A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

Hiroharu Kamioka1, Kiichiro Tsutani2, Yoshiteru Mutoh3, Hiroyasu Okuizum4, Miho Ohta5, Shuichi Handa4, Shinpei Okada6, Jun Kitayuguchi7, Masamitsu Kamada7, Nobuyoshi Shiozawa8, Sang-Jun Park4, Takuya Honda4, Shoko Moriyama41Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan; 2Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, 3Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan; 4Mimaki Onsen (Spa) Clinic, Tomi City, Japan; 5Laboratory of Aqua, Health, and Sports Medicine, 6Physical Education and Medicine Research Foundation, Nagano, Japan; 7Physical Education and Medicine Research Center Unnan, Unnan City, Japan; 8Department of Longevity and Social Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanBackground: The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs).Methods: Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web.Results: Twenty-one trials met all inclusion criteria. Languages included were English (N = 9), Japanese (N = 11), and Korean (N = 1). Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants) were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally showed a remarkable lack of description in the studies. Furthermore, there was the problem of heterogeneity, and we were therefore not able to perform a meta-analysis.Conclusion: Because there was insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of nRCTs, we were unable to offer any conclusions about the effects of this intervention. However, we were able to identify problems with current nRCTs of aquatic exercise, and propose a strategy of strengthening study quality, stressing the importance of study feasibility as a future research agenda objective.Keywords: aquatic exercise, systematic review, nonrandomized controlled trials&nbsp

Dose-response relationship between sports activity and musculoskeletal pain in adolescents.

Physical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose-response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n = 2403) and longitudinally (n = 374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio = 1.03, 95% confidence interval = 1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P < 0.001) but not a nonlinear association (P ≥ 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.This study was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan. MK is supported by a JSPS Postdoctoral Fellowship for Research Abroad. FI is supported by the Medical Research Council Epidemiology Unit (MC_UU_12015/1; MC_UU_12015/5).This is the final version of the article. It first appeared from Wolters Kluwer via http://dx.doi.org/10.1097/j.pain.000000000000052

健康長寿な地域における壮年期の生活実態と保健活動

目的は健康長寿な地域として高く評価されている市に在住する壮年期の生活実態として、現在と30年前の違いを明らかにすることである。調査は市に在住する40歳と70歳の全員を対象に、食、運動、休息等の生活状況等について郵送により無記名自記式で行った。その結果、40歳202名（回収率44.5％）、70歳390名（回収率74.4％）から回答があった。40歳は70歳の30年前に比べ、男女とも栄養のバランスや塩分、糖分等の食に対する意識は有意（p<0.05）に高かった。また、40歳は男女とも肉類を週３回以上食べる者が多く、男性では甘味飲料の摂取が多かった。一方、40歳は男女とも１日に１時間未満しか歩かない、翌日に疲れが残る、住んでいる地域で住みにくいと感じることがある者が多い等の現状が明らかとなった

島根県民の運動習慣の実態とロコモ認知度

島根県民の運動習慣の実態とロコモ認知度を明らかにするため、18歳以上の県内在住者に質問紙によるモニター調査を行った。484名の回答を得て451名を分析した（有効回答率93.2％）。約7割は運動習慣がないが、その多くは運動不足解消の意思を有し、50代以下と60代以上の運動習慣（p<.05）に有意差があった。ロコモ認知の割合は3割程度で、認知あり群となし群の運動習慣に有意差（p<.05）があった。以上のことから、50代以下の者の多くは運動への関心はあるが行動変容まで至っていないと示唆された。運動を習慣化する者の増加を目指し、幅広い年代層のロコモ認知度を高める必要がある

チイキザイジュウコウレイシャ ニ オケル テントウヨボウジココウリョクカン ト HDL コレステロール オヨビ シンタイノウリョク トノ カンレン コスゲムラオウダンケンキュウ

背景 : 本研究の目的は,転倒予防自己効力感とHDLコレステロール及び身体能力との関連性を調べることであった。方法 : 対象者は山梨県小菅村に在住する65歳以上の高齢者339名で,本調査には132名(38.9%)が参加した。移動能力として10m全力歩行,最大一歩幅,40cm踏台昇降を,バランス能力としてつぎ足歩行を測定した。血液性状の中で,主要なアウトカムとして,HDLコレステロールを用いた。転倒予防自己効力感は,10項目,4リッカートスケールからなる質問紙で評価した。研究デザインは,転倒恐怖の有無による2群間比較の横断研究である。結果 : 転倒予防自己効力感とHDLコレステロールの間に有意な関連はなかったが,転倒予防自己効力感が低い群では有意に移動能力が低かった。また,膝痛や腰痛を伴う男性では,転倒予防自己効力感が低かった。結論 : 自己効力感とHDLコレステロールとの関連は認められなかったが,本研究は地域在住で独立生活を営む高齢者に限定されているため,今後,良くデザインされた大規模な観察研究が必要だと考えられた。Background : The aim of the current study was to clarify relationships between self-efficacy and high-density lipoprotein cholesterol (HDL-C) and physical strength.Methods : Target participants were 339 elderly residents aged 65 years or older from Kosuge Village, Yamanashi Prefecture in Japan. One hundred and thirty two persons participated in the study (38.9%). Outcome measurements included the 10-m walking time, the maximal step length and 40-cm step test as moving ability, the tandem gait as balance ability, and HDL-C. Fall-prevention self-efficacy (FPSE) was evaluated using a questionnaire that examined 10 items (actions) and 4 Likert scale. A total of 40 points could be awarded. This research design was a cross-sectional study that divided the elderly into two groups by the existence of a fear of falling.Results : Although there was no significant relationship between fall-prevention self-efficacy and HDL-C, we demonstrated that a group with poor self-efficacy had significantly deteriorated moving ability and that only one male participant with knee pain and/or lumbago exhibited poor self-efficacy.Conclusions : We could not find significant relationships between self-efficacy and HDL-C. But this study is limited to the independent elderly people in a local area, and further studies should be conducted to detect the relationships

