Health effects of immediate telework introduction during the COVID-19 era in Japan: A cross-sectional study

[Background] Telework has been widely discussed in several fields; however, there is a lack of research on the health aspects of teleworking. The current study was conducted to determine the health effects of teleworking during an emergency statement as evidence for future policy development. [Method] This was a cross-sectional study in which we administered an online questionnaire to 5, 214 general workers (response rate = 36.4%) from June 2020 to August 2020. Based on working methods during the pandemic, workers were categorized into the office group (n = 86) and telework group (n = 1597), and we characterized their demographics, changes in lifestyle, telework status, physical symptoms, and mental health. [Results] The results showed that the workers’ residence, marital status, management positions, and employee status affected the choice of the work method. During the emergency, teleworkers experienced more changes in their habits than office workers. In terms of exercise habits, 67.0% of the individuals belonging to the office-telework (OT) group exercised less. Approximately half of the teleworkers were satisfied with their telework, and those in the OT group were less satisfied with their telework than those in the telework-telework (TT) group, and they reported an increase in both working hours and meeting hours. Work-family conflict was more pronounced in the TT group than in the two other groups. Only 13.2% of individuals did not experience any stress in the past 30 days, and all three groups showed varying degrees of anxiety and depressive tendencies. In addition, all teleworkers experienced adverse physical symptoms before and after the emergency. [Conclusion] Health issues associated with teleworking should be given adequate attention

A Case of Idiopathic Thrombocytopenic Purpura Involving Diffuse Alveolar Hemorrhage

Idiopathic Thrombocytopenic Purpura（ITP） is an autoimmune disease which cause thrombocytopenia by the autoantibody against plateletmembrane glycoproteins. It usually develops petechiae, purpra of the skin and mucosal bleeding for thrombocytopenia. It is uncommon for diffuse alveolar hemorrhage to be developed by ITP. We experienced　a case of ITP in which ａ respiratory infection involved diffuse alveolar hemorrhage. Here we propose the possibility that alveolar inflammation participates in development of a diffuse alveolar hemorrhage, so it is necessary to pay enough attention to ａ respiratory infection in ITP

内側型変形性膝関節症患者における外側スラストと痛みとこわばり及び日常生活活動の関連性

© [2015] American Physical Therapy Association.京都大学0048新制・課程博士博士(人間健康科学)甲第19641号人健博第33号新制||人健||3(附属図書館)32677京都大学大学院医学研究科人間健康科学系専攻(主査)教授 市橋 則明, 教授 山田 重人, 教授 妻木 範行学位規則第4条第1項該当Doctor of Human Health SciencesKyoto UniversityDFA

Spot the Difference for Cognitive Decline: A quick memory and attention test for screening cognitive decline

[Background]Dementia is currently one of the most common conditions in older adults, and early detection of cognitive decline is crucial for identifying dementia. We developed a new type of short-term memory and attention test that uses a spot-the-difference task: Spot the Difference for Cognitive Decline (SDCD). The purpose of the present study was to examine the accuracy of the SDCD test for the identification of cognitive impairment in community-dwelling older adults. [Methods]The participants were 443 Japanese community-dwelling older adults. The SDCD test uses two scenery pictures. Participants were instructed to memorize the details of the first picture for 30 seconds, after which the first picture was taken away and the second picture was shown. Next, the participants were asked to identify as many differences as possible between the first and second pictures, which were presented sequentially. The number of correct responses comprises the SDCD score (scores: 0–10). The Mini-Mental State Examination and Scenery Picture Memory Test were used to measure the participants' cognitive function. We used receiver-operating characteristic analysis to examine the power of the SDCD test and identify the optimal cutoff value of the SDCD score. [Results]Of the 443 participants, 30 (6.77%) had some cognitive impairment based on the Mini-Mental State Examination scores. Participants without cognitive impairment had higher SDCD scores than those with cognitive impairment (p 1 being normal; sensitivity: 70.5%; and specificity: 80.0%). [Conclusion]The present study found that the SDCD test could be an effective clinical tool for the identification of cognitive impairment in older adults

Clinical Phenotype Classifications Based on Static Varus Alignment and Varus Thrust in Japanese Patients With Medial Knee Osteoarthritis.

