The purpose of this article was to review overseas research on physical activity of patients with stroke for each stroke recovery phase and indicate its current status and associated issues in Japan. People at high risk for stroke tend to be physically inactive, and if they do suffer a stroke, they also tend to remain physically inactive after all phases of the stroke. Although there are targets of physical activity or activity levels, most patients with stroke cannot achieve these levels. However, various research into interventions that promote physical activity and reduction of sedentary behavior show that these interventions are often constructed using techniques of behavior change. Recently, mobile health interventions by use of mobile phones or wearable devices for patients with stroke has attracted much attention. Although research on the promotion of physical activity in patients with stroke is increasing in Japan, there are currently few studies on intervention and longitudinal follow-up. Future studies need to be conducted to show the importance of including the promotion of physical activity in stroke treatment guidelines.

Objective: After the Great East Japan Earthquake, elder people living in temporary housing were reported to have declined physical function due to lowered physical activity. Although the communities made some efforts to increase their physical activity, it is uncertain whether social participation is beneficial or not. A preliminary study was performed to examine the impact of exercise tasks for social participation on the improvement of elderly people’s physical inactivity.

Methods: The subjects were 18 persons age≥65 years with low physical activity (<10 METs・h/w) who lived in temporary housing. The intervention was conducted from July 2015 to January 2016, when monthly exercise lecture were undertaken, and the outcome was evaluated every three months. Exercise tasks for social participation were worship to temples or work at garden.

Results: The average weekly activity, where the largest activity was carried out in one month, physical activity increased three months after the baseline: mean±standard derivation= 7.6±1.9 METs･h/w to 20.2±11.2 METs･h/w, p<0.01 for total physical activity, 7.9±1.1 METs･h/w to 13.2±3.3 METs･h/w, p<0.05 for worship to temples, 7.3±2.5 METs･h/w to 27.3±11.7 METs･h/w, p<0.05 for work in garden. NO significant change was obtained six months after the baseline: mean±standard derivation= 7.6±1.9 METs･h/w to 14.1±12.1 METs･h/w, p=0.24 for total physical activity, 7.9±1.1 METs･h/w to 9.6±5.4 METs･h/w, p=0.54 for worship to temples, 7.3±2.5 METs･h/w to 21.6±15.9 METs･h/w, p=0.37 for work at garden.

Conclusion: The recommendation of participation in social activity could be short-term effects for increased physical activity among elderly people.

Objective: This study’s aim was to examine the development and implementation of a physical activity action plan at the prefectural level in Japan.

Methods: We developed a Local Policy Audit Tool (L-PAT), which consists of 11 items based on the HEPA PAT (Health-Enhancing Physical Activity Policy Audit Tool), covering key policy actions including: presence of local action plan; cooperation between sectors; and implementation. The study was conducted from August 2015 to March 2016. L-PAT was sent to local government representatives in key sectors (health, sports, education, urban planning, transport, and environment) in all 47 prefectures. The sample comprised 282 respondents.

Results: Out of 282 surveys sent out, there were 202 responses (response rate=71.6%). Reports of local action plans and the rates of implementation were higher from health (100%, 93.6%, respectively) and sports (97.6%, 100%, respectively) departments and much lower from other departments. Reports of local plans were moderately developed in urban planning (55%) and transport (30%) departments, which were concerned with the built environment, but rates of implementation were low (13.6%, 22.2%, respectively). Cooperation between the departments was most frequently reported among the health, sports, and education departments, and least frequently reported between all other departments.

Conclusion: The present results indicated that the health and sports departments are the most active in both the development and implementation of the HEPA policy at the prefectural level. Some prefectures reported local actions by the urban planning and transport departments that improved HEPA. Future qualitative studies that identify the details of action plans and the effects of the actions are needed.

Objective: Sporting events have been used as a catalyst to get people to start exercising. The objective of this study was to quantitatively and qualitatively understand what municipalities do to prepare for sporting events.

Methods: Questionnaires were given to 115 municipalities that participated in the Sasakawa Sports Foundation’s Challenge Day in both 2016 and 2017. The questionnaire asked about the types of organizations that helped with publicity and implementations, as well as the number of sport programs that people could participate in on the day of the event. Six municipalities that saw a remarkable rise in participation in the following year were extracted and asked about what they did to prepare and specific examples of how they increased participation, using a semistructured interview method.

Results: An analysis of the data showed that there was a significant increase in participation, from 58 ± 18% in 2016 to 63 ± 16% in 2017. Furthermore, in both years, many organizations helped to publicize Challenge Day and helped with implementations, and participation was significantly higher in municipalities that had help with implementations. When programs were administered in a way that invited participants other than local residents, workers, and students, participation was significantly high. Interview responses were divided into two categories: (1) Ways to get organizations to help with publicity/implementations, and (2) Specific examples of initiatives to increase participation.

Conclusion: In regard to the Challenge Day sporting event, the results revealed the importance of getting implementary help from many organizations, and running programs that allow people from outside the municipality, as well as specific ways to achieve those things. These findings can help to improve preparations for Challenge Day.

Objective: To examine psychosocial determinants associated with sports injury severity in judo as well as track and field sports.

Methods: A questionnaire survey was conducted with male and female university judo players (n=793) and track-and-field athletes (n=655), who were identified using the snowball sampling. The questionnaire included the following items; the state of sports injuries, competition records, individual traits, coping resources, health-related issues, and stress responses. The questionnaire was conducted twice within a one-year interval. Responses of participants without sports injuries were analyzed in the first survey (judo: n=222, track-and-field: n=191). Multinomial logistic regression analysis was conducted on each type of sport with the states of injuries after one year (uninjured, mildly injured, and severely injured) as objective variables and standardized psychosocial determinants at the first survey as explanatory variables, by adjusting for gender, age, competition records, and duration of past injuries.

Results: In the second survey conducted after one year, the incidence of mild and severe injuries was 40 (18%) and 20 (9%) for judo players, 14 (7%) and 18 (9%) for track-and-field athletes. Multivariate analysis was conducted, and adjusted odds ratios[95%CI] compared to the uninjured judo players were as follows; the sense of authenticity=.49[.27-.90] in the mildly injured group, acquired resilience=2.26[1.03-4.98], problem-solving behavioral traits=2.86[1.30-6.27], and reduced mental health=3.26[1.41-7.54] in the severely injured group (p <.05). On the other hand, adjusted odds ratios compared to the uninjured track-and-field athletes’ group were as follows; self-confidence for health management =.32[.13-.77] in the mildly injured group, innate resilience=.36[.14-.91] and acquired resilience=2.60[1.08-6.25] in the severely injured group (p <.05).

Conclusion: It was indicated that factors related to the occurrence of sports injuries differed based on the types of sports and the degree of severity. Moreover, it was suggested that acquired resilience might increase the risk of having severe injuries in both types of sports.