ABSTRACT
Objective: Falls in older adults are a major public health issue, and it is unclear whether the neighborhood environment is associated with falls among this group. This cross-sectional study investigated whether hilly neighborhood environmental factors were associated with fall status (falls or fear of falling) in rural Japanese older adults.Materials and Methods: Data obtained from 965 participants aged 65 years and older living in Unnan City, Shimane Prefecture, Japan, in 2017 were analyzed. Fall status was assessed based on the 1-year fall incidence (yes/no) for the past year and fear of falling (yes/no) using a self-report questionnaire. For hilly neighborhood environmental factors, the mean elevation and land slope were assessed using a geographic information system. The logistic regression model examined the odds ratios (OR) and 95% confidence intervals (CIs) of fall status in quartiles for elevation and land slope, respectively, and was adjusted for confounders.Results: Falls and fear of falling were observed in 16.8% and 43.2% of participants, respectively. Falls were associated with elevation (OR 1.99, 95% CI 1.17–3.37 for Q2 vs. Q1; OR 2.02, 95% CI 1.19–3.44 for Q3 vs. Q1) and land slope (OR 1.74, 95% CI 1.04–2.93 for Q3 vs. Q1; OR 1.74, 95% CI 1.04–2.93 for Q4 vs. Q1). Fear of falling was associated with elevation (OR 1.78, 95% CI 1.19–2.65 for Q3 vs. Q1) and land slope (OR 1.51, 95% CI 1.01–2.25 for Q4 vs. Q1).Conclusion: Our study found that elevation and land slope as hilly neighborhood environment factors were positively associated with falls or fear of falling among older adults living in rural Japan. Prospective observational studies that investigate the effects of region-specific environmental factors on falls among older adults should be conducted.
ABSTRACT
In this study, we investigated whether subjects with a Lower Maximum Step Length (MSL) Percentage (LMP) display unstable locomotion while negotiating an obstacle. Data were collected using a three-dimensional motion analysis system. The toe-obstacle clearance of the leading limb was monitored in 10 young adults while stepping over three height obstacles from 30%, 40% and 50% of MSL. The vertical clearance at the time of the obstacle crossing decreased systematically with more complicated experimental set up. In particular, subjects with LMP showed smaller clearances than subjects with a Higher Maximum step length Percentage (HMP). Furthermore, a significant correlation was observed between the toe-obstacle clearance and MSL. The mean of variance value of toe-obstacle clearance of the leading limb differed between the subjects with LMP and those with HMP. Our findings help to explain the relation of MSL and gait adaption ability to negotiate obstacles safely during obstacles crossing.
ABSTRACT
The purpose of this study was to investigate the identification of distinct characteristics of postural control during transition from a dynamic into a static state in young and older adults. We tested 8 healthy elderly (mean age of 67 yr±0.8) and 8 healthy young (mean age of 23 yr±1.2) adult subjects. After the consent session, all trial participants gave written informed consent if they agreed voluntarily to participate. The subject transitioned from a dynamic state into a static state on the force platform during a step maximally. Center of pressure (COP) from the force platform were recorded during 15s from both feet on the force plat with a sampling frequency of 100 Hz.The anterior-posterior (A-P) and medial-lateral (M-L) direction mean of COP of older adult subjects produced different postural sway and presented significant difference on the distributed value of COP in the quiet standing after the dynamic task, in comparison to the young adult subjects. A-P direction and M-L direction mean of COP was significant difference during the seconds from 0 to 2 (p＜0.05), and 1.5 to 2.5 (p＜0.05), respectively, between young and old subjects. The difference in the mean distance of COP and distributed value of COP between younger and older subjects were revealed by this study. These findings indicate that the development of a simple, non-stressful technique to analyze postural control in older adults is highly useful.