[Objective]To investigate the association between knee pain during gait and 4 clinical phenotypes based on static varus alignment and varus thrust in patients with medial knee osteoarthritis (OA). [Methods]Patients in an orthopedic clinic (n = 266) diagnosed as having knee OA (Kellgren/Lawrence [K/L] grade ≥1) were divided into 4 phenotype groups according to the presence or absence of static varus alignment and varus thrust (dynamic varus): no varus (n = 173), dynamic varus (n = 17), static varus (n = 50), and static varus + dynamic varus (n = 26). The knee range of motion, spatiotemporal gait parameters, visual analog scale scores for knee pain, and scores on the Japanese Knee Osteoarthritis Measure were used to assess clinical outcomes. Multiple logistic regression analyses identified the relationship between knee pain during gait and the 4 phenotypes, adjusted for possible risk factors, including age, sex, body mass index, K/L grade, and gait velocity. [Results]Multiple logistic regression analysis showed that varus thrust without varus alignment was associated with knee pain during gait (odds ratio [OR] 3.30, 95% confidence interval [95% CI] 1.08–12.4), and that varus thrust combined with varus alignment was strongly associated with knee pain during gait (OR 17.1, 95% CI 3.19–320.0). Sensitivity analyses applying alternative cutoff values for defining static varus alignment showed comparable results. [Conclusion]Varus thrust with or without static varus alignment was associated with the occurrence of knee pain during gait. Tailored interventions based on individual malalignment phenotypes may improve clinical outcomes in patients with knee OA

Factors for reducing monetary loss due to presenteeism using a tailored healthcare web-application among office workers with chronic neck pain: a single-arm pre-post comparison study

Objectives: This study aimed to examine the factors for reducing monetary loss due to presenteeism by using a tailored healthcare web-application among office workers with chronic neck pain. Methods: The study was single-arm pre-post comparison study using secondary data of 130 Japanese office workers with chronic neck pain who used a tailored healthcare web-application (web-app) over 12 weeks. This data was obtained from BackTech Inc. (Kyoto, Japan), which manages the healthcare web-app. The primary outcome measure was the monetary loss due to presenteeism based on the quality and quantity method. Secondary outcome measures were intensity of physical symptoms measured by the Visual Analog Scale, frequency of web-app use obtained from the database, and the risk of depression score assessed by the Depression and Suicide Screen. Results: Eighty-six participants were included in the complete-case analysis. Monetary loss due to presenteeism and the risk of depression reduced, while physical symptoms improved significantly (p<0.01) after using the web-app. After covariate adjustment, decrease in neck pain intensity (β=0.25, confidence interval=2.34 to 32.66) and high frequency of web-app use (β=−0.24, confidence interval=−10.29 to −0.63) were significantly associated with a reduction in monetary loss due to presenteeism. Conclusion: Neck pain intensity and frequency of web-app use may be important factors for reducing monetary loss due to presenteeism among office workers with chronic neck pain who used a tailored health care web-app

Association between floating toe and toe grip strength in school age children: a cross-sectional study

[Purpose] This study investigated the association between floating toe and toe grip strength. [Subjects and Methods] A total of 635 Japanese children aged 9-11 years participated in this study. Floating toe was evaluated using footprint images, while toe grip strength was measured using a toe grip dynamometer. All 1, 270 feet were classified into a floating toe group and a normal toe group according to visual evaluation of the footprint images. Intergroup differences in toe grip strength were analyzed using the unpaired t-test and logistic regression analysis adjusted for age, gender, and Rohrer Index. [Results] There were 512 feet (40.3%) in the floating toe group. Mean toe grip strength of the feet with floating toe was significantly lower than that of normal feet (floating toe group, 12.9 ± 3.7 kg; normal toe group, 13.6 ± 4.1 kg). In addition, lower toe grip strength was associated with floating toe on logistic regression analysis after adjustment for age, gender, and Rohrer Index (odds ratio, 0.954; 95% confidence interval, 0.925-0.984). [Conclusion] This study revealed that lower toe grip strength was significantly associated with floating toe. Therefore, increasing toe grip strength may play a role in preventing floating toe in school age children

Inverted Rearfoot posture in subjects with coexisting patellofemoral osteoarthritis in medial knee osteoarthritis: an exploratory study

