Effects of Physiatrist and Physiotherapist-supervised Therapeutic Exercise on Physical Function in Frail Older Patients with Multimorbidity.

Objectives: : To ease the burden on care facilities, there is a need to reduce the number of frail older people with multiple chronic and non-communicable diseases (multimorbidity) that require long-term care. We investigated the effects of therapeutic exercise in rehabilitation treatment for older individuals with frailty and multimorbidity. Methods: : We performed 4 weeks of inpatient rehabilitation treatment for frail older patients with multimorbidity. The therapeutic exercise was performed based on whole-body evaluations by qualified physiatrists and physiotherapists. Sixty-minute sessions were conducted twice a day and six times a week in accordance with the American College of Sports Medicine guidelines. Physical functions (grip strength, isometric lower muscle strength, 10-m walking test, and 6-min walking test) were measured at admission and discharge. Results: : Of the 33 patients, 8 were unable to complete physical function evaluations, and 1 patient had a stress fracture of the right calcaneus beyond the rehabilitation time. Twenty-four patients were included in the analysis. Compared to the admission period, significant improvements were observed for all evaluated parameters post-therapy (P < 0.05). However, no significant correlation was found between the number of chronic diseases and changes to physical function (P > 0.05). Conclusions: : Physical function of frail older individuals with multimorbidity improves through rehabilitation treatments supervised by physiatrists and physiotherapists. The number of chronic illnesses and the improvements in physical function were not related. Therefore, rehabilitation treatments for older patients may target both frailty and multimorbidity. Our results will aid in the rehabilitation treatment plans for this demographic.

Hypolipidemic effect of Shoyu polysaccharides from soy sauce in animals and humans.

Soy sauce (Shoyu) is a traditional Japanese fermented seasoning and is available worldwide. We investigated the effects of Shoyu polysaccharides (SPS) prepared from soy sauce on hyperlipidemia in vitro and in vivo. First, SPS inhibited pancreatic lipase. Second, in experiments with animals, it was found that SPS reduced serum triacylglycerol (TG) elevation induced by high-fat diets. Third, in a 2-week placebo-controlled parallel group study, healthy men (TG <150 mg/dl) were treated with 600 mg of SPS (n=5) or placebo (n=5) every day. After 2 weeks, serum TG elevation was significantly (P<0.05) lower in the SPS-treated group than in the placebo-treated group after 6 h of a high-fat diet. Fourth, in a 4-week randomized, double-blind, placebo-controlled parallel group study, hyperlipidemic men (TG >150 mg/dl) were treated with 600 mg of SPS (n=15) or placebo (n=15) daily. After 4 weeks, serum TG levels in the SPS-treated group were significantly (P<0.05) lower than the baseline (0 week). In conclusion, SPS of soy sauce reduce lipid absorption, and soy sauce is a potentially promising seasoning for the treatment of hyperlipidemia through food.

Synergistic degradation of arabinoxylan with alpha-L-arabinofuranosidase, xylanase and beta-xylosidase from soy sauce koji mold, Aspergillus oryzae, in high salt condition.

This study addresses induction and some properties of alpha-L-arabinofuranosidase from a soy sauce koji mold, Aspergillus oryzae HL15, cultured on solid and liquid media. Alpha-L-arabinofuranosidase was induced by soybean polysaccharide and secreted into media on solid cultivation; the enzyme was associated with mycelium as a cell-wall-bound form in liquid cultivation. A major alpha-L-arabinofuranosidase, which was purified homogeneously on SDS-PAGE, showed highest activity in the presence of 10% of NaCl; also, somewhat higher activity was observed even in 25% NaCl than in the absence of NaCl. Arabinoxylan was synergistically degraded by xylanase, beta-xylosidase, and alpha-L-arabinofuranosidase from A. oryzae HL15 in the condition of imitative pH 5.0 and 15% NaCl concentration of the soy sauce moromi mash. These results suggest that arabinose and xylose, which are closely related to melanoidin formation, can be released by synergistic action of these enzymes in soy sauce moromi mash.