Effects of Community Environment, Leisure, and Social Activities on Health Status of Older Adults with Diabetes in South Korea.

This study investigates the effects of community environment, leisure, and social activities on the health status of older adults with diabetes, a serious disease in modern society. Data from the 2020 National Survey of Older Koreans were analyzed. Descriptive statistics were used to assess participants' characteristics, and regression analyses were conducted to assess the effects of community environment, leisure, and social activities. Mediating effects were tested using hierarchical regression analysis and bootstrapping. The key results are as follows. (a) Community environmental satisfaction affected participation in leisure and social activities. (b) Community accessibility had a negative effect on subjective health, while community environmental satisfaction had a positive effect on subjective health, cognitive function, and chronic diseases. (c) Leisure activities had a positive effect on cognitive health, while social activities influenced subjective health, cognitive function, and chronic diseases. (d) Analysis of the mediating effect of leisure and social activities on the relationship between the community environment and health status of older adults with diabetes confirmed a partial mediating effect. To improve older adults' mental and physical health, mere quantitative increases in the community environment will not be sufficient. It is necessary to cultivate and manage professionals to increase opportunities for participation by increasing social exchanges and systematically managing older adults' health.

Exploring E-Health Literacy and Technology-Use Anxiety among Older Adults in Korea.

The COVID-19 pandemic has increased the importance of health literacy in disseminating information on health in a non-contact society. This study focused on examining the acceptance capacity by older adults of smart devices in Korea and investigating the potential differences between men and women in terms of e-health literacy and technology-use anxiety. The study included 1369 respondents who were adults over 50 years of age and used welfare centers, public health centers, senior citizen centers, and exercise centers in Seoul and Incheon. An online survey was conducted from 1 June 2021 to 24 June 2021. The study found that the older adults' low levels of digital literacy could limit their access to health information and negatively impact their health. The difference between men and women in terms of technology-use anxiety was statistically significant, with the latent mean for men being higher than that for women. The effect sizes of the potential mean differences were found to be at a medium level for e-health literacy and a significant level for technology-use anxiety. With Korea's aging population and the need for the continuous management of chronic diseases among older adults, it is essential to discuss internet-based health information for disease maintenance and treatment.

Development of Aerobic Exercise Equipment Using Universal Design: Treadmill and Arm Ergometer.

Exercise products based on universal design, which reduce restrictions on the exercise environment and ensure convenience and safe use, are beneficial for people with a disability; however, the current universal design only considers the preferences of the general population, which is not suitable for the disabled population. This results in the exclusivity of the sports facilities and supplies for people with a disability. Consequently, we explored the components of universal design and product satisfaction by considering users with disabilities and proposed the direction for designing extended universal exercise equipment that is suitable for them. Specifically, this study focuses on developing exercise equipment for people with a disability. Based on the results from the evaluation of acceptance and satisfaction of universal sports products for people with a disability using design thinking, we suggest the following. First, it is necessary to consider safety devices for exercise products. Second, the user interface should be improved in terms of convenience. Third, the ergonomic instrument design should be improved. Finally, the instrument design should be centered on user convenience.

Development of Evaluation Indicators for Sports Facilities for People with Disabilities Considering the Universal Design: Focusing on the Republic of Korea.

We developed evaluation indicators for sports facilities for people with disabilities and adopted the universal design to conduct Delphi surveys on sports facilities and sports experts. First, the range of universal design element reflection and the method of deriving the evaluation indicators were established through a literature review. Second, 21 experts conducted the first Delphi survey to select the important features of the seven principles of universal design and describe the necessary sub-factors to consider when designing sports facilities. The described elements were divided into 15 categories, and 49 sub-factors were extracted. Third, based on the evaluation of the indicators' content, acceptance was investigated, and the survey data were analyzed through indicators of reliability and validity of the sub-factors and categories. Fourth, we discussed whether to accept the standard value on the basis of the evaluation index through an expert meeting. Subsequently, the final evaluation index was obtained. The developed evaluation index should be applied by the operators and users of public sports facilities, and validation work is needed. Guidelines for applying the universal design to various sports facilities for people with disabilities should be developed. The financing of sports facilities applying the universal design and related policies should be discussed.

Developing Indicators to Evaluate Instructor Management of Sports Centers for the People With Disabilities Based on Universal Design Principles in South Korea.