ABSTRACT
The purpose of this study was to review randomized controlled trials of the effects of treatment in spas, thereby clarifying therapeutic effects of these treatments on individual diseases, and its healthpromoting effects.<br>A review of the PubMed database for articles that fulfilled the following eligible criteria identified the studies that were chosen for this review. Key words were “randomized controlled trial” and “spa” or “balneotherapy”. Articles were published after 1990, and written in English. No criteria were set up concerning the number of subjects, the observation period, or the kind of disease studied. The quality of individual articles was evaluated on a 13-point modified PEDro scale that was constructed by adding three terms, representing the number of subjects, the observation period, and quellencharakter to the 10-point PEDro scale.<br>A total of 18 articles were chosen. Since two of them were essentially identical in content, these two articles were counted as one. As a result, a total of 17 articles were reviewed. Seven studies were conducted in France, 3 in Germany, 3 in Israel, 2 in the Netherlands, and 1 each in Italy and in Japan. Diseases studied in these articles were mostly disorders of the locomotorium, with pain as a main symptom; rheumatism in 6 articles, osteoarthritis in 4, lumbago in 3, and Parkinson's disease, varicosis, psoriasis, and health-promotion in one each. The mean score on the 13-point modified PEDro scale was 7.5 (SD, 2.3), with a minimum score of 2 points and a maximum score of 12 points.<br>The method of intervention in the spa varied widely from study to study. In addition to balneotherapy, exercise therapy, mud pack treatment, and douche massage were employed in numerous studies. Besides the intensity of pain and the amount of anodynes consumed by patients, emotional effects, QOL, physical working capacity, and even decreases in medical expenses were monitored as indicators for evaluation of the effect of the treatments in some studies. Improvements in the indicators were always more marked in balneotherapy intervention groups than in control groups, irrespective of the diseases studied. The improvements persisted for relatively long periods. In particular, a review of the high quality articles that reported effects of balneotherapy on patients with rheumatism, osteoarthritis, or lumbago showed that effects of intervention provided only once could be expected to persist for six months. With regard to the effect of quellencharakter on diseases, no definitive conclusion was obtained. On the basis of these results, we devised a “3-layer model of evidence to be accumulated in balneotherapy”
ABSTRACT
This study attempted to clarify the effects of 3- and 6-month comprehensive health education programs based on hot spa bathing, lifestyle education and physical exercise on physique, psychological vigor, blood properties, pains in the knee and back, and mental and psychological aspects of women. We examined middle-aged and elderly women who were randomly divided into two groups and followed up until six months and one year later, respectively.<br>Spa programmers, an exercise instructor, and a dietician instructed subjects to one hour of life-style education and physical exercise (lecture on behavior modification, walking, rhythmic exercise, cooking practice, etc.) and one hour (including time for changing clothes and washing body) of a half bath (salt spring, temperature at 41.5) once a week. The program for the 3-month group (n=19) was repeated in the 6-month group (n=14).<br>The evaluation items were BMI, PWC75%HRmax (by a bicycle ergometer as aerobic capacity), blood properties (total cholesterol, HDL cholesterol, arteriolosclerotic index, uric acid, and HbAlc), profile of mood states, self-rating depression scale, subjective happiness, and pains in the knee and back.<br>Compared with pre-intervention data (26.3±3.6), the BMI decreased significantly (p<0.05) immediately after the intervention (25.7±3.5) and at the follow up six months later (25.7±3.3) in the group of 6-month intervention. In addition, the PWC75%HRmax, HbAlc, pains in the back, vigor, depression, and subjective happiness remained significantly improved (p<0.05), as measured at the 6-month follow-up. On the other hand, some of the items improved in the 3-month intervention group immediately after the intervention, but returned to nearly the same levels as those before intervention at the 1-year follow-up. Significant differences (p<0.05) were found in the PWC75%HRmax, HbAlc, and fatigue between the two groups, all of which were improved in the 6-month intervention group.<br>These results suggest that a low frequency, once-a-week intervention requires duration longer than three months to maintain the effects, and that the effects should be monitored over years for a correct assessment.
ABSTRACT
The purpose of this study was to examine how constitutions, blood profiles, knee and back pain, and the psychological state of middle-aged and elderly women were influenced by comprehensive health education that consisted of instructions in appropriate ways of bathing in hot springs and education on lifestyle and exercise.<br>Of the middle-aged and elderly female residents in village A in Nagano prefecture, 266 underwent health check-ups in August and September 2002. Fifty-six of these women voluntarily participated in this study, and were divided into an intervention and a control group randomly. Finally, the intervention group and control groups consisted of 22 and 26 subjects, respectively, who were considered suitable for study purposes.<br>The intervention group received comprehensive health education once a week for 3 months (total 11 times) between the latter part of September and the middle of December. For the comprehensive health education, subjects participated in hot spa bathing in a salt spring for 20 minutes in all (two 10-minute periods), and lifestyle education and exercise, including stretching, walking, light sports, dietary instruction, etc., during 60-minute sessions. After the series of comprehensive health education was completed, the following improvements were noted in the intervention group. As to blood profiles, the plasma level of uric acid significantly decreased from 4.4±1.1mg/<i>dl</i> to 4.1±1.1mg/<i>dl</i> (p<0.05) and the arterioloscerotic index decreased from 2.85±0.90 to 2.68±0.83 (p=0.07). The intensity of lumbago expressed on a visual analogue scale significantly decreased from 23.5±28.4% to 14.2±21.5% (p<0.01). The intensity of psychological tension decreased from 45.3±6.3 points to 43.2±6.0 points (p=0.06). The mean number of comprehensive health education sessions attended was 9.9±1.4 (range 7 to 11). The number of improvements implemented with regard to a healthy lifestyle significantly increased (p<0.05). Behavior of the subjects in the intervention group appeared to have changed towards a desirable lifestyle.<br>The results of this study show that even intermittent and brief health education combining “hot spa bathing and lifestyle education and exercise” is effective to maintain and improve health of middle-aged and elderly women.
