Sarcopenia assessed using a questionnaire can predict in-hospital mortality in older patients with pulmonary tuberculosis.

BACKGROUND & AIMS: Pulmonary tuberculosis is a severe disease with a high mortality rate. However, whether sarcopenia is a risk factor for in-hospital mortality remains unclear. The SARC-F (five items: strength, assistance in walking, rising from a chair, climbing stairs, and falls) is a questionnaire developed to screen for sarcopenia. This study aimed to determine whether the high risk of sarcopenia, assessed using the SARC-F questionnaire, affects in-hospital mortality in older patients with pulmonary tuberculosis. METHODS: This was a retrospective, observational study. We included patients with active pulmonary tuberculosis aged ≥65 years who required inpatient treatment between 30 April 2021 and 30 November 2022. We assessed sarcopenia using SARC-F, and SARC-F ≥ 4 points at admission was defined as a high risk of sarcopenia. The primary outcome was all-cause mortality during hospitalisation. We extracted information on age, sex, body mass index, comorbidities, blood and biochemical tests, modified Glasgow Prognostic Score, calf circumference, geriatric nutritional risk index, physiotherapy, and length of hospital stay from medical records. RESULTS: We included 147 patients (mean age: 83.0 ± 7.8 years; males: 61.9%). Ninety-three (63.3%) patients had a high risk of developing sarcopenia. Patients with a high risk of sarcopenia were significantly older (mean: 85.0 ± 7.1 years), had a lower body mass index (median: 18.1 kg/m2, range: 16.1-20.5 kg/m2), had a higher modified Glasgow Prognostic Score (median: 2, range: 2-2), and had a lower calf circumference (mean: 26.8 ± 3.6 cm), had a lower geriatric nutritional risk index (mean: 72.2 ± 12.9) than those without high-risk sarcopenia. More patients with a high risk of sarcopenia underwent physiotherapy (93.5%) than those without high-risk sarcopenia (P < 0.01, all). Kaplan-Meier survival curves showed that patients with a high risk of sarcopenia had significantly lower overall survival than those without high-risk sarcopenia (log-rank test, P = 0.001). Logistic regression analysis for in-hospital mortality showed that a high risk of sarcopenia significantly affected in-hospital mortality (odds ratio [OR]: 6.425, 95% confidence interval [CI]: 1.399-47.299). In addition, logistic regression analysis for each item of SARC-F showed that assistance in walking (OR: 3.931, 95% CI: 1.816-9.617) and rising from a chair (OR: 2.458, 95% CI: 1.235-5.330) significantly affected in-hospital mortality. CONCLUSION: A high risk of sarcopenia, as assessed using SARC-F at admission, was a risk factor for in-hospital mortality in older patients with pulmonary tuberculosis. Among the SARC-F items, assistance in walking and rising from a chair were the risk factors for in-hospital mortality.

Influence of kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy on postpartum depressive symptoms.

OBJECTIVE: To investigate whether kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy influenced depressive symptoms at 1 month after delivery. METHOD: Final participants were 43 pregnant women who experienced pregnancy-related lumbopelvic pain at late pregnancy and completed self-reported questionnaires at late pregnancy and 1 month after delivery. The Tampa Scale for Kinesiophobia was used to evaluate kinesiophobia, and depressive symptoms were assessed using the Self-Rating Depression Scale. We divided participants into two groups (depression and no-depression) using the score of the Self-Rating Depression Scale at 1 month after delivery. Univariate analysis and multiple logistic regression analysis identified kinesiophobia at late pregnancy as an independent predictor of depression at 1 month after delivery. RESULTS: In univariate analysis, kinesiophobia at late pregnancy was significantly higher in the depression group than in the no-depression group (P= .033). In multiple logistic regression analysis, kinesiophobia at late pregnancy were significantly associated with depression at 1 month after delivery even after adjusting for confounding factors (Odds Ratio, 1.25; 95% Confidence Interval, 1.03-1.52). CONCLUSION: Results found that kinesiophobia at late pregnancy negatively influenced depressive symptoms at 1 month after delivery, suggesting that approaches to treat kinesiophobia at late pregnancymight reduce the risk of onset of postpartum depressive symptoms.

