BACKGROUND: In recent years, it has become clear that participation in social activities by the older adult suppresses their need for long-term care. Likewise, social participation can promote long-term care prevention among frail older adults who are at a higher risk of needing long-term care. However, their social participation rate is low, and the factors causing these low rates of participation are unclear. Therefore, this study identifies the factors affecting social participation of frail older adults. METHODS: After excluding those certified as requiring long-term care, 28,636 older adults within the target region were selected to receive questionnaires. The questionnaires were distributed and collected via mail. A total of 22,048 respondents (77.0%), including 9,325 men and 10,150 women, were included; 2,655 frail older adults were identified for analysis. Questionnaire items inquired about social participation, basic attributes, need for long-term care, mobility, subjective health, direct and indirect contact with relatives living separately and direct and indirect contact with friends and neighbors. For the statistical analysis, this study employed a binomial logistic regression analysis with social participation as the objective variable. RESULTS: The rate of social participation among frail older adults was 13.7%. Items related to social participation included sex, economic status, mobility, subjective health, direct contact with friends, and indirect contact with friends. CONCLUSIONS: Interactions with friends and neighbors and physical functionality are correlated with levels of social participation among frail older adults, suggesting that social participation can be promoted by maintaining friendships, forming new ones, and maintaining and improving physical functionality.
Frail Elderly , Social Participation , Male , Aged , Humans , Female , Cross-Sectional Studies , Japan/epidemiology , Independent Living
[Purpose] To assess the reliability and validity of accelerometer-based impact absorption rate measurements during single-leg drop-jump landings. [Participants and Methods] Study participants were healthy adult males. The task involved a single-leg drop-jump from the platform with a forward landing onto a floor reaction force plate. Accelerometers were fastened to the trunk, while foot switches were attached to the forefoot plantar surfaces. The impact absorption rate was calculated as the peak composite acceleration during the single-leg drop-jump landing divided by the duration from foot contact to the attainment of peak value. The loading rate (LR) was calculated by dividing the peak vertical force by the duration from foot contact to the attainment of peak value, leveraging the data obtained from a floor reaction force plate. Intraclass correlation coefficients (ICC) were used for intra- and inter-rater reliability analyses of 18 and 12 participants, respectively. The validity was examined through the correlation between impact absorption rate and LR in the 18 participants. [Results] The intra- (ICC (1,1)) and inter-rater (ICC (2,1)) reliabilities for the impact absorption rates were 0.89 and 0.88, respectively. A significant positive correlation was observed between impact absorption rates and LR (r=0.71). [Conclusion] The impact absorption rate may be valuable in clinical practice.
[Purpose] The purpose of this study was to verify whether Timed Up and Go (TUG) test measurements differed according to the seat height of the chair, presence or absence of armrests, and measurement location in young healthy adults, and to clarify the flexibility of the TUG settings. [Participants and Methods] Fifty-nine young healthy males and females participated in this study. The TUG test was performed under several conditions. Eight measurements were obtained at both the usual walking speed and the individual's fastest walking speed. [Results] There were no significant differences in TUG test measurements according to variation in seat height, different measurement locations, with and without the use of armrests, or at the usual walking speed or the fastest walking speed. [Conclusion] In young healthy adults, TUG test measurements were unaffected by differences in chair height, use of armrests, or the location of the measurement. If TUG measurements are found to differ according to these variables, it is necessary to consider the influence of the individual's ability rather than the measurement method.
Robot-assisted activity (RAA) using a communication robot (RAA-CR) has been proposed as a tool for alleviating behavioral and psychological symptoms accompanying dementia (BPSD) in patients with cognitive decline. This study aimed to clarify the effects of differences in cognitive function among older adults on changes in active brain areas induced by RAA-CR. Twenty-nine older adults were divided into a cognitive decline group (n = 11) and a control group (n = 18). The participants individually received a 5-minute RAA session, and their resting EEG activity was measured before and after the session. Brain spatial analysis was performed on recorded EEG data using standardized low-resolution brain electromagnetic tomography. In addition, statistical comparisons of neural activity in the brain were made before and after RAA-CR and between the cognitively impaired and control groups. These results suggest that RAA-CR stimulates neural activity in the region centered on the posterior cingulate gyrus and precuneus in cognitively healthy older adults but does not significantly alter brain neural activity in cognitively impaired older adults. Therefore, modifications to the implementation methods may be necessary to effectively implement RAA-CR in cognitively impaired individuals.
