Psychometric Properties of the Japanese Version of the Health Enhancement Lifestyle Profile (HELP-J) Using Rasch Analysis: A Preliminary Study.

The Health Enhancement Lifestyle Profile (HELP) was an assessment instrument for health-related behaviors and was translated into Japanese (HELP-J) using subjective rating scales. This study investigated the internal validity of the HELP-J using a Rasch analysis. Snowball and purposive sampling were used for data collection. The data obtained from the 109 respondents were subjected to Rasch analysis to assess their internal validity. The rating scale analysis supported a 3-category scale; five of the seven subscales showed unidimensionality. Thus, this study presents essential information on the possibility of translating the original HELP into Japanese and converting it into a unidimensional scale.

Relationship Between Gliding and Lateral Femoral Pain in Patients With Trochanteric Fracture.

OBJECTIVE: To investigate the association between gliding and lateral femoral pain with trochanteric fracture (TF). DESIGN: Prospective cohort study. SETTING: The survey was conducted at approximately 3 weeks and 11 weeks post operation. PARTICIPANTS: Patients (N=23) with TF after surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Pain was assessed using a numeric rating scale for the following 5 conditions: rest pain, tenderness pain, stretch pain (SP), contraction pain, and weight-loading pain. Based on weight-loading pain, the subjects were divided into 2 groups: severe and moderate. Gliding of both the vastus lateralis (VL) muscle and subcutaneous (SC) tissue were recorded during knee motion using B-mode ultrasonography with a 12-MHz linear transducer fixed on the lateral thigh using an original fixation device. Particle image velocimetry analysis software was adapted to create the flow velocity of both VL muscle and SC tissue from echo imaging, and 2 regions of interest were selected on the VL muscle and SC tissue. Gliding was calculated using a coefficient of correlation from each time series data set. RESULTS: Gliding and pain (stretch/contraction) were significantly different between the 2 groups at 3 weeks post operation. Changes in both weight-loading pain (r=0.49) and SP (r=0.42) correlated significantly with improvements in gliding. CONCLUSION: Patients with weight-loading pain after surgery for TF showed decreased gliding during recovery, and an improvement in gliding was associated with improvements in both weight-loading pain and SP.

The Relationship Between Meaningful Occupation and Self-Rated Health in Japanese Individuals: The Wakayama Study.

In this study, we conducted a quantitative cross-sectional evaluation of the relationships between self-related health and occupational form, occupational performance, and occupational satisfaction. The participants were 675 community-dwelling subjects (283 men, 392 women) who completed a self-administered questionnaire. From this data, we performed a multiple logistic regression analysis using the high and low values of self-rated health as the dependent variables and the characteristics of occupational form, occupational performance, and occupational satisfaction as the independent variables. There were three analysis models: Model 1, which mutually adjusted for all the independent variables; Model 2, with adjustment of the basic attributes, in addition to the first model; and Model 3, which was based on Model 2, but also adjusted for diseases. In all three models, high self-rated health was significantly correlated with high occupational performance scores. These findings confirmed that supporting occupational performance improvement is useful for improving self-rated health.

Effects of real-time VR clinical practice on reducing the stigma toward dementia among students of occupational therapy: A randomized controlled trial.

Aim: This study aimed to examine the effects of real-time online clinical practice using real-time virtual reality (VR) compared with 2D PC screening on reducing stigma toward dementia, and to investigate the feasibility of online clinical practice using VR. Methods: A single-center, open-label, randomized controlled trial was conducted. Occupational therapy students were randomized to view occupational therapy evaluation screens for dementia patients using a VR headset or 2D monitor. The Attitudes Toward Dementia Scale (ADS), the Dementia Knowledge Scale (DKS), and Images of the Elderly with Dementia (IED) were assessed before and after the intervention. The level of clinical practice satisfaction and the System Usability Scale (SUS) were also assessed. Results: The number of subjects in the intervention and control groups was 10 and 9, respectively. In ADS scores and IED, the main effect was shown in both groups and did not show interactions. In DKS scores, the main effect and interaction were not shown. The VR headset tended to be more usable than the 2D monitor in terms of usability. Satisfaction ratings indicated the characteristics of a realistic clinical experience through real-time VR viewing. Conclusion: Real-time VR and 2D online clinical practice could reduce the stigma toward dementia, but there were no significant differences between the types. The real-time VR experience was more similar to actual clinical practice than a 2D PC screening due to the sense of immersion, but issues in blinding and lack of audio and video quality were found.

Factors influencing caregivers' burden among family caregivers and institutionalization of in-home elderly people cared for by family caregivers.

