Subjective slow walking speed is associated with locomotive syndrome severity in 34,935 adults undergoing medical checkups


  • Ohe, T. The history of locomotive syndrome-3. Japanese Orthop. Association (JOA). 122, 6 (2020). (In Japanese).

    Google Scholar 

  • Nakamura, K. & Ogata, T. Locomotive syndrome: definition and management. Clin. Rev. Bone Min. Metab. 14, 56–67 (2016).

    Google Scholar 

  • Nakamura, K. Locomotive syndrome: Disability-free life expectancy and locomotive organ health in a super-aged society. J. Orthop. Sci. 14, 1–2 (2009).

    Google Scholar 

  • Nakamura, K. The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. J. Orthop. Sci. 16, 489–491 (2011).

    Google Scholar 

  • The Japanese Orthopedic. Association official locomotive syndrome prevention awareness official website. https://locomo-joa.jp. Accessed 8 May 2025.

  • Seichi, A. et al. Development of a screening tool for risk of locomotive syndrome in the elderly: the 25-question geriatric locomotive function scale. J. Orthop. Sci. 17, 163–172 (2012).

    Google Scholar 

  • Muranaga, S. & Hirano, K. Development of a convenient way to predict ability to walk, using a two-step test. J. Showa Med. Assoc. 63, 301–308 (2003). (In Japanese).

    Google Scholar 

  • Muranaga, S. Evaluation of the muscular strength of the lower extremities using the standing movement and clinical application. J. Showa Med. Assoc. 61, 362–367 (2001). (In Japanese).

    Google Scholar 

  • Yoshimura, N. et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J. Bone Min. Metab. 27, 620–628 (2009).

    Google Scholar 

  • Wang, M. & Seibel, M. J. Secondary fracture prevention in primary care: A narrative review. Osteoporos. Int. 35, 1359–1376 (2024).

    Google Scholar 

  • Middleton, A., Fritz, S. L. & Lusardi, M. Walking speed: the functional vital sign. J. Aging Phys. Act. 23, 314–322 (2015).

    Google Scholar 

  • Yates, T. et al. Association of walking Pace and handgrip strength with all-cause, cardiovascular, and cancer mortality: A UK biobank observational study. Eur. Heart J. 38, 3232–3240 (2017).

    Google Scholar 

  • Celis-Morales, C. A. et al. Walking Pace is associated with lower risk of all-cause and cause-specific mortality. Med. Sci. Sports Exerc. 51, 472–480 (2019).

    Google Scholar 

  • Ueno, K. et al. Clinical utility of simple subjective gait speed for the risk stratification of heart failure in a primary prevention setting. Sci. Rep. 12, 11641 (2022).

    Google Scholar 

  • Kalligerou, F. et al. Objective and subjective measurements of motor function: results from the HELIAD study. J. Prev. Alzheimers Dis. 9, 743–751 (2022).

    Google Scholar 

  • He, P. et al. Combined handgrip strength and walking pace, genetic susceptibility, and incident hypertension: A prospective study in UK biobank. Scand. J. Med. Sci. Sports. 33, 989–999 (2023).

    Google Scholar 

  • Iwasaki, M. et al. Fast walking is a preventive factor against new-onset diabetes mellitus in a large cohort from a Japanese general population. Sci. Rep. 11, 716 (2021).

    Google Scholar 

  • Mehmet, H., Robinson, S. R. & Yang, A. W. H. Assessment of gait speed in older adults. J. Geriatr. Phys. Ther. 43, 42–52 (2020).

    Google Scholar 

  • Yamamoto, Y. et al. Association between subjective walking speed and metabolic diseases in individuals with obesity: A cross-sectional analysis. Sci. Rep. 14, 28228 (2024).

    Google Scholar 

  • Yoshimura, N. et al. Association between new indices in the locomotive syndrome risk test and decline in mobility: third survey of the ROAD study. J. Orthop. Sci. 20, 896–905 (2015).

    Google Scholar 

  • Taniguchi, M. et al. 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 Geriatr. 21, 489 (2021).

    Google Scholar 

  • Nishimura, A. et al. Do exercise habits during middle age affect locomotive syndrome in old age? Mod. Rheumatol. 28, 334–338 (2018).

    Google Scholar 

  • Nakamura, M. et al. Physical performance measures associated with locomotive syndrome in middle-aged and older Japanese women. J. Geriatr. Phys. Ther. 38, 202–207 (2015).

    Google Scholar 

  • Saito, Y. et al. Evaluation of gait characteristics in subjects with locomotive syndrome using wearable gait sensors. BMC Musculoskelet. Disord. 23, 457 (2022).

    Google Scholar 

  • Sato, H., Kondo, S., Saito, M. & Saura, R. Effects of strengthening the hip flexor muscles on walking ability and the locomotive syndrome rank test: an intervention study. J. Orthop. Sci. 25, 892–896 (2020).

    Google Scholar 

  • Nishimura, T. et al. Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: A cross-sectional study. J. Physiol. Anthropol. 40, 18 (2021).

