Table 1 Characteristics of participants
|
All (n = 231)
|
|
NLS risk group (n = 200)
|
|
LS risk group (n = 31)
|
|
P-valuec
|
Agea, years
|
58.0
|
(54.0, 62.0)
|
|
58.0
|
(54.0, 62.0)
|
|
59.0
|
(53.0, 64.0)
|
|
0.332
|
Heighta, cm
|
172.0
|
(168.0, 177.0)
|
|
172.3
|
(168.5, 177.1)
|
|
172.0
|
(167.0, 176.0)
|
|
0.888
|
Weighta, kg
|
71.0
|
(65.0, 78.0)
|
|
70.5
|
(65.0, 77.0)
|
|
72.0
|
(68.0, 80.0)
|
|
0.048
|
BMIa, kg/m2
|
23.8
|
(22.1, 25.5)
|
|
23.7
|
(22.0, 25.4)
|
|
24.4
|
(23.3, 26.5)
|
|
0.020
|
Daily step countsa, steps/day
|
5000.0
|
(0.0, 8000.0)
|
|
4000.0
|
(0.0, 8000.0)
|
|
5000.0
|
(1500.0, 6000.0)
|
|
0.939
|
Smoking statusa, n (%)
|
|
|
|
|
|
|
|
|
|
|
Never smoker
|
94
|
(40.7)
|
|
86
|
(43.0)
|
|
8
|
(25.8)
|
|
0.070
|
Current smoker
|
37
|
(16.0)
|
|
29
|
(14.5)
|
|
8
|
(25.8)
|
|
0.110
|
Former smoker
|
100
|
(43.3)
|
|
85
|
(42.5)
|
|
15
|
(48.4)
|
|
0.538
|
Drinking statusa, n (%)
|
|
|
|
|
|
|
|
|
|
|
None
|
23
|
(10.0)
|
|
22
|
(11.0)
|
|
1
|
(3.2)
|
|
0.329
|
Current
|
194
|
(84.0)
|
|
166
|
(83.0)
|
|
28
|
(90.3)
|
|
0.431
|
Former
|
14
|
(6.0)
|
|
12
|
(6.0)
|
|
2
|
(6.5)
|
|
1.000
|
Follow-up perioda, years
|
37.0
|
(33.0, 41.0)
|
|
36.5
|
(33.0, 41.0)
|
|
38.0
|
(32.0, 43.0)
|
|
0.355
|
Ageb, years
|
21.0
|
(21.0, 21.0)
|
|
21.0
|
(21.0, 21.0)
|
|
21.0
|
(21.0, 21.0)
|
|
0.564
|
Heightb, cm
|
172.8
|
(168.8, 177.8)
|
|
172.8
|
(168.8, 177.8)
|
|
173.3
|
(168.4, 176.7)
|
|
0.864
|
Weightb, kg
|
65.5
|
(61.5, 71.0)
|
|
65.5
|
(61.5, 71.0)
|
|
66.4
|
(61.5, 72.5)
|
|
0.740
|
BMIb, kg/m2
|
22.0
|
(21.0, 23.2)
|
|
22.0
|
(21.0, 23.2)
|
|
22.2
|
(21.3, 23.5)
|
|
0.801
|
Year of graduationb
|
1981
|
(1977, 1985)
|
|
1981
|
(1977, 1985)
|
|
1980
|
(1975, 1986)
|
|
|
The data are presented as medians (interquartile range) for continuous variables and number (percentage) for categorical variables.
BMI, body mass index, calculated as weight in kilograms divided by height in meters squared; LS, locomotive syndrome; NLS risk group, answered ‘‘no’’ to all seven items on ‘‘Loco-check’’; LS risk group, ‘‘yes’’ to one or more items on ‘‘Loco-check.’’
a All items were the date at follow-up questionnaire. b All items were the date in the fourth year at university. c P-value of independent-samples t-test (for continuous variables) or Chi-squared test (for categorical variables) is between NLS risk group and LS risk group.
