Objective: A 12-week trial was conducted to examine the feasibility and preliminary effects of a biopsychosocial model-based self-management program (SMP) for knee pain on physical activity and sedentary behavior in patients with knee pain.

Methods: All forty-four patients with knee pain (age, 72.4 years; 93% female) received physical therapy and were divided into an intervention group willing to participate in SMP (n=24) and a control group not willing to participate (n=20). A SMP of nine 60-minute on pain, arthritis and lifestyle were provided over 12 weeks by physical therapists. Moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) time were assessed using a questionnaire at baseline and week 12.

Results: No adverse events occurred during the intervention. Seven of the 44 patients dropped out of the study, with a mean attendance rate of 78.8% in the SMP. The between-group difference in MVPA (METs・minute/weeks) change did not reach statistical significance, but the reduction in SB time (minutes/day) was significantly greater in the intervention group than in the control group (Mean difference: –190, 95%CI –262, –116. Cohen's d = 0.78).

Conclusion: Our study suggests that adding SMP to physical therapy was feasible and effective in reducing SB time in patients with knee pain.

Objectives: To verify the reliability and validity of the two-step test as an assessment of gait performance in the home setting and to identify the cutoff values for independent gait.

Methods: A database (N = 226) was constructed from the results of a cross-sectional survey of home-visit rehabilitation users at 10 facilities, and data sets were extracted for analysis (reliability: n = 98, validity: n = 117, cutoff values: n = 209). The survey items comprised the demographic and clinical characteristic variables, knee extension strength, two-step values calculated from the two-step test, grade of gait independence, and Rivermead Mobility Index (Japanese version), among others. The intra-rater reliability and measurement error were examined for reliability, and validity was examined based on correlations among physical function, gait ability, and the two-step values. Twelve independent gait conditions from indoor gait with a cane to community ambulation of 800 m or more without assistive devices were set according to the gait means and gait distance, and the cutoff values for each condition were examined.

Results: The intra-rater reliability of the two-step test was high, with no fixed bias, but proportional bias was shown. The two-step value was more strongly correlated with gait ability than with the strength of the knee extensors, and the cutoff values were identified according to each independent gait condition.

Conclusions: The two-step test is a reliable and valid gait assessment tool in the home setting and has useful cutoff values for discriminating gait independence.

Objectives: This study aimed to examine the relationship between intramuscular non-contractile tissue of the quadriceps and swallowing ability in elderly inpatients with pneumonia.

Methods: Forty-seven elderly inpatients with pneumonia were included. Swallowing ability was assessed using the Food Intake Level Scale (FILS). The echo intensities of the ultrasound images were used to assess the intramuscular non-contractile tissue of the quadriceps. The mean echo intensities of the right and left quadriceps were analyzed. A higher echo intensity indicated greater amounts of intramuscular non-contractile tissue. We used multiple regression analysis to identify the factors that were independently associated with FILS. Echo intensity and muscle thickness of the quadriceps, subcutaneous fat thickness of the thigh, age, sex, length of hospital stay, Geriatric Nutritional Risk Index (GNRI) score, C-reactive protein level, updated Charlson comorbidity index score, and number of medications were independent variables.

Results: The echo intensity (standardized partial regression coefficient: –0.386; p = 0.034), GNRI (standardized partial regression coefficient: 0.529; p = 0.014), and subcutaneous fat thickness of the thigh (standardized partial regression coefficient: 0.339; p = 0.043) were significantly and independently associated with FILS (R² = 0.484).

Conclusions: Our results suggest that the amount of intramuscular non-contractile tissue of the quadriceps is more strongly related to swallowing ability than muscle mass in elderly inpatients with pneumonia.

Objective: To preliminarily test whether digital images of the lower leg and edge detection can be used to determine elderly women with low Skeletal Muscle Index (SMI).

Methods: An elderly woman who was hospitalized was the subject of this study. Digital images of the subject's lower leg taken with a digital camera were used for edge detection using the Canny method. The criteria for low SMI were grouped using the criterion of 5.7 kg/m² proposed by the Asian Working Group, and analysis by convolutional neural network was performed on digital and edge-detected images of the lower leg, respectively.

Results: Thirty-two subjects were included in the study. The C statistic for determining low SMI in digital and edge-detected images of the lower leg was 0.83 (95% CI: 0.83–1.00) and 0.92 (95% CI: 0.92–1.00), respectivel.

Conclusion: Digital images of the lower leg may be used to classify those with low SMI.

Objective: The purpose of this study was to determine the prevalence of urinary incontinence and pelvic organ prolapse in female patients who had end-stage osteoarthritis of the hip. The study also surveyed patient awareness of the conditions, the level of concern, and the expectations for care.

Methods: Thirty-eight female patients (mean age, 64.9 years) who had end-stage osteoarthritis before total hip arthroplasty were included in the study. The International Consultation on Incontinence Questionnaire-Short Form and the Pelvic Organ Prolapse Distress Inventory 6 were used to assess the prevalence of urinary incontinence and pelvic organ prolapse symptoms. In addition, awareness and concerns regarding urinary incontinence and pelvic organ prolapse, and expectations for care were surveyed using self-administered questionnaires.

Results: The prevalence of urinary incontinence and pelvic organ prolapse was 65.8% and 63.2%, respectively; 47.4% of patients had both symptoms. The prevalence of urinary incontinence and pelvic organ prolapse awareness was 58.5% and 29.3%, respectively. Greater than 70% of the patients were concerned about the disorders and approximately one-half expected guidance for care.

Conclusions: The prevalence of urinary incontinence and pelvic organ prolapse was high in female patients who had end-stage osteoarthritis of the hip. Many patients had an interest and expectation for guidance.