Background: The knee adduction moment (KAM) is considered an index for estimating the knee mechanical load, and increased KAM peak and KAM impulse are related to increased medial knee load and progression of knee joint degeneration. We aimed to verify the biomechanical factors of gait related to medial knee loading in patients 6 months after TKA. Methods: Thirty-nine women who underwent TKA were enrolled. A three-dimensional gait analysis was performed 6 months postoperatively to generate data on the lower limb joint angle, moment, and power at the backward component (braking phase) and forward component (propulsion phase) peaks of the ground reaction force. Medial knee loading was evaluated using the time-integrated value of KAM during the stance period (KAM impulse). The higher the value of the KAM impulse, the higher the medial knee joint load. The relationships between the KAM impulse and the data for biomechanical factors were evaluated using partial correlation analysis with gait speed as a control factor. Results: In the braking phase, the KAM impulse positively correlated with the knee adduction angle (r = 0.377) and negatively correlated with the toe-out angle (r = -0.355). The KAM impulse positively correlated with the knee adduction angle (r = 0.402), the hip flexion moment (r = 0.335), and the hip adduction moment (r = 0.565) and negatively correlated with the toe-out angle (r = -0.357) in the propulsive phase. Conclusion: The KAM impulse 6 months after TKA was related to the knee adduction angle, hip flexion moment, hip adduction moment, and toe-out angle. These findings may provide fundamental data for controlling variable medial knee joint load after TKA and implementing patient management strategies to ensure implant durability.
BACKGROUND: Patient-reported outcome measures (PROMs) have recently been considered as indicating clinical outcomes after total hip arthroplasty (THA). Although various factors are reportedly associated with post-THA and PROMs, the relationship with gait parameters, which are objective assessment factors after THA, remains unclear. RESEARCH QUESTION: What is the relationship between PROMs and gait biomechanical factors four weeks after THA? METHODS: Forty-five patients (six men and 39 women) who underwent THA were included. Three-dimensional gait analysis was performed four weeks post-THA; joint angle, internal moment, and power of the lower extremity at the first and second peaks of the vertical component of the floor reaction force were assessed for the operated side. PROMs were evaluated using the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ). The relationship between the JHEQ score and extracted gait parameters was analyzed using gender and gait speed as control factors. RESULTS: For the JHEQ sub-domain, movement was positively correlated with the internal knee extension moment values at the first peak (r = 0.347). There was no significant correlation between JHEQ and the internal hip abduction moment value at the first peak. Mental status was negatively correlated with the hip flexion angle value at the second peak (r = -0.373), and positively correlated with the hip flexion moment value (r = 0.348). Total JHEQ scores and mental status were negatively correlated with the power of hip flexion value at the second peaks, respectively (r = -0.316, -0.444). SIGNIFICANCE: The results of this study may provide recovery guidelines to be used as an index for gait assessment in the early post-THA period. Further studies are needed to verify whether gait parameters can improve PROMs in the early post-THA period.