Table 2 Comparison between the NLS group and LS risk group on physical fitness tests and motor ability tests
|
All (n = 231)
|
NLS risk group (n = 200)
|
LS risk group (n = 31)
|
t-test P-valuea
|
ANCOVA P-valueb
|
|
Physical fitness tests
|
|
|
|
|
|
|
|
|
Side-step test, point
|
51.19
|
(4.2)
|
51.37
|
(4.3)
|
50.10
|
(3.2)
|
0.114
|
0.133
|
Vertical jump test, cm
|
63.84
|
(6.6)
|
63.71
|
(6.7)
|
64.74
|
(6.1)
|
0.420
|
0.337
|
Back muscle strength, kg
|
171.96
|
(30.2)
|
171.69
|
(30.2)
|
173.71
|
(30.5)
|
0.729
|
0.520
|
Grip strength, kg
|
51.42
|
(6.3)
|
51.34
|
(6.1)
|
51.97
|
(7.1)
|
0.604
|
0.617
|
Trunk lift, cm
|
59.22
|
(7.2)
|
59.11
|
(6.9)
|
59.97
|
(9.2)
|
0.538
|
0.713
|
Standing trunk flexion, cm
|
14.61
|
(5.6)
|
14.42
|
(5.6)
|
15.90
|
(5.8)
|
0.171
|
0.211
|
Step-testc
|
73.37
|
(14.4)
|
73.83
|
(14.0)
|
70.43
|
(16.4)
|
0.222
|
0.250
|
Physical fitness scores, point
|
28.13
|
(2.1)
|
28.13
|
(2.1)
|
28.13
|
(1.9)
|
0.992
|
0.900
|
Motor ability tests
|
|
|
|
|
|
|
|
|
50-m run, s
|
7.07
|
(0.3)
|
7.07
|
(0.3)
|
7.03
|
(0.3)
|
0.534
|
0.434
|
1,500-m run, s
|
331.37
|
(31.8)
|
331.45
|
(32.4)
|
330.90
|
(28.5)
|
0.930
|
0.839
|
Running long jump, cm
|
528.99
|
(43.5)
|
528.88
|
(43.4)
|
529.71
|
(44.3)
|
0.921
|
0.795
|
Hand-ball throw, m
|
31.45
|
(4.1)
|
31.31
|
(4.0)
|
32.32
|
(4.5)
|
0.199
|
0.211
|
Pull-up, point
|
14.33
|
(5.4)
|
14.37
|
(5.5)
|
14.10
|
(4.7)
|
0.795
|
0.826
|
Motor ability scores, point
|
63.90
|
(12.2)
|
63.74
|
(12.2)
|
64.97
|
(12.4)
|
0.602
|
0.505
|
The data are presented as the mean value (standard deviation).
NLS, answered ‘‘no’’ to all seven items on ‘‘Loco-check’’; LS, locomotive syndrome; LS, ‘‘yes’’ to one or more items on ‘‘Loco-check”.
ANCOVA: analysis of covariance.
a P value of independent-samples t-test. bAge-adjusted at follow-up questionnaire. c Step-test is scored by the index derived from the formula shown in the eMaterials.
Table 3 Hazard ratios of the risk of locomotive syndrome according to Side-step test (agility) fitness level
|
|
Diagnosed
|
Unadjusted model
|
Adjusted model
|
|
|
locomotive syndrome
|
(Model 1)
|
(Model 2)
|
(Model 3)
|
(Model 4)
|
|
All
|
n (%)
|
HR (95% CI)
|
P- value
|
HR (95% CI)
|
P- value
|
HR (95% CI)
|
P- value
|
HR (95% CI)
|
P- value
|
Side-step test, point (agility)
|
|
31 (13.4%)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Low ≤ 50
|
90
|
18 (20.0%)
|
1.00 (Reference)
|
|
1.00 (Reference)
|
|
1.00 (Reference)
|
|
1.00 (Reference)
|
|
51 ≤ Medium ≤ 53
|
80
|
9 (11.3%)
|
0.71 (0.315–1.591)
|
0.403
|
0.66 (0.289–1.502)
|
0.321
|
0.49 (0.203–1.161)
|
0.104
|
0.44 (0.159–1.222)
|
0.115
|
High ≥ 54
|
61
|
4 (6.6%)
|
0.45 (0.151–1.337)
|
0.150
|
0.43 (0.142–1.272)
|
0.126
|
0.24 (0.075–0.792)
|
0.019
|
0.22 (0.058–0.798)
|
0.022
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HR, hazard ratios; CI, confidence interval. The data are presented as the hazard ratio (95% confidence interval [CI]).
