To enlighten people with unnoticed/ overlooked social issues, a quantity of communication amount or government enforcement would be neeeded in the norm. However, we took the grassroots way for people to be proactive in the action. Just defining the lifestage before becoming bedridden as a unique period and clarifying the symptoms of the orthopedic dificiencies can make an issue. First, we gave the symptoms a name, Locomotive Syndrome, and nicknamed it LOCOMO. Then, we invented a simple test that anyone can challenge anywhere; stand up from a chair on one foot. According to the level of symptoms, orthopedists diagnose for a set of excersize or medical care. The simplicity of the word and concept, along with the shocking fact that 1 out of 3 Japanese citizens are at risk of LOCOMO quickly caught attention of media, gained target recognition and affected their behavior change.

- We involved many media by press releases and events, appealing that the LOCOMO is a major crisis of super-aging-society Japan.

-With the fact that 1/3 of the population is at risk of LOCOMO, we provoked a counteraction business opportunity. More than 120 companies developed products and services, which then self-promoted LOCOMO through their product promotions.

- We engaged more than 700 local governments across the country by the simple LOCOMO Risk Test tool and they held seminars of LOCOMO.

- Our initiatives appealed to orthopedic surgeons nationwide, which grew to over 1,500 "LOCOMO Advice Doctors" in all the 47 prefectures in Japan.

- We held seminars for local residents to train 3,000 “Evangelistic LOCOMO Mates”.

- We urged the Japan government and Ministry of Health, Labour, and Welfare adopted LOCOMO as one of the national health goals, which is “80% of Japanese are aware of LOCOMO by 2023.”

- The LOCOMO Challenge campaign contributed in naming an unnoticed health issue in the emerging age segment, the elderlies. The campaign was not a mere supporting action to this target, but was a call-to-action to self-support your health and change your everyday actions for social wellness.

- Business sector responded with a new market for LOCOMO related products and services totaling 1.3 billion USD.

- Media responded with 1.0 billion earned impressions. Many news anchors and celebrities challenged the test, unable to stand up from the chair on one leg, and their shocked faces were reported.

- Consumer recognition reached 80% among females over 70’s. Those who understand LOCOMO exercise three times more than those who do not.

- And lastly, a WHO Director evaluated LOCOMO Challenge as "an advanced healthcare initiative, seen nowhere else in the world" on a national major newspaper, Mainichi Shimbun.

The LOCOMO Challenge is not simply a healthcare communication campaign. The achievement of this project is unique in the formation of a cross-border collective of orthopedists, an agency, and the business sector to invent a new market by gaining recognition of the issue as well as pushing consumer action. The NPO LOCOMO Challenge Council was organized by the Japanese Orthopaedic Association and us to create a mutual goal for any stakeholder regardless of sector. The simple call-to-action (=stand up from the chair) could become simple enough to be taken notice by the government, and finally global authorities.

Our strategy was to involve multi-dimensional stakeholders under the common banner of LOCOMO Challenge, revitalize the discussion, make LOCOMO a national concern, and initiate countermeasures. To build a social goal, we fomed together with the Japanese Orthopaedic Association an NPO “LOCOMO Challenge Council” for PR and stakeholder engagement.

The core story for PR was the fact that one third of the whole Japanese population are at risk of LOCOMO, and the promotion of the simple test of standing up from a chair on one foot.

Our core target is female in her 70’s with the highest risk of LOCOMO, and the target media is mass media reaching these elderlies, that is, TV programs featuring healthcare, talk shows, news programs, national newspapers, healthcare magazines / websites. These media welcomed actionable contents, and many TV shows on-aired the LOCOMO test with renowned personels.

Japan’s aging rate (over 65 yrs) is 27%. In Japan, the most progressing aging society, elderly people are being trapped in bed unable to walk for years before they meet their death. This resulted in a shortage of hospital beds, an increase in national medical expenses, and a burden on the nursing families, which had become a major social problem. The weakening of limbs starts in the 40’s, but everyone is convinced that he or she is still fine. The lifespan of human beings has doubled in the past 100 years due to medical advances, but the human body is not designed to live over 80 years, and neither are our limbs. The Japanese Orthopaedic Association wanted to raise this issue to the Japanese society, take measures, and make awareness toward the importance of locomotive organs before it’s too late and so many people become bedridden.