ABSTRACT
Near infrared spectroscopy has been used to determine the chemical composition of food stuffs, i, e., the protein, fat, and moisture content. Recently in the U. S. A, this technique was applied to the estimation of human body composition, and a portable instrument was developed. This study was designed to determine the prediction equation of body fat for Japanese people. 69 men and 52 women, aged 18 to 58 years, covering a wide range of percent fat levels, physiques, physical activity levels, had body fat estimated by hydrostatic weighing (HW), skinfold thicknesses (SF) and near infrared spectroscopy. Near infrared interactance spectra were measured on the anterior midline of the biceps halfway (between the anticubital fossa and acromion), the spectral data from which gave best correlation with HW and SF compared the other sites, using the wavelength of 947 nm. The spectral values and percent fat values obtained from HW about 1/2 of subjects were used to develop a prediction equation. This equation was then used to predict % body fat of the other 1/2 subjects. The correlation coefficient between % body fat as predicted by the near infrared method and as predicted by the HW technique was 0.88 (p<0.001, SEE=3.2) . This correlation value was similar to the value between % body fat as predicted by HW and as predicted by SF. In the American data, the correlation coefficients were higher when the other variables were added ; height, weight, age, but in the Japanese they did not almost change even when the other variables were added. There was not a difference between the spectra of right and left arm values. In the results, the prediction equation of % body fat for the Japanese population was determined as follows:<BR>% body fat =54.14-29.47× (the spectral data at 947 nm) [r=0.88, p<0.001, SEE=3.2] (for right arm) .
ABSTRACT
The purpose of this study was to compare two methods of CO<SUB>2</SUB> rebreathing-equilibrium method (Collier, 1965) and extrapolation method (Defares, 1958) -for determining the mixed venous CO<SUB>2</SUB> pressure (PvCO<SUB>2</SUB>) during exercise. Following a sitting rest for 5 min, five healthy males performed upright bicycle ergometer exercises with work rate of 100 and 150W for 5 min. During both at rest and in exercise, PvCO<SUB>2</SUB> was measured twice to evaluate the reproducibility of both methods. The equilibrium method was performed according to that by Jones & Campbell (1982) . In the extrapolation method, instead of using the graphical analysis described by Klauaen (1965), PvCO<SUB>2</SUB> was directly calculated by applying the modified exponential equation (Defares, 1958) . In the duplicate tests, coefficient of variation was lower while correlation coefficient was higher, with increasing work rate in both methods. It was noted that these tendencies were more pronounced in the extrapolation method than in the equilibrium method. It was concluded that in contrast to the results of Auchincloss et al. (1980), the extrapolation method was more reproducible than the equilibrium method.
ABSTRACT
The present study was designed to investigate the effects of low altitude training on swimming performance with setting the same duration (3-wk) and the same level of altitude (2, 300m) . Eight male (Gm<SUB>1</SUB>) swimmers aged 13 to 19 years and four male (Gm<SUB>2</SUB>) and eight female (Gf<SUB>2</SUB>) swimmers aged 13 to 18 years sent to Mexico City, and they conducted swimming work outs. All of them were top Japanese swimmers of various events. They repeated the swimming training twice a day continuously for four days with one day rest. Hemoglobin concentration (Hb), red blood cell count (RBC) and hematocrit (Hct) were determined before, during and after the altitude training several times. The values of Hb, RBC and Hct of all three groups increased significantly from before training to after training except Hb in Gm<SUB>1</SUB>. On the other hand, these three variables did not necessarily increase during the altitude training. Gm<SUB>1</SUB> and Gf<SUB>2</SUB> tended to increase Hb and RBC during the training. As for swimming performance at sea level, the individual best swimming records were improved significantly in 200m events, but not in 100m events in Gm<SUB>1</SUB>. Therefore, it may be concluded that 3-wk altitude (2, 300m) training possibly improve swimming performance in the events equal to or longer than 200m at sea level.