Daily physical activity is associated with increased sonographically measured bone status during lactation.

OBJECTIVES: The purpose of this cross-sectional study was to investigate the association between daily physical activity and sonographically measured bone status among women during the lactation period. METHODS: Final participants were 152 women 4 months after childbirth. Bone status of the participants was measured using quantitative ultrasonometry of the calcaneus (speed of sound). Daily physical activity was assessed using the Japanese version of International Physical Activity Questionnaire short version. After getting the International Physical Activity Questionnaire results, we classified participants into three categories (low/moderate/high) according to a protocol. Participants categorized into the low group according to the International Physical Activity Questionnaire were considered to be in the low physical activity group and those categorized into the moderate and high groups were considered to be in the moderate to vigorous physical activity group. RESULTS: Speed of sound was significantly higher in the moderate to vigorous physical activity group (moderate to vigorous physical activity versus low physical activity, 1533 m/s versus 1523 m/s, p = 0.03). Daily physical activity was significantly associated with speed of sound, even after adjustment for confounding factors and prognosticators (ß = 0.195, p = 0.02). CONCLUSION: Sonographically measured bone status was significantly higher in women who were physically active than in those who were physically inactive, suggesting that daily physical activity might help to maintain good bone status.

Association Between Excessive Weight Gain During Pregnancy and Persistent Low Back and Pelvic Pain After Delivery.

STUDY DESIGN: Retrospective study. OBJECTIVE: To investigate the association between gestational weight gain (GWG) during pregnancy and persistent low back and pelvic pain (LBPP) after delivery. SUMMARY OF BACKGROUND DATA: Persistent LBPP after delivery is a risk factor for developing depression and chronic pain as well as incurring sick leave. Women experience weight gain during pregnancy. Excessive weight gain places a greater burden on the musculoskeletal system. However, little is known about how GWG is associated with LBPP after delivery. METHODS: After Ethics Committee approval, we analyzed 330 women at 4 months after delivery who had LBPP during pregnancy. The exclusion criteria were as follows: specific low back pain, multiple birth, and incomplete data. Four months after delivery, LBPP was assessed using a self-report questionnaire. Persistent LBPP was defined as pain at 4 months after delivery with an onset during pregnancy or within 3 weeks after delivery. GWG was calculated as the difference between the pregnancy weight and the prepregnancy weight, which we categorized into three groups: <10, 10 to <15, and ≥15 kg. Other confounding factors including age, height, weight at 4 months after delivery, parity, gestational week, mode of delivery, weight of the fetus, and prepregnancy LBPP were assessed. We used logistic regression analysis to calculate LBPP odds ratios (ORs) according to GWG. RESULTS: The prevalence of persistent LBPP was 34.1% (n = 113). Compared with women with a GWG of <10 kg, women with a GWG of ≥15 kg had a higher prevalence of persistent LBPP (OR = 2.77, 95% confidence interval (95% CI) = 1.28-5.96, adjusted OR = 2.35, 95% CI = 1.06-5.21); however, no significant difference was found for women with a GWG of 10 to <15 kg (OR = 1.18, 95% CI = 0.72-1.92, adjusted OR = 1.02, 95% CI = 0.61-1.72). CONCLUSIONS: Our study showed that excessive weight gain during pregnancy is one of the risk factors of persistent LBPP. Appropriate weight control during pregnancy could help prevent persistent LBPP after delivery. LEVEL OF EVIDENCE: 3.

Association Between Public Transportation Use and Loneliness Among Urban Elderly People Who Stop Driving.