Arthroplasty, Replacement, Hip , Female , Gait , Gait Analysis , Humans , Male , Patient Reported Outcome Measures , Postoperative Period
[Purpose] We aimed to investigate the central nervous system factors that affect muscle strength based on the differences in load and time using the discrete wavelet transform, which is capable of a time-frequency-potential analysis. [Participants and Methods] Surface electromyography (EMG) of the right upper bicep muscle in 16 healthy adult males were measured at 10% MVC (maximum voluntary isometric contraction), 30%, 50%, 70%, and 80% to 100% MVC. We used a discrete wavelet transform for the electromyographic analysis and calculated the median instantaneous frequency spectrum (MDF) and frequency band component content rate (FCR) at 1-ms intervals as well as their spectrum integrated values (I-EMG). [Results] MDF and FCR tended to be high throughout the measurements. Specifically, the high-frequency band component content rate was high at the time of low muscle strength; fast-twitch muscle fibers may be involved during these muscle contractions. We found significant changes in the I-EMG as the muscle strength increased from 10% MVC to 100% MVC. [Conclusion] Analyzing the surface electromyograph using discrete wavelet transform enabled us to assess the central nervous system factors that increase in the EMG amplitude integrated values and change in the median instantaneous frequency spectrum and in the frequency band component content rate.
BACKGROUND: This study was focused on the gait parameters of the knee extensor and hip abductor muscle groups, which are believed to contribute to knee joint function improvement in early postoperative TKA. The associations between patient-reported outcome measures (PROMs) 6 months after total knee arthroplasty (TKA) and the early postoperative internal knee extension moment, knee extension negative joint power, and internal hip abduction moment while walking were investigated. METHODS: Twenty-one patients who underwent primary TKA for knee osteoarthritis were included. Three weeks after TKA, gait at a comfortable speed was measured by three-dimensional motion analysis. The lower limb joint angle, internal joint moment, and joint power parameters on the operated side while standing were calculated. The PROMs 6 months after TKA were assessed using the Japanese Knee Osteoarthritis Measure (JKOM). The relationship between each gait biomechanical parameter and the JKOM was determined. RESULTS: The maximum internal knee extension moment and maximum knee extension negative joint power during the early stance showed moderate negative correlations with the JKOM scores. The maximum internal hip abduction moment was not correlated with the JKOM scores. The maximum internal hip extension moment during the early stance and internal hip flexion moment during the late stance showed moderate negative correlations with the total JKOM scores. CONCLUSION: The early postoperative internal knee extension moment, maximum knee extension negative joint power, and internal hip extension and flexion moment are associated with patient PROMs 6 months after TKA.
Arthroplasty, Replacement, Knee/methods , Gait/physiology , Knee Joint/surgery , Osteoarthritis, Knee/surgery , Patient Reported Outcome Measures , Range of Motion, Articular/physiology , Walking/physiology , Aged , Female , Follow-Up Studies , Humans , Knee Joint/physiopathology , Male , Osteoarthritis, Knee/physiopathology , Postoperative Period , Time Factors
Robot-assisted activity (RAA) is a non-pharmacological therapy used to treat behavioral and psychological symptoms of dementia. This study investigated the immediate effects of RAA on psychological and neurophysiological indices. Twenty-eight elderly people were assigned to the cognitive decline group (n = 11) or control group (n = 17) based on their Mini-Mental State Examination scores. After 5-min RAA sessions that involved patients interacting with a communication robot, patient emotions and mood states were measured, and resting-state EEG activity and salivary cortisol were assessed before and after RAA. We found that compared with those in the control group, participants in the cognitive decline group did not enjoy RAA using the communication robot. This was corroborated by EEG findings indicating decreased relaxation immediately after RAA exposure. These results suggested that participants with cognitive decline had difficulty understanding the contents of communication with the robot. Our results indicated that elderly people who have cognitive decline and use day-service centers are less likely to experience the immediate benefits of RAA, including positive emotions and mental relaxation. To conduct effective RAA for such populations, it may be useful to select a method that is better understood and enjoyed by participants.