OBJECTIVES: The purpose of this study was to determine the factors related to changes in the burden of caregivers who look after the elderly at home, as well as factors related to the institutionalization of the elderly who require care. The types of care services associated with reducing caregivers' burden and continuing in-home care were also studied. METHODS: The study subjects were adults aged ≥65 years who used the services of in-home care management centres located in Osaka Prefecture, Japan, and their caregivers. This 2-year longitudinal study began in October 2007, with a total of three surveys undertaken once a year. The survey methods included self-administered questionnaires and the review of clinical records. RESULTS: Dementia and its accompanying behavioural disturbances were found to be significantly related to the increased burden of caregivers and the institutionalization of those requiring care. A significantly higher proportion of caregivers with an increasing burden or those who maintained a high level of burden used day care services compared to those in the other groups. CONCLUSION: Preventive intervention against dementia and its accompanying behavioural disturbances should be considered in the day care service to reduce caregivers' burden and to decrease institutionalization.

Effects of cigarette smoking on the association between respiratory muscle strength and skeletal muscle mass in middle-aged and older adults: the Wakayama Study.

PURPOSE: This study aimed to examine whether cumulative smoking exposure affects the association between peak expiratory flow rate (PEFR) and skeletal muscle mass in middle-aged and older adults. METHODS: The study participants comprised 832 community-dwelling individuals aged 50-89 years (mean age: 69 years) without chronic obstructive pulmonary disease. Bioelectrical impedance analysis was performed to estimate the skeletal muscle mass of each participant. PEFR was assessed using an electronic spirometer. Cumulative smoking exposure was expressed in pack years, that is a product of the average number of packs of cigarettes smoked per day and smoking duration in years. RESULTS: The whole-body skeletal muscle mass progressively reduced with decreasing PEFR levels in both males and females. In the multiple regression analysis, PEFR was found to be significantly associated with skeletal muscle mass, independent of the potential confounding factors. When participants were stratified based on the cumulative smoking exposure, the association between low PEFR and reduced skeletal muscle mass persisted in individuals with non-smoking and light-to-moderate smoking exposure (< 30 pack-years). However, this association was not clearly observed in individuals with heavy smoking exposure (≥ 30 pack-years). CONCLUSION: The findings of this study support the notion that PEFR declines with a reduction in systemic skeletal muscle mass due to aging. However, chronic cigarette smoking induces respiratory dysfunction exceeding the expected values by age, and thus a low PEFR level may not be used as a marker of reduced muscle mass in older adults exposed to heavy smoking.

Associations between deterioration of self-rated health and occupational form among community-dwelling Japanese individuals.

Objectives: In occupational therapy, occupations refer to everyday activities that people perform as individuals, in families, and with communities to live a meaningful life. Thus far, there has been no large-scale survey conducted using quantitative data to study deterioration of self-rated health from an occupational perspective. This large-scale study therefore aimed to clarify the associations between deterioration of self-rated health and occupational form, performance, and satisfaction using quantitative data. Study design: One-year prospective cohort study. Methods: Subjects included 438 community-dwelling individuals (175 males and 263 females; mean age, 66.3 ± 10.5 years) who participated in the study during 2017-2018. We administered to patients a questionnaire on self-rated health and occupational form (number, frequency, and duration), occupational performance, and occupational satisfaction. A multi-level Poisson regression analysis was performed, wherein deterioration of self-rated health was the dependent variable and occupational form, performance, and satisfaction were the independent variables. In Model 1, the independent variables were adjusted for each other; in Model 2, sex, living alone, and alcohol consumption were added to Model 1; and in Model 3, disease was added to Model 2. Results: The frequency of occupation monthly/yearly was associated with deterioration of self-rated health compared to that daily/weekly among those aged <65 years. Adjusted prevalence ratios (95% confidence interval) for models 1, 2, and 3 were 2.95 (1.07-8.18), 3.19 (1.13-8.99), and 3.81 (1.29-11.20), respectively. Conclusions: This study revealed factors for the deterioration of self-rated health from an occupational perspective that was directly related to daily life. Increasing the occupation frequency may be more important than increasing the number and duration of occupation to prevent deterioration of self-rated health.

Relationship between Fall History and Self-Perceived Motor Fitness in Community-Dwelling People: A Cross-Sectional Study.

History of falling is an important fall risk factor. If a relationship between fall history and self-perceived motor fitness could be established, then treating it as a correctable risk of re-fall due to falls may be possible. We conducted a cross-sectional study of the relationship between fall history and self-perceived motor fitness in daily life among 670 community-dwelling people (mean age 62.0 ± 9.6 years, 277 men and 393 women) who had participated in health examinations. They completed a self-administered questionnaire that asked about their history of single or multiple falls and included a 14-item motor fitness scale. The responses were analyzed using multivariate logistic regression analysis. The results showed that in both younger and older (<65 years) subjects, a history of single or multiple falls was associated with a negative response to "being able to put on socks, pants or a skirt while standing without support". For subjects ≥65 years, an association was also observed with "shortness of breath when climbing stairs". Self-perceived motor fitness related to fall history can easily be noticed by an individual and may help them become aware of fall-related factors earlier in everyday life.

