[Relationship between exercise adherence and personality characteristics in persons experienced in the Medical Fitness program].

Objective　We examined effective exercise adherence support methods for persons experienced in the Medical Fitness (MF) program to clarify the relation of personality traits with exercise adherence and the factors that improve exercise adherence.Methods　Subjects were 283 adults who had registered as members in the MF program at an affiliate of Hospital A. We implemented an anonymous self-administered questionnaire by postal mail. Using the Japanese version of the Ten Item Personality Inventory (which contains 10 items that measure the Big Five personality traits), we evaluated the following characteristics: "Extraversion", "Agreeableness", "Conscientiousness", "Neuroticism", and "Openness". The subjects who reported exercising regularly at the time of survey were considered persons with subjective exercise adherence.Results　In persons with subjective exercise adherence, "Conscientiousness" was significantly lower (P=0.003) among men and "Neuroticism" was significantly higher (P=0.018) among women when compared to persons with subjective exercise adherence. There was no correlation between the things that emphasize exercise adherence and "Conscientiousness" among men. There was a negative correlation between "can achieve goal" and "Neuroticism" among women.Conclusions　It is essential to consider personality and gender differences when devising exercise adherence support measures for the MF program. Our results suggest that women with high neuroticism do not need "can achieve goal" to maintain their exercise habits; therefore, it is necessary to examine teaching methods that do not focus on only goal achievement as part of exercise adherence support for MF.

Physiotherapy program through home visits for community-dwelling elderly Japanese women with mild knee pain.

Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

FALL-RELATED ACTIVITIES OF DAILY LIVING AND BEHAVIOUR DISTURBANCES IN DEMENTIA.

The purpose of this study is to clarify the activities of daily living and behaviour disturbances related to inpatients and outpatients with dementia experiencing falls. Patients diagnosed with dementia belonging to 18 facilities which consented to the study were subjected. The study involved "whether or not the patient has fallen in the past 12 months", "Barthel Index (B.I)", and "Dementia Behaviour Disturbance Scale (DBD)" and other data from 325 people in 18 facilities who had been diagnosed with dementia. The ratio of subjects who had fallen to those who had not was 113:212. The results of multiple logistic regression analysis showed that the study items related to falls including the DBD item of "making unwarranted accusations" had an OR = 1.445, 95% CI (1.133-1.843), the DBD item of "refusing to eat" had an OR = 0.699, 95% CI (0.521- 0.938), the B.I item of "feeding" had OR = 1.115, 95% CI (1.032-1.204) and the B.I item of "bathing" had OR = 0.782, 95% CI (0.671-0.912). Integral characteristics of dementia patients who have fallen are assumed to be making unwarranted accusations, having a low rate of refusing to eat, being able to eat alone and requiring attention when bathing.

Evaluation of performance status of daily living activities and of the future risk of falls in the non-handicapped, community-dwelling elderly.

OBJECTIVES: There is a growing need to evaluate the performance status of the activities of daily living (ADL) of the elderly in the rapidly aging Japanese society. The purpose of this study was to verify the usefulness of our new scoring sheet for assessing present ADL status and to clarify whether or not the assessed ADL status can predict the future risk of adverse conditions related to falls. METHODS: The validation study was performed using 116 non-handicapped community-dwelling Japanese elderly at least 60 years of age. Of those subjects, 44 were also analyzed for the relationship between baseline ADL status and subsequent risk of adverse conditions related to falls. RESULTS: The daily living performance score sheet had good internal consistency, with a Cronbach's alpha of 0.82 and a sequential hierarchical structure that reflected the difficulty of the activities. The total score was significantly and positively associated with six of eight subscale scores on the Short-Form 36-Item Health Survey (P < 0.01). In the follow-up study, every one-point decrease in total score was significantly associated with a 39% elevated risk of a stumble or fall (P = 0.022) and also borderline significantly associated with higher risks of a fall, anxiety while walking indoors, and anxiety while walking outdoors (P < 0.10). CONCLUSION: Our new scoring sheet can reliably and comprehensively assess present ADL status. The assessed ADL could predict the future risk of adverse conditions related to falls.