n=169) had locomotive syndrome and only 1.17% (n=2) had no locomotive syndrome. Conclusion: The results revealed high frequencies of locomotive syndrome among the elderly women’s that may be a risk factor for further impairments and disability in future

1]. Kimura A, Seichi A, Konno S, Yabuki S, Hayashi K. Prevalence of locomotive syndrome in Japan: a nationwide, cross-sectional Internet survey. Journal of Orthopaedic Science. 2014;19(5):792-7.

[2]. Matsumoto H, Hagino H, Wada T, Kobayashi E. Locomotive syndrome presents a risk for falls and fractures in the elderly Japanese population. Osteoporosis and sarcopenia. 2016;2(3):156-63.

[3]. Kasukawa Y, Miyakoshi N, Hongo M, Ishikawa Y, Kudo D, Kimura R, et al. Locomotive syndrome is associated with health-related quality of life and low back pain in the elderly, including individuals more than 80 years old. Progress in rehabilitation medicine. 2020;5:20200029.

[4]. Nakamura K. Locomotive syndrome: disability-free life expectancy and locomotive organ health in a “super-aged” society. Springer; 2009. p. 1-2.

[5]. Jung H, Tanaka S, Tanaka R. A cutoff value for body composition on the severity of locomotive syndrome in Japanese older women: A cross-sectional study. Health Care for Women International. 2022:1-13.

[6]. Harada A. Locomotive syndrome and frailty. Frailty in patients with fall & fall-related fracture. Clinical calcium. 2012;22(4):27-33.

[7]. Niwa H, Ojima T, Watanabe Y, Ide K, Yamato Y, Hoshino H, et al. Association between the 25-question Geriatric Locomotive Function Scale score and the incidence of certified need of care in the long-term care insurance system: The TOEI study. Journal of Orthopaedic Science. 2021;26(4):672-7.

[8]. Kobayashi T, Morimoto T, Shimanoe C, Ono R, Otani K, Mawatari M. Development of a tool for screening the severity of locomotive syndrome by the loco-check. Journal of Orthopaedic Science. 2022;27(3):701-6.

[9]. Makino T, Kaito T, Yonenobu K. Spinal disorders as a cause of locomotive syndrome: The influence on functional mobility and activities of daily living. Clinical Reviews in Bone and Mineral Metabolism. 2016;14(2):105-15.[10]. Ishijima M, Kaneko H, Hada S, Kinoshita M, Sadatsuki R, Liu L, et al. Osteoarthritis as a cause of locomotive syndrome: Its influence on functional mobility and activities of daily living. Clinical Reviews in Bone and Mineral Metabolism. 2016;14(2):77-104.

[11]. Ushio M, Sumitani M, Abe H, Mietani K, Hozumi J, Inoue R, et al. 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 journal. 2019;2(2):184-9.

[12]. Nishimura T, Imai A, Fujimoto M, Kurihara T, Kagawa K, Nagata T, et al. Adverse effects of the coexistence of locomotive syndrome and sarcopenia on the walking ability and performance of activities of daily living in Japanese elderly females: a cross-sectional study. Journal of physical therapy science. 2020;32(3):227-32.

[13]. Iizuka Y, Iizuka H, Mieda T, Tajika T, Yamamoto A, Takagishi K. Population-based study of the association of osteoporosis and chronic musculoskeletal pain and locomotive syndrome: the Katashina study. Journal of Orthopaedic Science. 2015;20(6):1085-9.

[14]. Imagama S, Hasegawa Y, Ando K, Kobayashi K, Hida T, Ito K, et al. Staged decrease of physical ability on the locomotive syndrome risk test is related to neuropathic pain, nociceptive pain, shoulder complaints, and quality of life in middle-aged and elderly people–the utility of the locomotive syndrome risk test. Modern Rheumatology. 2017;27(6):1051-6.

[15]. Akahane M, Yoshihara S, Maeyashiki A, Tanaka Y, Imamura T. Lifestyle factors are significantly associated with the locomotive syndrome: a cross-sectional study. BMC geriatrics. 2017;17(1):1-7.

[16]. Kobayashi T, Morimoto T, Otani K, Mawatari M. Locomotive Syndrome and Lumbar Spine Disease: A Systematic Review. Journal of Clinical Medicine. 2022;11(5):1304.

[17]. Ono R, Yamazaki S, Takegami M, Otani K, Sekiguchi M, Onishi Y, et al. Gender difference in association between low back pain and metabolic syndrome: locomotive syndrome and health outcome in Aizu cohort study (LOHAS). Spine. 2012;37(13):1130-7.

[18]. Kobayashi K, Imagama S, Ando K, Tsushima M, Machino M, Ota K, et al. Weakness of grip strength reflects future locomotive syndrome and progression of locomotive risk stage: a 10-year longitudinal cohort study. Modern Rheumatology. 2020;30(3):573-9.

[19]. Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Iwaya T. Development of a screening tool for risk of locomotive syndrome in the elderly: the 25-question Geriatric Locomotive Function Scale. Journal of Orthopaedic Science. 2012;17(2):163-72.

[20]. Nakamura K. The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. Springer; 2011. p. 489-91.

[21]. Taniguchi M, Ikezoe T, Tsuboyama T, Tabara Y, Matsuda F, Ichihashi N. Prevalence and physical characteristics of locomotive syndrome stages as classified by the new criteria 2020 in older Japanese people: results from the Nagahama study. BMC geriatrics. 2021;21(1):1-10.

[22]. Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N. The influence of locomotive syndrome on health-related quality of life in a community-living population. Modern Rheumatology. 2013;23(5):939-44.

[23]. Wang C, Ikemoto T, Hirasawa A, Arai Y-C, Kikuchi S, Deie M. Assessment of locomotive syndrome among older individuals: a confirmatory factor analysis of the 25-question Geriatric Locomotive Function Scale. PeerJ. 2020;8:e9026.

[24]. Akahane M, Maeyashiki A, Tanaka Y, Imamura T. The impact of musculoskeletal diseases on the presence of locomotive syndrome. Modern Rheumatology. 2019;29(1):151-6.

[25]. Sasaki E, Ishibashi Y, Tsuda E, Ono A, Yamamoto Y, Inoue R, et al. Evaluation of locomotive disability using loco-check: a cross-sectional study in the Japanese general population. Journal of orthopaedic science. 2013;18(1):121-9.