This study was conducted to develop evaluation indicators for instructor-led management of sports centers for the disabled using universal design (UD) principles in South Korea. These indicators have been developed through Delphi technique to identify the effectiveness of an instructor's management skills. There were 11 documents related to UD used in the literature review, and seven were related to the evaluation index. Through reading and analyzing the relevant contents of the collected literature and many rounds of the Delphi technique, we selected the method and criteria for deriving the evaluation index. In this study, we developed a method that constitutes an evaluation index. The index comprises one evaluation criterion and four evaluation indices. First, for the sub-items of the "recruitment" category, four principles of UD and one supplementary principle of product performance program (PPP) were applied to create items for the evaluation index. Second, the sub-items of the "education" category comprise three evaluation criteria and 10 evaluation indicators. These were applied to the fourth principle of UD and the first and second by-supplementary principles of PPP. The third category, "welfare," comprised two evaluation criteria and six evaluation indices, and the first by-supplementary principle of PPP was applied to the evaluation indices. The index created for evaluating instructors in sports centers using the method elucidated in this study was adequately reliable. Following a similar method, more evaluation indicators should be developed for evaluations of other functions (such as programs, public relations, safety, and finance) based on the principles of UD.

Microneedle Array Electrode-Based Wearable EMG System for Detection of Driver Drowsiness through Steering Wheel Grip.

Driver drowsiness is a major cause of fatal accidents throughout the world. Recently, some studies have investigated steering wheel grip force-based alternative methods for detecting driver drowsiness. In this study, a driver drowsiness detection system was developed by investigating the electromyography (EMG) signal of the muscles involved in steering wheel grip during driving. The EMG signal was measured from the forearm position of the driver during a one-hour interactive driving task. Additionally, the participant's drowsiness level was also measured to investigate the relationship between muscle activity and driver's drowsiness level. Frequency domain analysis was performed using the short-time Fourier transform (STFT) and spectrogram to assess the frequency response of the resultant signal. An EMG signal magnitude-based driver drowsiness detection and alertness algorithm is also proposed. The algorithm detects weak muscle activity by detecting the fall in EMG signal magnitude due to an increase in driver drowsiness. The previously presented microneedle electrode (MNE) was used to acquire the EMG signal and compared with the signal obtained using silver-silver chloride (Ag/AgCl) wet electrodes. The results indicated that during the driving task, participants' drowsiness level increased while the activity of the muscles involved in steering wheel grip decreased concurrently over time. Frequency domain analysis showed that the frequency components shifted from the high to low-frequency spectrum during the one-hour driving task. The proposed algorithm showed good performance for the detection of low muscle activity in real time. MNE showed highly comparable results with dry Ag/AgCl electrodes, which confirm its use for EMG signal monitoring. The overall results indicate that the presented method has good potential to be used as a driver's drowsiness detection and alertness system.

A Study on the Influence of Social Leisure Activities on the Progression to the Stage of Frailty in Korean Seniors.

In this study, we performed a logistic regression analysis according to the frequency of participation in social leisure activities (education, clubs, social groups, volunteer activities, religious activities, and senior citizens' welfare center use) by men and women aged ≥ 65 years. We investigated the frequency of participation in social leisure activities and their association with the level of frailty (health vs. pre-frailty, health vs. frailty, pre-frailty vs. frailty). This study included 10,297 older adults (men: 4128, women: 6169) who participated in the 2017 National Survey of Older Koreans, and were divided into three groups (healthy, pre-frailty, and frailty). Five frailty index components were used to measure the frailty level. There was a positive relationship between the elderly's religious activities, four times a week, from the healthy stage to the frailty stage, from the healthy stage to the pre-frailty stage, and from the pre-frailty stage to the frailty. In addition, positive associations emerged in leisure activities and club activities, respectively, from the healthy stage to the frailty stage (once a week, respectively). Positive association also emerged from the healthy stage to the pre-frailty and from the pre-frailty stage to the frailty stage (once a month to once in a two-week period).

Verification of the Mediating Effect of Social Support on Physical Activity and Aging Anxiety of Korean Pre-Older Adults.

There is a lack of research on Korean prospective elderly persons. In particular, there is little research regarding whether social support has a mediating effect on the relationship between physical activity and aging anxiety. Accordingly, this study investigated how social support affected physical activity and aging anxiety in 778 prospective senior citizens (55 to 65 years old) out of a total of 1447 senior citizens who participated in the Embrain Panel Power and Panel Marketing Interactive. Participants completed the IPAQ (International Physical Activity Questionnaires), Social Support Scale, and Aging Anxiety Scale. Physical activity in these Korean pre-older adults affected aging anxiety (p < 0.001), with a fixed effect of physical activity on social support (p < 0.001). Further, social support affected aging anxiety (p < 0.001). Social support was also an important parameter in the relationship between physical activity and aging anxiety. In conclusion, high physical activity of pre-older Korean persons lowered their anxiety regarding aging. Social support acted as a mediator that lowered anxiety regarding aging in the most active pre-older persons.

Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women.

OBJECTIVE: We investigated the effectiveness of a 12-week SaBang-DolGi walking exercise program on the physical and mental health of menopausal women and aimed to provide the basic data needed to develop health promotion programs for the active and healthy aging of menopausal women. MATERIALS AND METHODS: The participants comprised 40 women aged 50-65 years who were divided into two randomly selected groups in training sessions (exercising group, n = 21 and control group, n = 19). A physical (grip, muscle and endurance) test and mental health test (simple mental health test II) were conducted using questionnaires with the aim of examining subjects' physical and mental health before and after exercise. RESULTS: After the intervention, the participants experienced positive changes in the physical dimension, with significant enhancements particularly in mental well-being and menopause-related health and subdomains. Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. CONCLUSIONS: We found that the SaBang-DolGi walking exercise program helps to promote the physical and mental health of menopausal women who are exposed to the various stresses and depressions that accompany physical deterioration; the program was found to encourage active and healthy aging.

Swimming Exercise Ameliorates Symptoms of MOG-Induced Experimental Autoimmune Encephalomyelitis by Inhibiting Inflammation and Demyelination in Rats.

PURPOSE: Multiple sclerosis is an autoimmune disease that affects the central nerve system, resulting in cumulative loss of motor function. Multiple sclerosis is induced through multiple mechanisms and is caused by inflammation and demyelination. This study aims to evaluate the neuroprotective effect of swimming exercise in experimental autoimmune encephalomyelitis (EAE) rats, an animal model of multiple sclerosis. METHODS: EAE was induced by an intradermal injection of 50-µg purified myelin oligodendrocyte glycoprotein 33-55 (MOG33-55) dissolved in 200-µL saline at the base of the tail. The rats in the swimming exercise group were made to swim for 30 minutes once pert a day for 26 consecutive days, starting 5 days after induction of EAE. To compare the effect of swimming exercise with interferon-ß, a drug for multiple sclerosis, interferon-ß was injected intraperitoneally into rats of the EAE-induced and interferon-ß-treated group during the exercise period. RESULTS: Injection of MOG33-55 caused weight loss, decreased clinical disability score, and increased level of pro-inflammatory cytokines and inflammatory mediators in the lumbar spinal cord. Loss of motor function and weakness increased demyelination score. Swimming exercise suppressed demyelination and expression of pro-inflammatory cytokines and inflammatory mediators. These changes promoted recovery of EAE symptoms such as body weight loss, motor dysfunction, and weakness. Swimming exercise caused the same level of improvement as interferon-ß treatment. CONCLUSION: The results of this experiment suggest the possibility of swimming exercise in urological diseases that are difficult to treat. Swimming exercises can be considered for relief of symptom in incurable multiple sclerosis.

Analysis of differences in subjective health status according to characteristics of hospitalized cancer patients.

This study is intended to analyze differences in the self-rated health of patients according to the characteristics of hospitalized cancer patients. To this end, this study analyzed the differences in self-rated health according to cancer diagnosis type, cancer stage and adjunctive treatment and analyzed the recognition of difficulties in physical activities during hospitalization. A questionnaire survey was conducted among data of 162 hospitalized cancer patients. For the self-rated health of cancer patients according to diagnosis type, it was lower in the gastric cancer group than in the thyroid cancer group and the breast cancer group. For self-rated health according to cancer stage, it was higher in the order of the stage 3 group, stage 2 group and stage 1 group. For the self-rated health of patients receiving adjunctive treatment, it was the lowest in the chemotherapy+radiotherapy group. And for personal constraints according to cancer stage in the category of "physical," it was higher in the stage 3 group than in the stage 1 group. For hospital environment restrictions according to cancer stage in the category of "tool," it was higher in the stage 1 group than in the stage 3 group. In conclusion, personal constraints on the physical activities of cancer patients appear to be due to fatigue and a lack of motivation, but medical services that influence motivation are critical to individual and continued care strategies for the patients.

A study of the physical activity restriction in the cancer patients using hierarchical regression analysis.

