Purpose: Pelvic floor muscles play an important role in excretion control and thus maintaining their function is crucial to quality of life. The aim of this study was to examine muscle atrophy in a mouse model of androgen deprivation and the effect of voluntary wheel-running exercise on pelvic floor muscles.
Methods: Castration and sham-operation were performed on 3-month-old male mice (C57BL/6J). Castrated mice were randomly housed in cages equipped with a running wheel. After 8 weeks from the operation, muscle samples were collected from limb and perineal (Limb muscles: tibialis anterior, gastrocnemius, extensor digitorum longus, plantaris and soleus. Perineal muscles: bulbospongiosus and levator ani). Myofibers were isolated from extensor digitorum longus and peri-urethral sphincter and the diameters were measured.
Results: Castration significantly decreased perineal muscles' mass and myofiber diameter of periurethral sphincter, whereas limb muscles were not affected. Voluntary wheel-running exercise cannot ameliorate castration-induced muscle atrophy in pelvic floor muscles.
Conclusion: Whole-body exercise cannot prevent pelvic floor muscle loss caused by androgen deprivation and thus it is suggested that target-muscle-specific training needs to be considered for the intervention.
Purpose: This study investigated the correlation between questionnaire survey responses and exercise time after discharge from the recovery period in hospitalized patients.
Methods: This study recruited 100 patients in the recovery ward. In addition to the questionnaire survey, we requested records on exercise time. The questionnaire was based on existing models and psychology theories on exercise adherence. Exercise time was measured for one month from the discharge day by placing a sticker on a calendar as a diary of self-activity.
Results: Data from 100 questionnaires and 35 exercise times were obtained. Factor analysis of the questionnaire, converged to 25 items and four factors. To verify the reliability, the α coefficient was calculated for 25 items, resulting in an α of 0.895. Correlation analysis with the average exercise time after discharge was confirmed as a significant weak correlation as verification of validity.
Conclusion: The results suggested a relationship between the psychological aspects of exercise after discharge from the convalescent ward and exercise time after discharge.
Purpose: In this study, we compared interlimb coordination in patients before and after total knee arthroplasty (TKA) using the phase coordination index (PCI). Additionally, we investigated its association with other variables at each time.
Methods: This study included 55 patients who underwent TKA (mean age 76.1 ± 7.4 years). We assessed and compared the preoperative PCI with the PCI measured on the day before discharge (approximately 17 days after TKA). Pearson's correlation and multiple regression analyses were used to determine factors affecting the PCI.
Results: We observed no significant difference between the pre- (6.73% ± 3.09%) and post-TKA (6.94% ± 2.97%) PCI. The pre-TKA PCI was significantly correlated with knee extension strength on the nonoperative side and knee pain on the operative side, and knee extension strength on the nonoperative side was selected as an independent variable in this study. Postoperatively, a significant correlation was observed only between the PCI and patient age.
Conclusions: This study showed that pre- and post-TKA interlimb coordination was comparable; however, different factors were associated with the pre- or post-TKA PCI.
Objective: We aimed to clarify factors related to lung compliance in patients with permanent ventilation dependence.
Methods: This was a cross-sectional study. We measured the static lung compliance (Cstat) and dynamic lung compliance (Cdyn) of 29 patients, and compared the values between those with and without atelectasis, pleural effusion, and spontaneous breathing. Correlation analyses were performed to examine the relationships between lung compliances and ventilation status, demographic parameters, and biochemical blood data.
Results: Cstat was significantly lower in patients with atelectasis than in those without. Cstat and Cdyn were significantly correlated with the body mass index (BMI), rapid shallow breathing index (RSBI), alveolar arterial oxygen partial pressure difference, and days of ventilator management. Cstat was also significantly correlated with age, C-reactive protein, and the number of pneumonia episodes.
Conclusion: The negative influence of BMI on Cstat and Cdyn was high, suggesting the need for nutritional management against obesity. This study also suggested that Cstat is affected by atelectasis, the number of pneumonia episodes, and inflammatory blood response. The decreases in Cstat and Cdyn may affect the ventilation efficiency reflected by RSBI. It is necessary to examine whether the improvements in atelectasis and pneumonia frequency affect Cstat and the ventilation efficiency index in the future.
Purpose: The aim of this study is to reveal the cost-effectiveness of exercise programs designed for fall prevention among healthy younger old community-dwelling adults in Japan.
Methods: The analysis was conducted on behalf of public insurers for health and long term care services. Quality-adjusted life years (QALY) and expenses for health services and long-term care services were described in terms of “effectiveness” and “cost,” respectively. The assumed subjects were healthy community-dwelling females (n=1,000) and males (n=1,000) aged 65 years old. The incremental cost-effective ratio (ICER) of the program was analyzed and simulated using a 10-year cycle Markov model (base case). The threshold for assessing cost-effectiveness was set at less than 5 million Japanese yen/QALY.
Results: The ICER for the female group was 1,550,900 Japanese yen/QALY, and 2,277,086 Japanese yen/QALY for the male group.
