-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Gait variables derived from trunk accelerometry may predict the risk of falls; however, their associations with falls are not fully understood. The purpose of the study was to determine which gait variables derived from upper and lower trunk accelerometry are associated with the incidence of falls, and to compare the discriminative ability of gait variables and physical performance. METHODS: This study was a 1-year prospective study. Older people (n = 73) walked normally while wearing accelerometers attached to the upper and lower trunk. Participants were classified as fallers (n = 16) or non-fallers (n = 57) based on the incidence of falls over 1 year. The harmonic ratio (HR) of the upper and lower trunk was measured. Physical performance was measured in five chair stands and in the timed up and go test. RESULTS: The HR of the upper and lower trunk were consistently lower in fallers than non-fallers (P < 0.05). Upper trunk HR, was independently associated with the incidence of falls (P < 0.05) after adjusting for confounding factors including physical performances. Consequently, upper trunk HR showed high discrimination for the risk of falls (AUC = 0.81). CONCLUSIONS: HR derived from upper trunk accelerometry may predict the risk of falls, independently of physical performance. The discriminative ability of HR for the risk of falls may have some validity, and further studies are needed to confirm the clinical relevance of trunk HR.
Journal of NeuroEngineering and Rehabilitation 01/2013; 10(1):7. · 3.26 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Aim: The purpose of this study was to analyze the improvement in oral function and environment in high-risk elderly persons participating in a program to improve oral function organized by their local government. Methods: Participants comprised 36 high-risk elderly and the mean age was 77.11 ± 7.24 years. The program involved training sessions carried out five or six times every 2-3 weeks for 3 months. Oral function and environment was evaluated before and after the program. The research period extended from 2008 to 2010. Results: The effects of intervention were clearly observed in oral diadochokinesis score in the high-risk elderly. Persons with a lower repetitive saliva swallowing test (RSST) and oral diadochokinesis score before intervention showed a tendency toward even greater improvement. No significant changes were observed in saliva secretion or total amounts of Streptococcus mutans, Lactobacilli, Candida or total microorganisms. Conclusions: The effects of intervention were clearly recognized in regards to oral diadochokinesis. Improvement in RSST and oral diadochokinesis scores was marked in those persons showing a lower number of articulations before intervention. Geriatr Gerontol Int 2012; ••: ••-••.
Geriatrics & Gerontology International 09/2012;
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to evaluate the characteristics of human resources for health promotion advocacy in a rural community. A 16-item questionnaire was sent to 1000 residents of a rural Japanese town. Items concerned demographics, participation in organizational activities, awareness of volunteer activities, and willingness to participate in community-based oral health activities. Responses were measured on a 5-point scale. The response rate was 57.4%. To reveal potential factors from the distribution of responses, a principal component analysis was performed, and 4 components were extracted. The components were interpreted as "Municipality initiative," "Personal initiative," "Worth volunteering," and "Internal health locus of control (HLC)," respectively. The results of multiple regression analysis using the above components stratified by gender and age- group revealed that potential leaders in oral health activities in Japan are presently participating in social activities of their own accord and highly value volunteer activity. Target groups are senior males and middle-aged females.
Asia-Pacific Journal of Public Health 12/2011; · 1.06 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We conducted a survey to investigate the status regarding the implementation of oral health care for inpatients aged 65 years and older who were in the acute stages of stroke and to examine the factors related to the details of excellent model hospitals.
We sent a questionnaire on oral health care targeting all 8089 hospitals in Japan. On the basis of the responses obtained from the hospitals, we conducted a survey to analyze the factors defining what are known to be excellent model hospitals. We then conducted a logistic regression analysis using a stepwise procedure.
Replies were received from 2444 of the 8089 hospitals (30.2%): 91.8% of the hospitals reported that oral health care was a part of the daily nursing routine while 91.2% of the hospitals considered that aspiration pneumonia could be prevented by appropriate oral health care. Only 30% of the nurses had undergone oral hygiene training. Among the factors involved in excellent model hospitals, we observed a strong correlation with a sense of the necessity for oral health care, oral hygiene training for nurses and a large number of hospital beds.
Large scale hospitals tend to be more interested in oral health care than smaller hospitals. Providing oral health care is already common in acute hospitals in Japan. There is a great demand for oral hygiene training and obtaining information from dental professionals. It is important to promote the cooperation between dental and nursing personnel within hospitals regarding oral hygiene training.
Geriatrics & Gerontology International 05/2011; 11(4):460-6.
