Interventions to improve locomotive syndrome: a systematic review and meta-analysis of randomized controlled trials

Locomotive syndrome is a musculoskeletal disease of individuals who are highly likely to require nursing care. There is no systematic review that systematically evaluates and consolidates the findings of randomized controlled trials, although the number of randomized controlled trials considering the interven-tion effect on locomotive syndrome has been increasing with the spread of the concept. Therefore, this systematic review of randomized controlled trials is aimed at consolidating evidence regarding effective interventions to improve locomotive syndrome. We searched seven databases electronically. Studies were included in this systematic review if the following were met: (1) the articles were randomized controlled trials written in English or Japanese in a peer-reviewed journal, and (2) the clinical evaluation of the locomotive syndrome should include at least one of the following: the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale. This systematic review included 10 studies. Several individual papers showed that the intervention group significantly improved the outcome measure for the diagnosis of locomotive syndrome compared with the control group. Only oral glucosamine intake provided sufficient information to conduct a meta-analysis, but the results were not statistically significant. This systematic review and meta-analysis did not provide strong evidence for specific interventions in improving locomotive syndrome, although individual randomized controlled trials have shown that oral intake of glucosamine, electrical stimulation, and exercise could improve locomotive syndrome. We hope that more high-quality randomized controlled exercise intervention trials aimed at improving locomotive syndrome, which is a musculoskeletal dysfunction, will be carried out in the future.