Aim: To examine the association between public transportation use and loneliness in urban elderly who stop driving. Methods: In this cross-sectional study, we assessed 31 community-dwelling older adults who had stopped driving. Public transportation use was assessed by using frequency and divided into two groups. The users group was participants who used public transportation more than once a week and the nonusers group was participants who used public transportation less than once a week. Loneliness was measured using the Japanese version of the UCLA Loneliness Scale version 3 (UCLA.LS.ver3), with a higher score indicating greater loneliness. The independent t test was used to compare the UCLA.LS.ver3 scores between users and nonusers group. A multiple linear regression model was used with the UCLA.LS.ver3 score as the objective variable and public transportation use as the explanatory variable. Results: The UCLA.LS.ver3 score was significantly higher in the nonusers group than in the users group (nonusers group: 12.7 ± 1.9; users group: 10.1 ± 2.9, p = .017). After adjustments, public transportation use was significantly associated with lower loneliness (ß = -2.55, p = .029). Conclusion: Public transportation use might have important role to prevent loneliness in older adults who stop driving.

Lower physical activity is associated with daytime sleepiness in children aged 9-12 years.

This study clarified the prevalence of daytime sleepiness in fourth-, fifth-, and sixth-grade children and examined the association between physical activity (PA) and daytime sleepiness in children aged 9-12 years. This cross-sectional study included 314 children (mean age ± standard deviation: 10.5 ± 1.0 years; male: 52.9%) enrolled in two public elementary schools in Kobe, Japan. PA was assessed using the Physical Activity Questionnaire for Older Children. The outcome was self-reported daytime sleepiness. The prevalence of daytime sleepiness in fourth-, fifth-, and sixth-grade children were 10.8%, 25.2%, and 28.6%, respectively. In univariate analysis, subjects with reported daytime sleepiness had lower PA levels than those without daytime sleepiness (odds ratio (OR) = .67; 95% confidence interval (CI) = .47-.95). Multiple logistic regression analysis demonstrated that lower PA was significantly associated with daytime sleepiness after adjusting for multiple confounders (OR = .54; 95% CI = .37-.81). The prevalence of daytime sleepiness in fifth and sixth grades was higher than fourth grade. Furthermore, this study clarified the significant association between PA and daytime sleepiness and suggested that PA could be one of the factors to prevent daytime sleepiness in children aged 9-12 years.

Reliability and Validity of the Japanese Version of the Physical Activity Questionnaire for Older Children.

OBJECTIVES: This study aimed to examine the reliability and validity of the Japanese version of the Physical Activity Questionnaire for Older Children (PAQ-C) in Japanese children aged 9 to 12 years. METHODS: A total of 210 children aged between 9 and 12 years participated. Internal consistency and test-retest reliability were evaluated using Cronbach alpha coefficient and intraclass correlation coefficient (ICC), respectively. Validity was evaluated using athletic competence (AC), self-efficacy (SE), body mass index (BMI), body fat percentage (%BF), cardiovascular fitness (CVF), and World Health Organization Health Behavior in School-aged Children (WHO HBSC) physical activity questionnaire. RESULTS: Internal consistency was acceptable (alpha = 0.80) and test-retest reliability showed excellent agreement (ICC = 0.83). The PAQ-C score was significantly correlated with AC (r = 0.41), SE (r = 0.65), %BF (r = 0.19), and CVF (r = -0.32). The PAQ-C score of the active group classified by the WHO HBSC physical activity questionnaire (mean score ± standard deviation [SD] = 3.03 ± 0.57) was significantly higher than that of the inactive group (mean score ± SD = 2.27 ± 0.63, P < .01). CONCLUSIONS: The PAQ-C had acceptable reliability and validity. The PAQ-C is a useful instrument to evaluate physical activity for Japanese children aged 9 to 12 years.

Association Between Objectively Measured Physical Activity and the Number of Chronic Musculoskeletal Pain Sites in Community-Dwelling Older Adults.