ジョセイカイゴシャ ニ オケル ヨウツウ ノ ジッタイ ト カンレンヨウイン ニ カンスル オウダンケンキュウ

本研究は,横断研究により,女性介護者における腰痛との関連要因を明らかにすることを目的とした。4カ所の特別養護老人ホームに勤務する女性介護職員88人を対象として,腰痛の有無,経験年数,Body Mass Index(BMI),握力,長座体前屈,指床間距離(Finger-Floor Distance : FFD),抑うつ自己評価スコア(the Center for Epidemiologic Study Depression Scale : CES-D),SF-8による身体的健康度(Physical Health Score : PHS)と精神的健康度(Mental Health Score : MHS),疲労の自覚症状を調査した。腰痛の有無を目的変数とし,その他の変数を説明変数とした多重ロジスティック回帰分析を行った。49人(55.7%)が,慢性的な腰痛を訴えていた。多重ロジスティック回帰分析の結果,腰痛の発生は,身長がオッズ比(OR)1.12,95%信頼区間(95%CI)1.02-1.23,SF-8による身体的健康度(PHS)が,OR : 0.89(95%CI : 0.86-0.97),精神的健康度(MHS)がOR : 0.90(95%CI : 0.81-0.99)で有意であった。本研究は,身長が高いことは中腰姿勢を助長し,腰痛を起こす原因になるかもしれないこと,身体・精神的な健康の程度は,腰痛と関係があることが明らかになった。今後,交代勤務に伴う睡眠障害や慢性疲労との関連性も含めて検討すべきであることが示唆された。The objective of this cross-sectional study was to reveal the actual conditions and related factors of low back pain among female caregivers in special nursing homes for the elderly.The participants were 88 female caregivers in four facilities for the elderly. We surveyed the existence of low back pain, employment period, Body Mass Index (BMI), grip power, sitting forward flexion, Finger-Floor Distance (FFD), the Center for Epidemiologic Study Depression Scale (CES-D), Physical Health Score (PHS) and Mental Health Score (MHS) by using SF-8 and subjective symptoms of fatigue. Multinomial logistic regression model was used to investigate how far low back pain was related to mental and physical health status, flexibility, power, employment period, and BMI.55.7% (N=46) of the participants notified the presence of chronic lumbago. The result of multinomial logistic regression model showed that the existence of low back pain was significant in the following variables : 1) Odds ratio (OR)=1.12 (95% confidence interval : 95%CI=1.02-1.23) for height, 2) OR=0.89 (95% CI=0.81-0.97) for PHS, 3) OR=0.90 (95% CI=0.81-0.99) for MHS.Our findings suggest that height may reinforce a half-crouching position, thus it can be a cause of low back pain, and that the degree of physical and mental health is related to low back pain. It was also suggested that lumbago prevention and/or reduction strategy should include the relevance of sleep interruption and chronic fatigue with shift work when this problem is examined in future

Compliance of Clinical Trial Protocols for Foods with Function Claims (FFC) in Japan: Consistency between Clinical Trial Registrations and Published Reports

Background: A new type of foods with a health claims notification system, the Foods with Function Claims (FFC), was introduced in Japan in April 2015. This cross-sectional study sought to clarify compliance of clinical trial protocols reported as the scientific basis of efficacy in the FFC system. Methods: All articles based on clinical trials published on the Consumer Affairs Agency website from 1 July 2018 to 30 June 2021 were reviewed. Items assessed included first author characteristics (for-profit or academia), journal name, year published, journal impact factor in 2020, article language, name of clinical trial registration (CTR), and seven compliance items (Title: T, Participant: P, Intervention: I, Comparison: C, Outcome: O, Study design: S, and Institutional Review Board, IRB). Among studies that conducted CTR, consistency with these seven compliance items was evaluated. Results: Out of 136 studies that met all inclusion criteria, 103 (76%) performed CTR, and CTR was either not performed or not specified for 33 (24%). Compliance between the protocol and the text was high (&ge;96%) for items P and S, but considerably lower for items T, I, C, O, and IRB (52%, 15%, 13%, 69%, and 27%, respectively). Furthermore, 43% of protocols did not include functional ingredients or food names in items T or I. The total score was 3.7 &plusmn; 1.1 pts (out of 7). Conclusions: Some CTs had no protocol registration, and even registered protocols were suboptimal in transparency. In addition to selective reporting, a new problem identified was that the content of the intervention (test food) was intentionally concealed

The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study

Maintaining people’s health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations