Objective: Sleeve gastrectomy (SG) effectively reduces food intake and enhances health and longevity, although weight loss often involves reductions in body fat and skeletal muscle. Hence, we examined how changes in skeletal muscle density relate to muscle strength and physical activity before and after SG. Methods: This pilot observational study included 173 patients (mean age: 46 ± 11 years) who attended the hospital before and 1 year after undergoing SG between December 2018 and July 2022. Muscle cross-sectional area (cm²), skeletal muscle density, and fat cross-sectional area (cm²) at the 3rd lumbar vertebra were measured on computed tomography (CT) images. The psoas muscle index (PMI) was calculated as the cross-sectional area of both psoas muscles (cm²) divided by height squared (m²), and CT values for skeletal muscle density of the psoas and multifidus muscles, visceral fat area (VFA), and subcutaneous fat area (SFA) were obtained. Relative and absolute muscle strengths, sitting time, and total physical activity from the International Physical Activity Questionnaire were also assessed. Results: Although VFA, SFA, PMI, and absolute muscle strength decreased significantly after SG compared to those before SG (p <0.001), skeletal muscle density, relative muscle strength, and total physical activity increased significantly after SG, with a significant reduction in sitting time (p <0.001). There were significant positive correlations between changes in skeletal muscle density and changes in relative muscle strength and total physical activity. Conclusions: Improving skeletal muscle density with SG may be associated with increased relative muscle strength and improved physical activity.

Objectives: Recently, rehabilitation professionals in Japan have become increasingly involved in Kayoi-no-ba for long-term care prevention. However, there are significant differences in the quality and content of professional rehabilitation support. This study aimed to develop a competency scale for rehabilitation professionals who support Kayoi-no-ba. Methods: A survey was mailed to rehabilitation supervisors at 440 facilities selected from a nationwide Internet search of facilities that implement the “community-based rehabilitation activity support project,” and rehabilitation professionals involved in supporting Kayoi-no-ba were asked to respond to the survey. The questionnaire was self-administered, and responses were sought via a 6-point scale for the 50 proposed competency items. For statistical analysis, exploratory factor analysis was conducted to examine the factor structure of the scale. Covariance structure analysis was used to assess model fit and to evaluate the reliability and internal consistency of the scale. Results: Among the 260 facilities that responded (59.1%), 607 participants provided valid responses. The final competency scale had a 3-factor structure (knowledge and attitude, ability to coordinate groups, and clinical practice skills) comprising 20 items. Model fit and internal consistency were good. Conclusions: Our findings indicate that rehabilitation professionals who support Kayoi-no-ba should have the attitude and knowledge of supporters, the ability to coordinate groups, and the clinical practice skills of rehabilitation therapists. This competency scale could be used as a guideline to improve the quality of support.

Objectives: The reliability of observational gait analyses is generally considered poor or moderate. This is considered due to the drawbacks in the experimental designs and measurement methods used in related studies. This study examined the reliability and validity of physical therapists’ (PTs) visual joint angle estimation in gait analysis with a rigorous design. Methods: Twenty PTs were divided into 2 groups of 10 each based on their experience: <10 years and >10 years. They observed videos and still images of patients with gait disorders and visually estimated the joint angles at specific points during the gait cycle. Reliability was assessed using the intraclass correlation coefficient, and validity was assessed by a correlation analysis, which compared their estimates with reference values obtained from the digital video analysis. Results: Intra-rater reliability for visual estimation using video tended to exceed 0.6 for most indicators, whereas inter-rater reliability ranged from 0.04 to 0.59. For validity, correlation coefficients indicated an accuracy of 0.06–0.62 for video and 0.08–0.68 for still images. Conclusions: Although intra-rater reliability tended to be higher than inter-rater reliability, neither reached levels considered sufficiently reliable, and validity showed only limited agreement with reference values. These results highlight the limitations of visual estimation in joint angle assessment. Future efforts should focus not only on improving observational consistency but also on improving agreement with reference values through corrective training using still images.