Conclusion: An exercise program for fall prevention among healthy younger old community-dwelling adults could be cost-effective in Japan.
Objective: This study aims to demonstrate the usefulness of exercise therapy for night pain improvement in patients with shoulder joint disease undergoing physical treatment. We examined the treatment course by the presence, and effect of joint injection or absence of night pain at the initial evaluation.
Methods: The subjects were 72 patients with unilateral shoulder joint disease undergoing physical treatment. Patients were classified into two groups based on the presence and absence of night pain at the initial evaluation. Then, the subjects in the group with night pain were further classified into two groups according to whether or not joint injection was performed at the initial examination. We analyzed the difference in the treatment course, including range of motion (ROM), visual analogue scale (VAS), and Athens Insomnia Scale (AIS) at 1 and 3 months after the start of treatment.
Results: In both groups, courses showed interaction. ROM, VAS on movement, AIS high degree of improvement were obtained in the night pain group. VAS on movement, high degree of improvement were obtained for one month later at the initial evaluation in the joint injection group.
Conclusion: Exercise therapy for patients with shoulder joint disease undergoing physical treatment can improve ROM, VAS, and AIS, regardless of the presence of night pain. In addition, pain can be improved early by joint injection at the initial visit.
Purpose: The purpose of this study was to investigate the characteristics of impaired trunk movements during lifting in people with lower back pain (WLBP) with fear of movement.
Methods: Twenty-six WLBP and eighteen pain-free healthy workers (HW) were recruited. We calculated the peak angular velocity of trunk and motion time during lifting an object. WLBP were evenly divided into low-fear and high fear groups. We compared the angular velocity of trunk with three groups and examined the relationship between these factors and pain-related factors.
Results: Our kinematic analyses revealed significant differences in the extension phase and the peak angular velocity of trunk extension in the first trial among the three groups. The peak angular velocity of trunk extension in first trial was significant correlated with TSK.
Conclusion: It was shown that lifting in people with lower back pain with fear of movement was characterized by the movement of the trunk extension.
Objective: The purpose of this study was to examine the joint kinematics and kinetics during walking with three types of walking aids in healthy elderly people.
Methods: Nineteen healthy elderly people participated in this study. A three-dimensional motion capture system and force plates were used to obtain kinetic and kinematic data while walking on a level surface. All subjects walked without any aid and with walkers, rollators, and rollators with forearm support. We measured the peak values of lower extremity joint angles, moments, and ground reaction forces in healthy elderly people.
Results: The peak values of knee adduction moment (KAM) while using the aids were smaller than without any aid. Furthermore, KAM was significantly lower when walking with rollators and rollators with forearm support compared to with walkers.
Conclusion: The use of rollators and rollators with forearm support can help to reduce KAM during level walking in healthy elderly people．
Introduction: We observed the effectiveness of periodic outpatient rehabilitation on physical function and the Instrumental Activity of Daily Living (IADL) in a patient with advanced breast cancer.
Case report: A 52-year-old woman with multiple brain metastases due to breast cancer visited our hospital for chemotherapy for 5 years. Before rehabilitation, the Frenchay Activities Index (FAI) for the evaluation of IADL was 18 points and the Short Physical Performance Battery (SPPB) for the evaluation of physical function was 6 points (balance: 1 point, gait: 4 points, and sit to stand: 1 point). Rehabilitation involved muscle strengthening exercise, balance exercise, and self-exercise guidance for 13 weeks; once for 20 minutes, 9 times in total, in the outpatient chemotherapy unit. After rehabilitation, the patient improved, with an FAI of 23 points and an SPPB is 9 points (balance: 3 points, gait: 4 points, and sit to stand: 2 points).
Conclusion: This report may suggest that periodic outpatient rehabilitation improved physical function, resulting in improvement of IADL in a breast cancer patient with multiple brain metastases.
Purpose: Decline of somatosensory function is associated with falls in the elderly. This study investigated the relationship between loss of plantar sensory threshold and fall risk in the elderly.
Methods: The sensory thresholds of plantar foot were measured in 110 people using day service facilities for the elderly with long-term care needs (33 men and 77 women; mean age, 80.7 years), using a new sensory testing device with high reproducibility. In addition, physical and cognitive functions including lower extremity strength and gait speed were measured. Fall history during the past 12 months was determined retrospectively, and each measurement variable was compared between the faller and non-faller groups. The relationship between plantar sensory threshold and fall history was examined by calculating the odds ratios of important variables determined by logistic regression analysis with the presence of a fall event as the objective variable.
Results: There were significant differences in the plantar sensory threshold, ankle dorsiflexion angle, and ratio of men to women between the fallers and non-fallers. The odds ratio adjusted by sex was significant in the plantar sensory threshold and the ankle dorsiflexion angle.
Conclusions: The plantar sensory threshold will be valuable information to explain falls in the elderly requiring long-term care. The results of this study suggested that assessment including the plantar sensory threshold in addition to conventional indices would be more effective for determining the risk of falls in elderly people who require long-term care.