Abstract Background While abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined. This study aimed to examine whether rearfoot posture is associated with a higher prevalence of radiographic PFOA in a compartment-specific manner in patients with medial tibiofemoral osteoarthritis (TFOA). Methods Participants from orthopedic clinics (n = 68, age 56–90 years, 75.0% female), diagnosed with radiographic medial TFOA (Kellgren/Lawrence [K/L] grade ≥ 2) were included in this study. The presence of PFOA and static rearfoot posture were evaluated using a radiographic skyline view and a footprint automatic measurement apparatus, respectively. The relationship between rearfoot posture and PFOA was examined using analysis of covariance and propensity score-adjusted logistic regression analysis. Results On average, patients with coexisting PFOA and medial TFOA (n = 39) had an inverted calcaneus 3.1° greater than those with isolated medial TFOA (n = 29). Increased calcaneus inverted angle was significantly associated with a higher probability of the presence of medial PFOA (odds ratio: 1.180, 95% confidence interval: [1.005, 1.439]; p = 0.043). Calcaneus inverted angle was not associated with higher odds of lateral PFOA presence based on the adjusted values. Conclusions The presence of an inverted rearfoot was associated with PFOA. Although these findings do not clearly indicate a biomechanical link between rearfoot posture and PFOA, this study shed light on the potential relationship between altered rearfoot posture and PFOA, as can be seen between rearfoot abnormality and PF pain

Shoe-fit is correlated with exercise tolerance in community-dwelling elderly people

[Purpose]: Maintenance of physical activity significantly affects quality of life, and the frequency of physical activity depends upon exercise tolerance. However, there is minimal information on the external factors that contribute to exercise tolerance. The aim of this study was to examine the association between exercise tolerance and shoe-fit in community-dwelling elderly people. [Methods]: Subjects were 155 elderly, healthy, community-dwelling Japanese volunteers. Exercise tolerance (Shuttle Walk Test [SWT]), 10-m walking time (10mWT), and forced expiratory volume in 1 second (FEV1) were measured. Shoe-fit was assessed and participants were divided into three groups according to the heel-fit of their shoes (Too Loose, Loose, Fit). Group scores in the above variables were compared. Further, a multivariate logistic regression model using a stepwise method was performed to investigate which shoe-fit factors were independently associated with SWT. [Results]: No significant differences in age, gender, body mass index, 10mWT, FEV1, or presence or absence of pain sites were observed between the three groups. The Fit (p = 0.001) and Loose (p = 0.008) groups had significantly higher SWT score than the Too Loose group. Multivariate logistic regression analysis showed that poor heel-fit was significantly correlated with a low SWT score, even following adjustments for age, gender, 10mWT and FEV1 (odds ratio: 0.25, 95% confidence interval: 0.07–0.95, p = 0.04). [Conclusions]: This study demonstrates that heel-fit is associated with exercise tolerance in community-dwelling elderly people. It is important for elderly people to wear adequate fit shoes in order to enhance physical functions and prevent declining physical functions

Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults.

[Objectives]Frailty in older adults is a serious problem because of various adverse health outcomes in many countries with aging populations, such as Japan. The purpose of this study was to determine whether frailty and pre-frailty are associated with cognitive decline and sarcopenia in community-dwelling older adults. [Design]This is a cross-sectional study. [Setting]Japan. [Participants]The participants were 273 Japanese community-dwelling older women aged 65 years and older. [Measurements]We used the frailty criteria developed by the Cardiovascular Health Study to define physical frailty. We divided the cohort into nonfrail, prefrail, and frail according to frailty scores. Cognitive decline and memory decline were defined by using the Mini-Mental State Examination and Scenery Picture Memory Test, respectively. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. [Results]In the multivariate logistic regression analysis by using non-frail participants as the reference, pre-frail elderly individuals were significantly more likely to have sarcopenia than non-frail elderly individuals [odds ratio (OR): 2.77, 95% confidence interval (CI): 1.05–9.26], but not cognitive decline or memory decline. Frail elderly individuals were significantly more likely to have cognitive decline (OR: 5.76, 95% CI: 1.20–27.6), memory decline (OR: 5.53, 95% CI: 1.64–18.7) and sarcopenia (OR: 19.1, 95% CI: 3.73–98.0) than non-frail elderly individuals. [Conclusions]Sarcopenia was associated with pre-frailty and frailty, whereas cognitive decline was associated only with frailty