Purpose : The present quasi-experimental study investigated the efficacy of an exercise class at a community clinic for middle-aged and elderly patients with lifestyle-related diseases who were being treated at the clinic. Methods : The study examined two groups of subjects : an intervention group of 56 patients who participated in the exercise class and a control group of 56 outpatients matched with the intervention group for age, gender, and BMI. Lifestyle-related disease indicators, physical activity, behavior modification stage, exercise-induced changes in subjective symptoms, and change in lifestyle were assessed. Ranging from mild to moderate in intensity, the exercise regimen consisted primarily of aerobic exercises, with some resistance exercises. No restrictions were placed on number of repetitions or duration of exercise. Results : Significant declines in BMI, blood pressure, and HbA1c were observed in the intervention group. Physical activity for the intervention group increased by an average of 5.9 METs·hours/week. The subjects reported significant improvements in behavior modification stage and gave high marks for the exercise-induced changes in subjective symptoms. Conclusions : For middle-aged and elderly patients with lifestyle-related diseases, participation in an exercise class held at a community clinic visited periodically by the patients improved behavior modification stage, BMI, blood pressure, and HbA1c. The results suggest that exercise classes held at community outpatient clinics visited at regular intervals by patients can be useful in improving lifestyle-related diseases.
In most mountainous local communities in Japan, self-help ability and social capital is critically important to solve and/or mitigate various kinds of problems in their daily life because of depopulation and ageing in the communities. This paper investigates the prevalence of health worries and uneasiness in the local people in order to consider about their self-help ability and social capital, and analyses its related factors on individual, household and local community basis. The interview was conducted for all the people above 18 years old, who were present on the research day (1,445 people, and 72% of the target population). As a result, the prevalence of health worries and uneasiness was the highest, followed by that of socio-economic complaints and others. Moreover, it was associated more with age than sex and household income and social activities and number of household members and geographical distance to clinics or hospitals, which had been pointed out by previous studies. In the community based analysis, contents of social capital and health worries and uneasiness were different among local communities within the same administrative village, so that the local community, which is the unit of seasonal hunting or ceremonies, was considered to be another independent health determinant factor of the people.