    Google Scholar 

  • Yoshihara, T. et al. Association between locomotive syndrome and blood parameters in Japanese middle-aged and elderly individuals: A cross-sectional study. BMC Musculoskelet. Disord. 20, 104 (2019).

    Google Scholar 

  • Syddall, H. E., Westbury, L. D., Cooper, C. & Sayer, A. A. Self-reported walking speed: A useful marker of physical performance among community-dwelling older people? J. Am. Med. Dir. Assoc. 16, 323–328 (2015).

    Google Scholar 

  • Komatsu, K. et al. Standardized evaluation of diabetic retinopathy using artificial intelligence and its association with metabolic dysfunction-associated steatotic liver disease in japan: A cross-sectional study. PLoS One. 19, e0315752 (2024).

    Google Scholar 

  • Akahane, M., Yoshihara, S., Maeyashiki, A., Tanaka, Y. & Imamura, T. Lifestyle factors are significantly associated with the locomotive syndrome: A cross-sectional study. BMC Geriatr. 17, 241 (2017).

    Google Scholar 

  • Yoshinaga, S. et al. Lifestyle related signs of locomotive syndrome in the general Japanese population: A cross-sectional study. J. Orthop. Sci. 24, 1105–1109 (2019).

    Google Scholar 

  • Kobayashi, T. et al. Clinical characteristics of locomotive syndrome categorised by the 25-question geriatric locomotive function scale: A systematic review. BMJ Open. 13, e068645 (2023).

    Google Scholar 

  • Kobayashi, T. et al. The association of comorbidities with the 25-question geriatric locomotive function scale and the diagnosis of locomotive syndrome. J. Orthop. Sci. 28, 453–459 (2023).

    Google Scholar 

  • Mitani, G. et al. Evaluation of the association between locomotive syndrome and metabolic syndrome. J. Orthop. Sci. 23, 1056–1062 (2018).

    Google Scholar 

  • Yamada, T. et al. Prevalence of locomotive dysfunction exacerbating systolic blood pressure and abdominal circumference: A longitudinal cohort analysis. Metab. Syndr. Relat. Disord. 19, 562–566 (2021).

    Google Scholar 

  • Yamaguchi, S. et al. Association of locomotive syndrome with present and past physical activities, and self-reported gait speed: A cross sectional study. Chiba Med. J. 94, 9–17 (2018).

    Google Scholar 

  • Ohtsuki, M. et al. Relationships between body mass index, lifestyle habits, and locomotive syndrome in young- and middle-aged adults: A cross-sectional survey of workers in Japan. J. Occup. Health. 61, 311–319 (2019).

    Google Scholar 

  • Ishihara, Y. et al. Locomotive syndrome relation to daily physical activity, physical function, and body composition in elderly people: a pilot study. Juntendo Med. J. 62, 225–230 (2016).

    Google Scholar 

  • Uesugi, Y., Kanaya, S., Nakanishi, H. & Naito, Y. The relationship between locomotive syndrome risk, gait pattern, and standing posture in young Japanese women: A cross-sectional study. Healthc. (Basel). 8, 565 (2020).

    Google Scholar 

  • Yamaguchi, S. et al. Association of locomotive syndrome with present and past physical activities, and self-reported gait speed: A cross sectional study. Chiba Med. J. 94E, 9–17 (2018).

    Google Scholar 

  • Inanaga, S. et al. Relationship between the 25-question geriatric locomotive function scale and physical function in the elderly people. J. Bone Min. Metab. 41, 550–556 (2023).

    Google Scholar 

  • Fujita, N. et al. Lumbar spinal Canal stenosis leads to locomotive syndrome in elderly patients. J. Orthop. Sci. 24, 19–23 (2019).

    Google Scholar 

  • Kato, S. et al. Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: A prospective cohort study. BMC Musculoskelet. Disord. 21, 515 (2020).

    Google Scholar 

  • Ohmori, T. et al. The efficacy of total hip arthroplasty on locomotive syndrome and its related physical function in patients with hip osteoarthritis. J. Orthop. Sci. 26, 389–395 (2021).

    Google Scholar 

  • Otani, K. et al. Locomotor dysfunction and risk of cardiovascular disease, quality of life, and medical costs: design of the locomotive syndrome and health outcome in Aizu cohort study (LOHAS) and baseline characteristics of the study population. J. Orthop. Sci. 17, 261–271 (2012).

    Google Scholar 

  • Verma, A., Kandwal, P., Gowda, A. K. S. & Yadav, R. A prospective study on gait impairment in patients with symptomatic lumbar canal stenosis and impact of surgical intervention on gait function. Clin. Spine Surg. Online ahead of print at (2024). https://doi.org/10.1097/BSD.0000000000001752

  • Santos, F. et al. Norms for usual and fast walking speed in adults 45–69 years old from the French general population: Constances study. J. Am. Med. Dir. Assoc. 25, 266–274 (2024).

    Google Scholar 

  • Yamada, K. et al. Reference values for the locomotive syndrome risk test quantifying mobility of 8681 adults aged 20–89 years: A cross-sectional nationwide study in Japan. J. Orthop. Sci. 25, 1084–1092 (2020).

    Google Scholar