[Purpose] This study evaluated the influence of vibratory stimulation-induced kinesthetic illusion on brain function after stroke. [Subjects] Twelve healthy individuals and 13 stroke patients without motor or sensory loss participated. [Methods] Electroencephalograms were taken at rest and during vibratory stimulation. As a neurophysiological index of brain function, we measured the µ-rhythm, which is present mainly in the kinesthetic cortex and is attenuated by movement or motor imagery and compared the data using source localization analyses in the Standardized Low Resolution Brain Electromagnetic Tomography (sLORETA) program. [Results] At rest, µ-rhythms appeared in the sensorimotor and supplementary motor cortices in both healthy controls and stroke patients. Under vibratory stimulation, no µ-rhythm appeared in the sensorimotor cortex of either group. Moreover, in the supplementary motor area, which stores the motor imagery required for kinesthetic illusions, the µ-rhythms of patients were significantly stronger than those of the controls, although the µ-rhythms of both groups were reduced. Thus, differences in neural activity in the supplementary motor area were apparent between the subject groups. [Conclusion] Kinesthetic illusions do occur in patients with motor deficits due to stroke. The neural basis of the supplementary motor area in stroke patients may be functionally different from that found in healthy controls.
[Purpose] The purpose of this study was to evaluate the lower limb muscle strength of the community-dwelling elderly, with or without cognitive decline, using isometric knee extension strength (IKES) and the 30-second chair stand test (CS-30). [Subjects] A total of 306 community-dwelling elderly participated in this study. Assessment items were the CS-30, IKES, Mini-Mental State Examination (MMSE), and Trail-Making Test Part A (TMT-A). [Methods] Participants were divided into three groups according to their MMSE score: cognitive impairment (MMSE ≤ 24), cognitive decline (MMSE 25 to 27), and normal (MMSE ≥ 28). We compared IKES and CS-30 among the three groups. [Results] IKES was not significantly different among the three groups. However, the CS-30 was significantly different among the three groups. Upon further analysis the CS-30 score of each group, when adjusted for age and TMT-A, did not indicate a significant difference. [Conclusion] These results suggest that the lower limb muscle strength of the elderly does not differ with cognitive decline. Moreover, we suggest that when using the CS-30 score as an indicator of lower limb muscle strength attentional function should be taken into account.
BACKGROUND: The purpose of this study was to examine task-related changes in prefrontal cortex (PFC) activity during a dual-task in both healthy young and older adults and compare patterns of activation between the age groups. We also sought to determine whether brain activation during a dual-task relates to executive/attentional function and how measured factors associated with both of these functions vary between older and younger adults. RESULTS: Thirty-five healthy volunteers (20 young and 15 elderly) participated in this study. Near-infrared spectroscopy (NIRS) was employed to measure PFC activation during a single-task (performing calculations or stepping) and dual-task (performing both single-tasks at once). Cognitive function was assessed in the older patients with the Trail-making test part B (TMT-B). Major outcomes were task performance, brain activation during task (oxygenated haemoglobin: Oxy-Hb) measured by NIRS, and TMT-B score. Mixed ANOVAs were used to compare task factors and age groups in task performance. Mixed ANOVAs also compared task factors, age group and time factors in task-induced changes in measured Oxy-Hb. Among the older participants, correlations between the TMT-B score and Oxy-Hb values measured in each single-task and in the dual-task were examined using a Pearson correlation coefficient.Oxy-Hb values were significantly increased in both the calculation task and the dual-task within patients in both age groups. However, the Oxy-Hb values associated with there were higher in the older group during the post-task period for the dual-task. Also, there were significant negative correlations between both task-performance accuracy and Oxy-Hb values during the dual-task and participant TMT-B scores. CONCLUSIONS: Older adults demonstrated age-specific PFC activation in response to dual-task challenge. There was also a significant negative correlation between PFC activation during dual-task and executive/attentional function. These findings suggest that the high cognitive load induced by dual-task activity generates increased PFC activity in older adults. However, this relationship appeared to be strongest in participants with better baseline attention and executive functions.
Aging , Hemodynamics/physiology , Prefrontal Cortex/physiology , Trail Making Test , Adult , Aged , Aged, 80 and over , Analysis of Variance , Female , Humans , Male , Mathematics , Oxyhemoglobins/metabolism , Problem Solving/physiology , Spectroscopy, Near-Infrared , Statistics as Topic , Young Adult
