What are the common misunderstandings about preventing falls and "locomotive syndrome"?
This answer is a draft. It stays unpublished until legal review and source verification are complete.
Among older people in Japan, falls are one of the main reasons for needing long-term care, and most of them happen at home. Here we explain why "stay still so you don't fall" is the worst possible strategy, and introduce "locomo" (locomotive syndrome), a concept proposed by the Japanese Orthopaedic Association.
In numbers
| Item | Detail | Source |
|---|---|---|
| Reasons for needing long-term care | "Fractures and falls" about 13%, among the top causes (after dementia, stroke and frailty of old age) | Comprehensive Survey of Living Conditions (2022) |
| Where falls happen | Most often at home (living room, bedroom, stairs, bathroom, entrance hall) | Consumer Affairs Agency; Tokyo Fire Department |
| Ambulance transports for falls | About 80% of ambulance transports of older people after everyday-life accidents are due to falls (Tokyo Fire Department) | Tokyo Fire Department |
| Locomo (locomotive syndrome) | Reduced mobility caused by disorders of the locomotive organs (bones, joints, muscles). Proposed by the Japanese Orthopaedic Association in 2007. Estimated at about 47 million people including the at-risk group | Japanese Orthopaedic Association |
| Loco-check | Cannot put on socks standing on one leg; trip inside the house; need a handrail on stairs; cannot walk for 15 minutes without stopping; cannot cross a pedestrian crossing before the light changes; find it hard to carry 2 kg of shopping home; find housework such as vacuuming hard — one "yes" is a warning sign | Same |
| Locotra | One-leg standing (1 minute per leg × 3 times a day), squats (5–6 reps × 3 times a day) | Same |
| Home measures | Detail |
|---|---|
| Steps and trip points | Remove door sills, carpet edges and electrical cords |
| Lighting | Night lights at floor level (motion-sensor), corridors and stairs |
| Handrails | Stairs, bathroom, toilet, entrance hall |
| Slipping | A bath mat; non-slip strips in corridors |
| Shoes and slippers | Backless slippers slip off and trip you → indoor shoes with a heel, or socks with non-slip soles |
| Medicines | Sleeping pills, blood-pressure medicines and taking many medicines together cause unsteadiness → ask your doctor or pharmacist |
| Eyesight | Cataracts; misjudging steps through bifocals |
[Verify] Check the share of care causes against the latest Comprehensive Survey of Living Conditions, and the locomo estimate, Loco-check and Locotra against the Japanese Orthopaedic Association's "Locomo ONLINE".
Misunderstanding 1｜Don't move, so you don't fall
Muscle strength and balance decline, and falls increase. One-leg standing and squats (Locotra) every day.
Misunderstanding 2｜Falls happen outdoors
Most happen at home. Review steps, cords, lighting and slippers.
Misunderstanding 3｜Slippers are safe
Backless slippers slip off and trip you. Indoor shoes with a heel, or non-slip socks.
Misunderstanding 4｜Locomo is about old people
Muscle strength starts falling in your 40s; one "yes" on the Loco-check puts you in the at-risk group. Stairs, step counts and strength training work better the earlier you start.
Misunderstanding 5｜A fall and a fracture are just bad luck
Bone-density testing and care for osteoporosis lower fracture risk. The guideline for testing is women after menopause, men from 70. Anyone who has fallen once has a higher risk of falling again, so review the causes.
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Sources
- Japanese Orthopaedic Association, *Locomo ONLINE* (Loco-check, Locotra) [ロコモONLINE]
https://locomo-joa.jp/
- Ministry of Health, Labour and Welfare, *Comprehensive Survey of Living Conditions 2022* [令和4年 国民生活基礎調査] (causes of needing long-term care)
https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa22/
- Consumer Affairs Agency, *Beware of falls among older people (at home)* [高齢者の転倒事故に注意（住宅内）]
https://www.caa.go.jp/policies/policy/consumer_safety/caution/
⚠️ Editorial note: the source URLs above were identified by search. Our working environment cannot reach go.jp domains, so the contents have not been checked against the text. Verify every source before publication and record who checked it and when.
About this article
What we share here are ideas and everyday practices passed down among people living in Japan, together with general information drawn from public sources. They are not official recommendations, and they are not professional instruction. Practices vary between households and regions.
This is general information. Results vary from person to person and depend on your own conditions and surroundings.
Please decide for yourself, using your own judgement, whether any of this suits your situation. We cannot accept responsibility for any damage, loss or injury arising from following this article.
This article is not meant to diagnose or manage any specific medical condition. If you are worried about your health, see a doctor rather than relying on your own judgement.
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