The Age at Diagnosis of Autism Spectrum Disorder in Children in Japan.

BACKGROUND: No large-scale study of the timing of autism spectrum disorder (ASD) diagnosis has been performed in Japan to date. The aim of this study was to examine sex differences and annual trends in age at diagnosis of ASD using clinical data. METHODS: Clinical data for children aged less than 18 years diagnosed with ASD between January 1, 2009, and December 31, 2013, and in whom follow-up was possible 1 year after diagnosis, were extracted. RESULTS: The mean age at ASD diagnosis was 7.2 ± 4.2 years and the mode age was 3 years. No sex difference was observed for age at diagnosis (p = 0.157). An annual trend of earlier diagnosis was observed when fiscal years were compared (p < 0.001). CONCLUSION: This study highlighted the need to develop and provide appropriate early intervention methods and services for ASD children in Japan.

Short stick exercises for fall prevention among older adults: a cluster randomized trial.

PURPOSE: To investigate the effects of short stick exercise (SSEs) on fall prevention and improvement of physical function in older adults. METHODS: A cluster randomized trial was conducted in five residential care facilities. The intervention group (n = 51) practiced SSEs for six months, followed by routine care for six more months. The control group (n = 54) received ordinary care for 12 months. The primary outcome measure was the number of fallers, taking into account the time to first fall using the Kaplan-Meier method. The secondary outcome measures were physical and mental functions. RESULTS: The number of fallers was significantly lower in the intervention group (n = 6) than in the control group (n = 16) during the 12 months. The adjusted hazard ratio for a first fall in the intervention group compared with the control group was 0.15 (CI, 0.03 to 0.74, p = 0.02). The fall-free period was significantly longer in the intervention group than in controls (mean ± SD, 10.1 ± 3.0 versus 9.0 ± 4.1 months, p = 0.027). The functional reach and sit and reach tests were significantly improved at three and six months. CONCLUSION: The SSEs appeared effective for fall prevention and improvement of physical function in older adults. Implications for Rehabilitation The newly developed short stick exercises appear an effective means of reducing falls among older adults in residential care facilities. The short stick exercises seem to have an immediate effect on improving physical functions. Effects gained by performing the short stick exercises, such as static balance, flexibility and agility may last for six months. The short stick exercises were found to be easy for older adults to practice continuously in residential care facilities.

Assessment of the exercise intensity of short stick exercises in elderly individuals.

The present study was to obtain basic data for applying the short stick exercises to frail elderly individuals. A total of 20 individuals aged ≥60 years (10 men, and 10 women) with independence in activities of daily living participated in a short stick exercise program. During the exercise program, the time required and the number of times the short stick was dropped were investigated. The exercise intensity was also evaluated based on expired gas and heart rate measurements. The mean exercise intensity of the short stick exercises was 1.9 ± 0.3 metabolic equivalents (METs), equivalent to talking while standing or walking indoors. Compared to the early elderly (those aged 60 to 74 years), the late elderly (those aged ≥75 years) had a significantly higher number of stick drops and significantly lower increase in heart rate from resting to the warming-up exercise. The short stick exercises had a low exercise intensity and can be applicable to exercise interventions of the frail elderly individuals. However, in the case of the late elderly, the high frequency of short stick drops and the change in heart rate during warming up must be considered.

Morphologic classification of nailfold capillary microscopy in workers exposed to hand-arm vibration.

The aim of this study was to investigate the association between the morphologic classification of nailfold capillary microscopy and the clinical and demographic findings in workers exposed to hand-arm vibration. The subjects were 44 male forestry workers (average age; 51.9 ± 14.8 yr). The nailfold capillaries (NC) and the mean blood flow velocity were measured on the middle finger of the dominant side by a peripheral capillary observer. The analyses were made using 39 subjects after excluding five subjects who received medication for hypertension. The observed NC were classified into 5 types according to Kusumoto's classification: Type I, n=5; Type II, n=15; Type III, n=8; Type IV, n=5; and Type V, n=6. After excluding the subjects in the Type V, we divided the subjects into two groups: Type I/II group, n=20; and Type III/IV group, n=13. In the Type III/IV group, the operating year of handheld vibrating tools was relatively longer, the mean blood flow velocity was significantly slower, and the body mass index was relatively higher as compared to the Type I/II group. These results suggested that the nailfold capillary microscopy may reflect the effect of the vibration exposure.