Model 1 was the unadjusted model.
Model 2 included Model 1 plus age (continuous variable) at university was adjusted as covariates.
Model 3 included Model 1 plus age (low, medium, high), weight (low, medium, high), and body mass index (low, medium, high) at the follow-up questionnaire were entered as adjusted factors.
Model 4 included Model 3 plus the results of physical fitness tests, motor ability tests (low, medium, high), and daily step counts, steps/day, were entered as adjusted factors, except the side-step test.
Table 4 Hazard ratios of the risk of locomotive syndrome according to physical fitness level, except the side-step test
|
|
Diagnosed
|
|
Adjusted model
|
|
|
locomotive syndrome
|
|
|
All
|
n (%)
|
|
HR (95% CI)
|
P value
|
Physical fitness tests
|
|
|
|
|
|
|
|
Vertical jump test, cm
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 61
|
81
|
8 (9.9%)
|
|
1.00 (Reference)
|
|
62 ≤ Medium ≤ 67
|
83
|
13 (15.7%)
|
|
1.79 (0.498–6.447)
|
0.372
|
High ≥ 68
|
67
|
10 (14.9%)
|
|
1.75 (0.455–6.695)
|
0.416
|
|
|
|
|
|
|
|
|
Back muscle strength, kg
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 158
|
77
|
9 (11.7%)
|
|
1.00 (Reference)
|
|
159 ≤ Medium ≤ 181
|
79
|
12 (15.2%)
|
|
1.45 (0.452–4.636)
|
0.533
|
High ≥ 182
|
75
|
10 (13.3%)
|
|
1.46 (0.376–5.632)
|
0.587
|
|
|
|
|
|
|
|
|
Grip strength, kg
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 49
|
86
|
12 (14.0%)
|
|
1.00 (Reference)
|
|
50 ≤ Medium ≤ 53
|
68
|
7 (10.3%)
|
|
0.57 (0.161–1.992)
|
0.376
|
High ≥ 54
|
77
|
12 (15.6%)
|
|
0.51 (0.147–1.734)
|
0.278
|
|
|
|
|
|
|
|
|
Trunk lift, cm
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 56
|
79
|
12 (15.2%)
|
|
1.00 (Reference)
|
|
57 ≤ Medium ≤ 62
|
81
|
6 (7.4%)
|
|
0.45 (0.143–1.425)
|
0.175
|
High ≥ 63
|
71
|
13 (18.3%)
|
|
1.36 (0.438–4.204)
|
0.596
|
|
|
|
|
|
|
|
|
Standing trunk flexion, cm
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 12
|
88
|
10 (11.4%)
|
|
1.00 (Reference)
|
|
13 ≤ Medium ≤ 17
|
74
|
9 (12.2%)
|
|
0.86 (0.298–2.460)
|
0.774
|
High ≥ 18
|
69
|
12 (17.4%)
|
|
1.00 (0.327–3.078)
|
0.996
|
|
|
|
|
|
|
|
|
Step-testa
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 65
|
77
|
13 (16.9%)
|
|
1.00 (Reference)
|
|
66 ≤ Medium ≤ 80
|
79
|
10 (12.7%)
|
|
0.91 (0.327–2.517)
|
0.851
|
High ≥ 81
|
75
|
8 (10.7%)
|
|
0.73 (0.216–2.450)
|
0.608
|
|
|
|
|
|
|
|
|
Physical fitness scores, point
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 27
|
85
|
10 (11.8%)
|
|
1.00 (Reference)
|
|
28 ≤ Medium ≤ 29
|
87
|
13 (14.9%)
|
|
1.10 (0.331–3.638)
|
0.878
|
High ≥ 30
|
59
|
8 (13.6%)
|
|
1.16 (0.247–5.481)
|
0.849
|
HR, hazard ratio; CI, confidence interval. The data are presented as the hazard ratio (95% confidence interval [CI]). In adjusted model the results of physical fitness tests and motor ability tests (low, medium, high), age (low, medium, high), weight (low, medium, high), body mass index (low, medium, high) and daily step counts, steps/day, at follow-up questionnaire were entered as adjusted factors.