OBJECTIVE: Physical inactivity is recognized as a pandemic health problem. The association of pain with physical activity, particularly when measured objectively, in older adults is unclear. This study investigates the association of number of chronic musculoskeletal pain sites and pain severity with objectively measured physical activity in community-dwelling older adults. DESIGN: Observational study. SETTING: Community. SUBJECTS: We analyzed 267 community-dwelling older adults (mean age = 75.3 years, 67.0% women). METHODS: Number of chronic musculoskeletal pain sites and pain severity were measured using a self-reported questionnaire. Mean steps per day and mean minutes of light physical activity per day and moderate to vigorous physical activity per day were measured using an accelerometer. Linear regression models were applied to analyze the association of number of chronic musculoskeletal pain sites and pain severity with physical activity. RESULTS: The results suggest that a higher number of chronic musculoskeletal pain sites is associated with lower step count (beta = -333.5, 95% confidence interval = -655.9 to -11.0, P < 0.05) and moderate to vigorous physical activity (beta = -2.5, 95% confidence interval = -4.7 to -0.4, P < 0.05) even after adjustment for age, gender, years of schooling, obesity, alcohol habits, smoking status, number of comorbidities, recent surgery, and depressive symptoms. CONCLUSIONS: Our results suggest that the number of chronic musculoskeletal pain sites is associated with low physical activity in older adults. Therefore, low physical activity due to chronic musculoskeletal pain should not be overlooked.

Association between joint stiffness and health-related quality of life in community-dwelling older adults.

OBJECTIVE: This study aimed to examine the association between joint stiffness and health-related quality of life (HRQOL) in community-dwelling older adults. METHODS: Participants in this cross-sectional study were 530 Japanese community-dwelling older adults (mean age, 73.9 years; women, 64.3%). Joint stiffness was assessed at the neck, low back, shoulder, elbow, hand or wrist, hip, knee, and ankle or feet; the duration of joint stiffness was also evaluated. We assessed HRQOL using the Short Form-12 (SF-12) and EuroQOL-5 Dimension (EQ-5D) questionnaires. We calculated the physical component summary scores (PCS) and mental component summary scores (MCS) from SF-12 and the EQ-5D index from EQ-5D. RESULTS: The prevalence of joint stiffness was 54.0%. Joint stiffness at two or more sites and at each site had a meaningful impact on PCS. Joint stiffness that lasted for 30min or more was meaningfully associated with low PCS and EQ-5D scores (PCS, 30-60min: beta=-6.122, P<0.05; >60min: beta=-5.962, P<0.01; EQ-5D index, 30-60min: beta=-0.068, P<0.01; >60min: beta=-0.070, P<0.01). Further, joint stiffness that lasted over 60min extended over MCS (MCS, >60min: beta=-3.212, P<0.05). CONCLUSIONS: Joint stiffness is associated with HRQOL. Assessing joint stiffness and intervention could be beneficial for HRQOL.

Influence of Habitual Physical Activity During Late Pregnancy on the Duration of Labor.

BACKGROUND: Physical activity during pregnancy has numerous benefits, but the influence on the duration of labor is unclear. We investigated the influence of habitual physical activity during late pregnancy on the duration of labor, with consideration of previous delivery experience and the stage of labor. METHODS: This prospective study included 103 women (48 nulliparous, 55 multiparous) in late pregnancy. Habitual physical activity was evaluated using the Baecke physical activity questionnaire (BQ). Women were divided into a high activity group (HA) and a low activity group (LA) based on their median total BQ score. Data pertaining to the duration of labor were obtained from the birth records after delivery. RESULTS: In multiparous women, the duration of the second stage of labor was significantly shorter in the HA group than in the LA group [median (range): HA, 11 min (1-102 min); LA, 20 min (4-175 min); P < .05]. The significant difference persisted after adjusting for confounding variables (standardized ß = -0.34; P = .01). In nulliparous women, there were no significant differences in duration of labor between groups. CONCLUSIONS: Higher physical activity in multiparous women during late pregnancy might positively influence the duration of the second stage of labor.