-
[show abstract]
[hide abstract]
ABSTRACT: The control of trunk movement plays an important role in stabilizing the head during gait. However, the effects of performing dual tasks on trunk movements during gait are unclear. We compared the effects of an arithmetic task and the colored Stroop test on trunk movement during gait in 34 healthy older adults. The participants walked 20 m normally, or while performing serial seven subtractions or the colored Stroop test. Trunk accelerations were measured using triaxial accelerometers attached to the lower and upper trunk and used to calculate trunk attenuation rate (TAR) as the reduction in acceleration from the lower to upper trunk. Both dual task conditions affected the TAR in the mediolateral and vertical directions (p<0.01), but not in the anteroposterior direction. In the mediolateral direction, the decrease in TAR was greater during the serial seven subtractions than during the Stroop test (p<0.01). In conclusion, dual task-related changes of whole trunk movement during gait, particularly in the mediolateral direction, are dependent on the type of additional task.
Gait & posture 01/2011; 33(4):712-4. · 2.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Shoes have a beneficial function in physical performance, particularly for gait. The purpose of this study was to investigate the association of shoe fit with gait parameters in community-dwelling older people. The fit of habitual shoes (HS) was evaluated in healthy older subjects and subjects were classified into well-fit (n=48) and poorly-fit (n=37) groups. The sizes of their feet were measured using an optical laser scanning system to provide newly-fitted shoes (NFS). Gait experiments were performed while wearing HS and NFS, separately. Trunk linear accelerations were measured along the vertical, anteroposterior and mediolateral axes using a tri-axial accelerometer attached to the L3 spinous process. Measurements were sampled at 200-Hz during a 20-m gait task at a self-selected speed. After signal processing, the gait velocity, stride duration, stride length and gait regularity (Reg) were obtained. Among the poorly-fit group, 86% wore shoes that were too loose. Subjects wearing ill-fitting shoes had a tendency to walk slower, had shorter stride lengths and lower Reg in the vertical direction than those wearing well-fitting shoes. Whereas NFS increased the gait velocity, the stride length and the Reg in the vertical direction, the increases in subjects that previously wore ill-fitting HS was significantly greater than in subjects that originally wore well-fitting HS. In conclusion, our study indicates that a significant proportion of older adults wear ill-fitting shoes and that well-fitting shoes are important to improve gait performance.
Gait & posture 06/2010; 32(2):274-8. · 2.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Postgraduate clinical training for dentists in Japan became mandatory in April 2006. Mandatory postgraduate clinical training for physicians has been criticized as having accelerated the imbalance in distribution of physicians. This suggests the danger that the same phenomenon might occur in distribution of dentists. It is also necessary to investigate the geographic distribution of dental trainees and practicing dentists in Japan. In this study, the number of dental trainees enrolled in each clinical training program and number that had actually received clinical training at each facility were compared by prefecture. The results suggest that disparities in the number of dental trainees among prefectures are being compensated for by movement across prefectural borders under the clinical training facilities-group system. Postgraduate dental trainees, however, showed a significantly greater imbalance in geographic distribution than practicing dentists. Continuation of the postgraduate clinical training for dentists under the existing system may accelerate this imbalance in distribution of dentists. To prevent this, practical measures should be taken in accordance with the coming review of the system, based on research regarding changes in geographic distribution of dental trainees.
The Bulletin of Tokyo Dental College 05/2009; 50(2):63-70.
-
[show abstract]
[hide abstract]
ABSTRACT: A case of bilateral pedicle stress fracture of L4 in a patient with osteoporotic compression fracture of L5 and without a history of major trauma or surgery is reported, and the literature is reviewed. Bilateral pedicle fracture is a rare entity and few cases have been reported in the literature. All reported cases had some underlying causative factors like previous spine surgery or stress related activities. To the best of the authors' knowledge, only one case of bilateral pedicle stress fracture without a history of trauma, previous spine surgery, or stress-related activities has been reported. A 77-year-old woman presented with severe low back pain and radiating pain in the right leg that was exacerbated after standing and walking. Plain radiograph showed pathological fracture at L5 level. Magnetic resonance imaging (MRI) revealed the compression of dural sac at L5 level. CT scan taken 3 months after admission revealed bilateral pedicle fractures through L4. The patient was treated with decompressive laminectomies of L4, followed by posterior spinal fusion with rigid pedicle screw fixation and autogenous bone graft mixed with hydroxyapatite. The patient achieved pain relief and returned to normal activity. Stress fracture of the pedicle within the proximal vertebra of an osteoporotic compression fracture of lumbar spine is an uncommon entity. It may, however, be an additional source of symptoms in patients with osteoporosis who present with further back pain. Surgeons caring for this group of patients should be aware of this condition.
