The Results of Locomotive Syndrome Digital Therapeutics Provided via a Smartphone Application: Proof-of-concept Single-group Trial
ABSTRACT
Background:
Individuals with locomotive syndrome (LS) have muscle weakness and reduced motor function due to musculoskeletal disorders that cause reduced mobility and physical function. In Japan, musculoskeletal disorders are the most common reason for requiring home support or nursing care, highlighting the need for preventing and ameliorating LS. Middle-aged and elderly individuals sometimes encounter difficulty making a habit of exercise therapy (the mainstay of LS treatment).
Objective:
We investigated whether digital therapeutics (DTx) can prevent or ameliorate LS in the middle-aged and elderly individuals.
Methods:
We conducted a prospective, longitudinal, non-randomized, single-group study of Japanese aged ≥40 years who were eligible for LS checkups (n=47). Each participant underwent an 8-week locomotion training (LT) intervention based on DTx supervised by medical staff. We objectively assessed the participants' subjective and objective motor abilities and motor awareness with the Timed Up & Go (TUG) test, 25-Geriatric Locomotive Function Scale (GLFS-25), and Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) at baseline (before the DTx), an interim point (4 weeks after the DTx initiation [4w]), and a final evaluation (8 weeks post-DTx initiation [8w]). We compared the three tests' scores at the three timepoints as dependent variables in a three-factor ANOVA with Bonferroni correction (significance defined as 0.05/3=0.0167).
Results:
No increase in anmotivation to exercise or refusal to exercise was observed. Significant improvements at 8 weeks versus the baseline were observed in the TUG scores (baseline 9.0, 95%CI: 8.4–9.6, 8w: 7.5, 95%CI: 7.1–8.0) (p<0.05) and GLFS-25 results (baseline 18.7, 95%CI: 14.5–22.8, 8w: 11.7, 95%CI: 8.8–14.7) (p<0.05). The BREQ-3 and its subscale data did not differ significantly at any assessment timepoint.
Conclusions:
These results indicate that an 8-week LT intervention using DTx significantly improved middle-aged and elderly individuals' TUG and GLFS-25 scores and will help prevent and ameliorate LS and establish better exercise habits among middle-aged and elderly individuals. Clinical Trial: University Hospital Medical Information Network Clinical Trials Registry UMIN000053922; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000061550
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