a Step-test was scored by the index derived from the formula shown in the eMaterials.
Table 5 Hazard ratios of the risk of locomotive syndrome according to motor ability level
|
|
Diagnosed
|
|
Adjusted model
|
|
|
locomotive syndrome
|
|
|
All
|
n (%)
|
|
HR (95% CI)
|
P value
|
Motor ability tests
|
|
|
|
|
|
|
|
50-m run, s
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 6.9
|
89
|
11 (12.4%)
|
|
1.00 (Reference)
|
|
7.0 ≤ Medium ≤ 7.2
|
77
|
15 (19.5%)
|
|
1.31 (0.462–3.726)
|
0.611
|
High ≥ 7.3
|
65
|
5 (7.7%)
|
|
0.33 (0.069–1.599)
|
0.169
|
|
|
|
|
|
|
|
|
1,500-m run, s
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 318
|
79
|
13 (16.5%)
|
|
1.00 (Reference)
|
|
319 ≤ Medium ≤ 342
|
75
|
9 (12.0%)
|
|
0.56 (0.193–1.649)
|
0.296
|
High ≥ 343
|
77
|
9 (11.7%)
|
|
0.58 (0.133–2.496)
|
0.462
|
|
|
|
|
|
|
|
|
Running long jump, cm
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 514
|
79
|
11 (13.9%)
|
|
1.00 (Reference)
|
|
515 ≤ Medium ≤ 545
|
78
|
11 (14.1%)
|
|
1.07 (0.297–3.855)
|
0.917
|
High ≥ 546
|
74
|
9 (12.2%)
|
|
0.86 (0.216–3.441)
|
0.834
|
|
|
|
|
|
|
|
|
Hand-ball throw, m
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 30
|
94
|
10 (10.6%)
|
|
1.00 (Reference)
|
|
31 ≤ Medium ≤ 33
|
73
|
8 (11.0%)
|
|
0.93 (0.273–3.142)
|
0.903
|
High ≥ 34
|
64
|
13 (20.3%)
|
|
0.68 (0.181–2.562)
|
0.569
|
|
|
|
|
|
|
|
|
Pull-up, point
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 11
|
82
|
9 (11.0%)
|
|
1.00 (Reference)
|
|
12 ≤ Medium ≤ 17
|
82
|
15 (18.3%)
|
|
1.73 (0.558–5.366)
|
0.342
|
High ≥ 18
|
67
|
7 (10.4%)
|
|
1.43 (0.344–5.936)
|
0.623
|
|
|
|
|
|
|
|
|
Motor ability scores, point
|
|
31 (13.4%)
|
|
|
|
|
|
Low ≤ 58
|
80
|
9 (11.3%)
|
|
1.00 (Reference)
|
|
59 ≤ Medium ≤ 70
|
80
|
10 (12.5%)
|
|
0.42 (0.088–1.998)
|
0.276
|
High ≥ 71
|
71
|
12 (16.9%)
|
|
0.51 (0.052–4.904)
|
0.556
|
HR, hazard ratios; CI, confidence interval.
The data are presented as the hazard ratio (95% confidence interval [CI]).
In adjusted model the results of physical fitness tests and motor ability tests (low, medium, high), age (low, medium, high), weight (low, medium, high), body mass index (low, medium, high) and Daily step counts, steps/day, at follow-up questionnaire were entered as adjusted factors.