European Spine Journal 12/2008; 18 Suppl 2:206-9. · 1.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although physical activity maintenance is important for OA management, it is not clear whether people with OA are more inactive or not. One possible reason is no simple monitoring tool to assess physical activity at the clinic. The aim of this study was to determine the reliability and validity of the Baecke Physical Activity Questionnaire (BQ) in adult women with hip disorders.
Sixty-four patients with unilateral or bilateral hip disorders were recruited from an outpatients clinic at a university hospital in Japan. BQ includes a total of 16 questions classified into three domains: work, sports, and non-sports leisure activity. For test-retest reliability, one BQ was administrated face-to-face, and a second was mailed to participants two weeks later. Test-retest reliability of BQ was assessed using intra-class correlation (ICC) and Bland and Altman method. To determine criterion validity, the correlation between BQ measurements and pedometer-measured step counts was assessed. Correlations between BQ measurements and step counts were assessed using Spearman rank correlation coefficient (rho).
Analyses were restricted to the 61 patients (53.3 +/- 11.3 years old) who wore the pedometer continuously for 5 days or more. Twenty eight patients had unilateral hip osteoarthritis, 17 patients had unilateral total hip arthroplasty, and 16 patients had hip osteoarthritis and total hip arthroplasty. The mean step count was 6,309 +/- 2,392 steps/day. In analysis for reliability, the value of ICC was 0.84 for work, 0.83 for sports, 0.78 for non-sports leisure activity, and 0.87 total. Bland and Altman analysis showed the step count and BQ total did not differ significantly from 0 with most falling between 0 +/- 1.96 SD. In analysis for validity, there was a significant but low to moderate correlation between step counts and 3 BQ subscales (rho, 0.30-0.49) and a higher correlation between step counts and total score (rho, 0.49).
BQ is a useful monitoring tool for assessing multiple domains of physical activity with acceptable reliability and validity in adult women with hip disorders.
BMC Musculoskeletal Disorders 02/2007; 8:61. · 1.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To measure ambulatory physical activity and determine associations between physical inactivity and joint function, gait function, disease severity, and employment status in adult women with hip osteoarthritis (OA) living in the community.
Sixty-five adult women with hip OA were recruited from an outpatient clinic. Ambulatory physical activity was measured using an activity monitor based on an accelerometer over 7 days, which estimated step counts, net energy expenditure, and time spent in activity by acceleration intensity. The Harris hip score, walking speed, and radiographic stage were assessed for joint function, gait function, and disease severity, respectively. Employment status was classified into unemployed and employed (sitting occupations and standing/walking occupations).
More than 40% of patients were classified as inactive, with less time spent in moderate-intensity activity (median 5.6 vs 22.9 min/day) compared with their counterparts. Employment status and the presence or absence of stage 4 (endstage) arthritis were independently associated with activity classification, and there was an interaction between these 2 variables; i.e., although stage 4 arthritis was associated with inactivity in patients who were unemployed, it bore no relationship in patients who were employed.
A significant proportion of adult women with hip OA were physically inactive, with a lack of moderate-intensity activity. The possible interaction between endstage OA and employment status requires further study to determine whether being at work negates the adverse effects of endstage OA or whether higher functioning due to physical activity enables patients with endstage OA to be employed.
The Journal of Rheumatology 06/2006; 33(5):939-45. · 3.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Calcifying cartilages undergo endochondral ossification, a process in which cartilage is replaced by bone. These tissues contain
chondrocytes that proliferate, leading, to differentiation and hypertrophy. Recent histological and biochemical studies suggest
that hypertrophic chondrocytes undergo apoptosis. We investigated the process of this cell death to determine when fragmentation
of DNA, a hallmark of apoptosis, occurs during cellular commitment to hypertrophy, and to test the hypothesis that the chondrocytes
are intrinsically programmed to undergo apoptosis. End-labeling of fragmented DNA of rat proximal tibiae revealed that a majority
of hypertrophic cells bore fragmented DNA, indicating that apoptosis was in progress in this zone. In pelleted chondrocyte
cultures isolated from, rat rib growth plates and employed in an in vitro model of a growth plate, hypertrophic cells were
also positive for end-labeling. Gel electrophoresis of DNA isolated from the chondrocyte cultures at 1–3 weeks yielded the
ladder formation characteristic of apoptosis. We conclude that the chondrocytes in the growth plate are programmed to self-annihilate
by apoptosis and that the apoptotic process is closely associated with the commitment to hypertrophy.
Journal of Orthopaedic Science 04/1997; 2(5):328-333. · 0.84 Impact Factor
-
-
