Hiroshi NAGASAWA’s research while affiliated with Kanagawa University of Human Services and other places

Purpose: This study aimed to determine how changes in life spaces affect motor function after outpatient rehabilitation among elderly persons requiring long-term care. Methods: Forty elderly persons (mean age, 80.3 ± 6.8 years; male, n = 28) who underwent outpatient rehabilitation at a health services facility for the aged participated in the present study. We measured upper and lower limb isometric muscle strength and applied the Life Space Assessment (LSA), 5-m maximum walking speed (5MWS), Timed up and go (TUG), One leg standing time test (OLS), and Functional reach tests (FRT) at baseline and at 6 and 12 months of follow-up. Participants who could be followed up for 12 months were assigned to groups according to whether LSA scores were increased or maintained (I/M group), or decreased (D group) at 12 months after baseline. Ratios of changes in motor function values were then compared between the two groups. Results: The ratios of changes in 5MWS and TUG findings were significantly lower and higher, respectively, in the D group than in the I/M group. Conclusion: The present findings suggest that a decrease in life space for a year effects on the mobility of elderly persons. It is important for elderly persons to maintain life space to prevent from declining motor function.

We examined the effects and feasibility of a twice-weekly combined therapy of branched-chain amino acids (BCAAs) and exercise on physical function improvement in frail and pre-frail elderly people requiring long-term care. We used a crossover design in which the combination of exercise and nutritional interventions was carried out twice a week during cycles A (3 months) and B (3 months) and the exercise intervention alone. The exercise intervention entailed the following 5 training sets: 3 sets of muscle training at 30% of maximum voluntary contraction, 1 set of aerobic exercise, and 1 set of balance training. For the nutritional intervention, 6 g of BCAAs or 6 g of maltodextrin was consumed 10 min before starting the exercise. We determined grip strength and quadriceps muscle isometric strength, performance on the Functional Reach Test (FRT) and the Timed Up and Go test, and activity level. In the comparison between the BCAA group and the control group after crossover, the improvement rates in quadriceps muscle strength and FRT performance were significantly greater (by approximately 10%) in the BCAA group. In the comparison between different orders of BCAA administration, significant effects were shown for the quadriceps muscle in both groups only when BCAAs were given. The combination of BCAA intake and exercise therapy yielded significant improvements in quadriceps muscle strength and dynamic balance ability.

[Purpose] The study examined the relationships of foot pressure with the walking speed and balance ability of elderly inpatients, and whether they are affected by walking speed and lower limb muscle strength. [Subjects] One hundred ten elderly inpatients. Those with a history of musculoskeletal or neurological disease were excluded. [Methods] Subjects were evaluated by the 10-m maximum walking speed (10MWS), timed up and go test, functional reach test, one-leg standing time, isometric knee extension muscle strength (IKS), and foot pressure, and divided into the three group based on 10MWS (1.0 m/sec) and IKS (0.35 kgf/kg). A multiple regression analysis including 10MWS as the dependent variable was performed on each group. [Results] Foot pressure influenced the walking speed of those who walked at a speed of 1.0 m/sec or more. [Conclusion] This result suggests that foot pressure possibly influences the walking speed of those who walk at a speed of 1.0 m/sec or more.

This study examined the effects and feasibility of a twice-weekly combined therapy of branched-chain amino acids (BCAAs) and exercise on physical function improvement in frail and pre-frail elderly people requiring long-term care. We used a crossover design in which the combination of exercise and nutritional interventions was carried out twice a week during cycles A (3 months) and B (3 months) and the exercise intervention alone was performed during the washout period. The exercise intervention entailed the following 5 training sets: 3 sets of muscle training at 30% of maximum voluntary contraction, 1 set of aerobic exercise, and 1 set of balance training. For the nutritional intervention, 6 g of BCAAs or 6 g of maltodextrin was consumed 10 min before starting the exercise. We determined upper and lower limb isometric strength, performance on the Functional Reach Test (FRT) and the Timed Up and Go test, and activity level. In the comparison between the BCAA group and the control group after crossover, the improvement rates in gross lower limb muscle strength (leg press, knee extension) and FRT performance were significantly greater (by approximately 10%) in the BCAA group. In the comparison between different orders of BCAA administration, significant effects were shown for the leg press in both groups only when BCAAs were given. The combination of BCAA intake and exercise therapy yielded significant improvements in gross lower limb muscle strength and dynamic balance ability.

[Purpose] This study examined the effect of energy balance on the discharge to home of frail elderly persons in a health facility for the aged. [Subjects] One hundred twenty-one frail elderly persons receiving residential care in a health facility for the aged. [Methods] Participants were divided into the following two groups: the discharge to home group (n=58), and the residential care group (n=63). We determined energy consumption, energy intake, energy balance, demographic data and the Functional Independence Measure of all the subjects. Energy consumption was calculated using METs values and a 24-h timetable. Evaluations were conducted 1 month after admission. [Results] Energy balance differed significantly between the two groups. [Conclusion] The results of this study suggest that controlling energy balance would support discharge to home of frail elderly persons.