Participation rate determines completion rate for specific health guidance as implemented by public health insurers.

Completion rate for specific health guidance (SHG) based on specific health checkup (SHC) status in Japan is very low. This study aimed to clarify factors affecting the rate using questionnaire survey, which was conducted by mail between December 2016 and January 2017 for insurers in the Tokai Region of Japan. The subjects were 69 insurers and the collection rate was 25.1%. The SHG participation rate was 26.3%, and the SHG completion rate was even lower (23.6%) than the participation rate. The rate was significantly lower in dependents than in insured persons. Multiple regression analysis with SHG completion rate as the dependent variable indicated that only "participation rate in SHG" was positively related to completion rate. With SHG participation rate as the dependent variable, however, having an insurer who "implemented SHG," "provided a thorough explanation to the subscribers of the objectives and significance of SHC and SHG when the programs were begun," and "provided health guidance to non-obese individuals" and SHC implementation rate were positively correlated with participation rate. Multiple regression analysis using completion rates for the two types of SHG, i.e., motivational and active support, as the dependent variables indicated that SHG participation rate was a positive factor for each type. Participation rate in each type was positively correlated to "ex-post assessment of the SHG," and/or insured persons. The primary factor affecting SHG completion rates was the SHG participation rate. It is also important, however, that insurers encourage participation of subscribers, especially dependents, in SHG.

Degree of exercise intensity during continuous chest compression in upper-body-trained individuals.

BACKGROUND: Although chest-compression-only cardiopulmonary resuscitation (CCO-CPR) is recommended for lay bystanders, fatigue is easily produced during CCO-CPR. If CCO-CPR can be performed at a lower intensity of exercise, higher resistance to fatigue is expected. Since chest compression is considered to be a submaximal upper body exercise in a steady rhythm and since the unit of load for chest compression is expressed as work rate, we investigated the possibility that peak work rate of the upper body determines the level of exercise intensity during CCO-CPR. METHODS: Twelve sedentary individuals (group Se), 11 rugby players (group R), and 11 swimmers (group Sw) performed 10-min CCO-CPR, and heart rate (HR) and rating of perceived exertion (RPE) were measured as indices of exercise intensity. Multiple linear regression analysis was carried out to assess potential relationships of upper body weight, peak lumbar extension force, peak work rate, and peak oxygen uptake recorded during arm-crank exercise with HR and RPE during CCO-CPR. RESULTS: Values of peak work rate during arm-crank exercise (Peak WR-AC) in group Se, group R, and group Sw were 108 ± 12, 139 ± 27, and 146 ± 24 watts, respectively. Values of the latter two groups were significantly higher than the value of group Se (group R, P < 0.01; group Sw, P < 0.001). HR during CCO-CPR increased with time, reaching 127.8 ± 17.6, 114.8 ± 16.5, and 118.1 ± 14.2 bpm at the 10th minute in group Se, group R, and group Sw, respectively. On the other hand, RPE during CCO-CPR increased with time, reaching 16.4 ± 1.4, 15.4 ± 1.7, and 13.9 ± 2.2 at the 10th minute in group Se, group R, and group Sw, respectively. Multiple linear regression analysis showed that only peak WR-AC affects both HR and RPE at the 10th minute of CCO-CPR (HR, r = -0.458; P < 0.01; RPE, r = -0.384, P < 0.05). CONCLUSIONS: The degree of exercise intensity during CCO-CPR is lower in individuals who have a higher peak work rate of the upper body.

Higher ventilatory responses during and after passive walking-like leg movement in older individuals.

BACKGROUND: Minute ventilation (V · E) during walking has been shown to be higher in older individuals than in young individuals, but the mechanisms underlying the higher ventilatory response is unclear. Central command and peripheral neural reflex are important neural control mechanisms underlying ventilatory response during exercise. Passive leg movement has been used to exclude the influence of central command due to the lack of voluntary activation of muscles. The aim of the present study was to compare the ventilatory response during and after passive walking-like leg movement (PWM) in young and older individuals. METHODS: Eight young subjects (20 ± 2 years) and seven older subjects (70 ± 1 years) participated in this study. Subjects spent 7 minutes in a quiet standing (QS) position. Thereafter, they performed 14-minute rhythmic PWM at 1 Hz and this was followed by 7 minutes of QS. RESULTS: V · E values during pre-PWM QS were calculated as 1-minute averages using data obtained between 5 and 6 minutes. V · E values at pre-PWM QS in the young and older groups were 8.4 ± 2.1 and 7.5 ± 1.2 l/minute, respectively. V · E values increased significantly at the first minute of PWM to 11.4 ± 2.2 and 10.4 ± 2.5 l/minute in the young and older groups, respectively (P <0.001). In the young group, V · E at the last minute of PWM (9.2 ± 2.0 l/minute) was not significantly different from that at pre-PWM QS due to a decline in V · E, whereas V · E at the last minute of PWM in the older group (9.4 ± 2.2 l/minute) was still significantly higher (P <0.01). On the other hand, V · E at the first minute of post-PWM QS (7.2 ± 1.8 l/minute) was significantly lower than that during pre-PWM QS in the young group (P <0.05) but not in the older group. CONCLUSIONS: Ventilatory response during and after PWM is higher in older individuals than in young individuals. This may be associated with a mechanism(s) other than central command. Our findings may explain part of the higher V · E response while walking in older individuals.

Suppression of cardiocirculatory responses to orthostatic stress by passive walking-like leg movement in healthy young men.

BACKGROUND: Although passive walking-like leg movement in the standing posture (PWM) has been used in the clinical field, the safety of PWM has not been fully determined despite the risks of orthostatic intolerance due to standing posture. The aim of the present study was to examine cardiocirculatory response during PWM in healthy young men. METHODS: The subjects (n = 13) spent 5 min in a sitting position and then 5 min in a quiet standing position to determine baseline levels. Thereafter, they underwent 25-min rhythmic PWM at 1 Hz while standing. In another bout, subjects experienced the same protocol except that they underwent 25-min quiet standing (QS) instead of 25-min PWM. Two subjects dropped out of the 25-min QS due to feeling of discomfort. Thus, data obtained in the remaining eleven subjects are presented. RESULTS: In the PWM trial, systolic arterial blood pressure (SAP) decreased from 112 ± 8 mmHg during the sitting baseline period to 107 ± 8 mmHg during the standing baseline period (p <0.05), while heart rate (HR) increased from 73 ± 9 bpm during the sitting baseline period to 84 ± 10 bpm during the standing baseline period (p <0.001). After the imposition of PWM, SAP increased from 107 ± 8 mmHg in the standing baseline period to 120 ± 6 mmHg (p <0.001), while HR decreased from 84 ± 10 bpm in the standing baseline period to 76 ± 9 bpm (p <0.05). In the QS trial, SAP, which had decreased during the standing baseline period compared to that during the sitting baseline period, remained lowered during the 25-min QS period, while HR, which had increased during the standing baseline period compared to that during the sitting baseline period, remained elevated during the 25-min QS period. In both bouts, HR showed almost mirror-image changes in the high-frequency component of HR variability, suggesting that the changes in HR were due to change in parasympathetic activation. Double product (HR × SAP), as a predictor of myocardial oxygen consumption, during the 25-min QS period tended to increase with time, but double product remained almost constant during the 25-min PWM period. CONCLUSIONS: The results suggest that PWM is effective for suppressing cardiocirculatory responses to orthostatic stress.