This study aimed to examine and analyze the relationship between the physical activity of cancer patients during the hospitalization and the change in exercise recognition and restrictions on physical activity in depth. In this study, adult cancer patients aged more than 20 years residing in the metropolitan area (such as Seoul, Gyeonggi, and Incheon) were selected as a population, and 194 cancer patients from five general hospitals located in metropolitan area were selected as subjects by the purposive sampling. The relative importance for the effect on the physical restriction was greater in the order of the time spent in sedentary activities and exercise positive recognition. The relative importance for cognitive psychological restriction was greater in the order of negative exercise recognition, positive exercise recognition, the time spent in sedentary activities, the time spent in ordinary daily activities and the time spent in intentional movement. In the hospital environment restriction, the facility had a statistically significant effect on the movement and positive exercise recognition. But, sociocultural restrictions were not affected by positive exercise recognition. As a result of this study, it was found that the physical activity restrictions of the cancer patients may affect differently depending on the physical activity level, exercise experience, and exercise recognition, requiring the interpretation of the physical activity restrictions in various ways.

Analysis of the relationship between physical activity and metabolic syndrome risk factors in adults with intellectual disabilities.

The purpose of this study was to investigate the relationship between physical activities and metabolic syndrome risk factors in adults with intellectual disabilities. Seventeen adults with intellectual disabilities at a sheltered workshop wore Actical for 5 days on workdays to measure their physical activity, and blood samples were taken to measure their physical fitness factors and examine their risk factors for metabolic syndrome. The average daily physical activity was found to be 655.41± 129.36 kcal, and the average total physical activity over 5 days was 3,224.94±149.68 kcal. A positive correlation was confirmed between physical activity and muscular strength, muscular endurance, total cholesterol, low-density lipoprotein cholesterol and disability rating. Factors that predicted physical activity of adults with disabilities were disability rating (t=6.280, P<0.001) and glycated hemoglobin (t= -2.315, P<0.036), which had a 73.9% correlation (R 2=0.739) with the physical activities of adults with intellectual disabilities. In conclusion, the physical activity level of adults with intellectual disabilities was significantly lower than that of adults in similar age groups, and such low physical activity may affect their muscular strength, muscular endurance, and metabolic syndrome risk factors. Therefore, additional studies on programs to improve and enhance physical activities at sheltered workshops, where adults with intellectual disabilities are mainly supervised and active, and guidelines for continuous health management are needed.

Factors that influence hospital inpatients' exercise constraints.

The purpose of this study is to present ways to provide more precise patient-oriented services by presenting implications and promoting a better understanding of exercise constraints. This study used questionnaire survey as measurement tool for 196 hospital inpatients in 5 general hospitals in the metropolitan area (Seoul, Gyeonggi, and Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis, correlation analysis, and hierarchical regression analysis using IBM SPSS Statistics ver. 23.0. The following results were obtained. First, physical activity level and health condition on their physical constraints showed that their health condition factors such as pain/discomfort and anxiety/depression had greater effects on physical constraints than other factors. Second, physical activity level, and health condition on their psychological constraints showed that health condition factors had major effects on patients' psychological constraints. Thirdly, physical activity level, and health condition on their sociocultural constraints found that anxiety/depression appeared as the key influence factor in physical and psychological constraints.

Trend of Daily Sports Participation in Korean Aged Population and Sports Policy: A Review of Research on Public Daily Sports Participation.

BACKGROUND: This study aimed to investigate the trend of physical activity and daily sports participation in the Korean aged population through the review of 'Research on Public Daily Sports Participation' published by the Ministry of Culture, Sports and Tourism. The main purpose was to suggest the best health and sports policy for the future. METHODS: The result of the research conducted by the government was published 13 times in total from 1989 to 2015. The aged were defined as people in their 60s and 70s since 2006. Based on the research published 7 times from 2006 to 2015, this study analyzed the changes and the trend recognition of health status, physical activities, sports activity effects and environment in the aged population in South Korea. RESULTS: Majority of the aged population was found to hardly recognize their health status, but positively aware of physical and sports activity effect, particularly that the sports facility environment has been improving. Therefore, it is encouraged to set up elderly-friendly routine sports environment to motivate their participation and consequently establish healthy exercise culture. CONCLUSION: This study has great significance as it suggests the direction of future health and sports policy by analyzing the trend of previous physical activities and daily sports participation among the aged population based on the government-published research.

The influence of environmental constraints within hospitals on physical activity level of cancer patients.

This study aims to examine the influence of hospital environmental constraints on physical activity level of cancer patients. The subjects of this study were 194 cancer patients from five general hospitals in the Seoul metropolitan area (Seoul, Gyeonggi-do, and Incheon). The collected data was analyzed by using SPSS ver. 23.0. As a result of analyzing the effect of environmental constraints on the physical activity level of cancer patients, the constraints related to hospital facilities and programs had no effect on patients' time spent in a hospital bed and their time spent on daily. However, the time cancer patients spend on intentional physical movements is affected by hospital facilities or programs. This means that hospital facilities or programs play an important role in patients' intentional physical activities. In conclusion, for hospitalized cancer patients, physical activity levels are influenced by environmental constraints in the hospital. Therefore, it is important to improve the hospital environment to increase physical activities such as walking and physical exercise, which are an important factor for cancer recovery and prevention of recurrence.

Development and validation of exercise rehabilitation program for cognitive function and activity of daily living improvement in mild dementia elderly.

We investigated the effect of exercise rehabilitation based on fine motor movement for the elderly with mild dementia. Using electroencephalogram (EEG), the change of brain wave of them based on fine motor movement and comparing the improvement level of cognitive ability and performance capability in daily living activity was recorded. The subjects were the elderly with mild dementia living in a sanatorium in Incheon city. Mini-Mental Status Examination, activity of daily living (ADL), and the influence on depression were examined. After 8-week exercise program, significant difference in cognitive function and ADL was observed, however, and there was no significant difference in depression. In the EEG, there was a significant difference in α-wave. This study suggests the chance to remind the necessity of exercise programs for improving cognitive function and ADL of the elderly with dementia.

Analysis of differences in exercise recognition by constraints on physical activity of hospitalized cancer patients based on their medical history.

The purpose of this study is to analyze the differences among the hospitalized cancer patients on their perception of exercise and physical activity constraints based on their medical history. The study used questionnaire survey as measurement tool for 194 cancer patients (male or female, aged 20 or older) living in Seoul metropolitan area (Seoul, Gyeonggi, Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis t-test, and one-way distribution using statistical program SPSS 18.0. The following results were obtained. First, there was no statistically significant difference between cancer stage and exercise recognition/physical activity constraint. Second, there was a significant difference between cancer stage and sociocultural constraint/facility constraint/program constraint. Third, there was a significant difference between cancer operation history and physical/socio-cultural/facility/program constraint. Fourth, there was a significant difference between cancer operation history and negative perception/facility/program constraint. Fifth, there was a significant difference between ancillary cancer treatment method and negative perception/facility/program constraint. Sixth, there was a significant difference between hospitalization period and positive perception/negative perception/physical constraint/cognitive constraint. In conclusion, this study will provide information necessary to create patient-centered healthcare service system by analyzing exercise recognition of hospitalized cancer patients based on their medical history and to investigate the constraint factors that prevents patients from actually making efforts to exercise.

A study on the effects of exercise motivation of the elderly people on euphoria.

The present study aimed to empirically determine the relationship between the degree of exercise participation by the elderly people and their euphoria. The analysis results are as follows. First, the difference between the elderly people's participation in the exercises and the euphoria that they have experienced showed that in all low variables of euphoria, the group who participated in the exercises showed a higher level of euphoria than the group who did not participate in the exercises. Second, the analysis of the effects of the elderly people's motivations for exercise participation on euphoria showed that there was a significant relation between the two. Furthermore, the following suggestions were made for areas that the current study did not cover, as well as for the follow-up studies. The follow-up studies would need an in-depth multiangled analysis of various fun factors in order to encourage the elderly people to participate in the exercises by conducting interviews and observation studies with the study participants.

Nationwide survey of cancer center programs in Korea.

This study was conducted to investigate cancer centers established for the purpose of satisfying various needs about cancer, improving the cancer treatment environment, and subdividing services ranging from diagnosis, treatment, and rehabilitation to palliative care. To this end, the authors have surveyed programs in 17 cancer centers representing Korea, including 12 national cancer centers and five major hospitals. As a result, it was found that the most common type of lecture program was disease management, followed by health care and hospitalization, while the most common type of participation program was psychological relief, followed by physical activity. The most frequently operated type of program was found to be psychological relief, followed by physical activity and health care in the regional cancer centers, while the most frequently operated type was disease management, followed by psychological relief and health care in the five major hospitals. The proportion of physical activity was very high in two regional cancer centers, whereas five regional cancer centers did not offer physical activity programs at all. In the five major hospitals, physical activity programs were conducted regularly at least once a month or at least once a week. In addition, further studies are required to provide professional and detailed medical services for the establishment and operation of programs for cancer patient management and the environmental aspects of the hospital.