動作タイミングと協調性に着目した簡易なホームエクササイズが健常高齢者の下肢機能に与える効果について : 準ランダム化比較試験

首都大学東

Physical Activity and Activities of Daily Living in Older Adult Patients With Heart Failure Admitted for Subacute Musculoskeletal Disease

Objective To examine activities of daily living (ADL) and physical activity in older adults with heart failure admitted to a rehabilitation ward for subacute musculoskeletal disease. Methods This study included patients with musculoskeletal disease (aged ≥75 years) who were admitted to the rehabilitation ward. Data on age, ADL, and time for physical activity (metabolic equivalents [METs]) were collected. Patients were divided into groups with or without heart failure, and the differences were compared using Mann–Whitney U-test. Results This study included 84 musculoskeletal patients, including 25 with heart failure. The heart-failure group had similar levels of ADL independence compared to the without-heart-failure group (p=0.28) but had shorter duration of continuous and sustained physical activities and less total time (p<0.01) of light-intensity physical activity or higher. Conclusion Older adults with subacute musculoskeletal disease with heart failure do not necessarily require a large amount of physical activity to maintain ADL at the time of discharge. But very low physical activity may increase the risk for developing hospitalization-associated disability. Physical activity in older adults with subacute musculoskeletal disease with heart failure should be monitored separately from ADL

地域在住女性高齢者における直線および曲線歩行能力と歩行関連自己効力感について : 高い社会機能を有する前期高齢者と後期高齢者の比較

Background: The characteristics of both straight- and curved-path walking abilities and walking self-efficacy among older women aged ≥ 75 years with high social functioning are not clear. This study aimed to clarify the characteristics of walking ability and self-efficacy among young-old (age 65-74 years) and old-old women (age ≥ 75 years) with high social functioning. Methods: The participants in this cross-sectional study were 36 community-dwelling older women (mean age ± standard deviation: 73.4 ± 5.2 years) recruited using a convenience sampling method. The 5-m and Figure-of-8 Walk Tests were used to evaluate straight- and curved-path walking abilities. Waking self-efficacy was evaluated using the modified Gait Efficacy Scale. The participants were divided into two age groups: 65-74 (n = 22) and ≥ 75 years (n = 14). The results of the 5-m and Figure-of-8 Walk Tests and the modified Gait Efficacy Scale were compared between groups using an unpaired t-test and the Mann-Whitney U test. The relationships between the evaluation items were analyzed using Pearson\u27s product-moment correlation coefficient and Spearman\u27s rank correlation coefficient. Results: Significant differences were found between the two groups in the 5-m Walk Test (p = 0.011) and Figure-of-8 Walk Test (p = 0.016); however, no significant differences were seen in modified Gait Efficacy Scale scores (p = 0.311). The correlation coefficients between modified Gait Efficacy Scale scores and walking abilities were lower in the group aged ≥ 75 years. Conclusions: The present study found that, compared with women aged 65-74 years, those aged ≥ 75 years with high social functioning showed no decline in walking self-efficacy or straight- and curved-path walking abilities.首都大学東京学位論文甲第965号副論

回復期リハビリテーション病棟入院患者の直線歩行能力と曲線歩行能力の関連性は歩行自立度によって異なる

Objective: This study was performed to examine differences in the association between straight and curved walking abilities of inpatients in the subacute phase and walking independence level. Design: Cross-sectional study. Methods: Subjects were divided into an independent group and a supervised group (n=10 each) by walking independence level within the ward decided by physical therapists. Inclusion criteria comprised the ability to ambulate independently within the ward, regardless of the use of walking aids. Straight walking abilities (walking velocity, stride length, and cadence) were evaluated using the 5-meter walk test. Curved walking abilities were evaluated using the Figure-of-8 Walk Test (F8W) and the 3-meter zigzag walk test (3ZW). Differences in associations between straight and curved walking abilities of inpatients were examined by calculating correlation coefficients between straight and curved walking abilities. Results: Age, walking velocity, stride length, F8W and 3ZW varied markedly between independent and supervised groups. In the independent group, F8W and 3ZW correlated significantly with walking velocity and cadence (p<0.05). In the supervised group, F8W correlated significantly with walking velocity and stride length (p<0.05), but 3ZW did not correlate significantly with straight walking abilities. Conclusions: The association between straight and curved walking abilities varied between inpatients who could ambulate independently and inpatients requiring supervision for ambulating. These differences may depend on skill on straight and curved walking abilities. There is a possibility that curved walking exercise is necessary for supervised group.首都大学東京学位論文甲第965号副論

Systematic inclusion of mandatory interprofessional education in health professions curricula at Gunma University: a report of student self-assessment in a nine-year implementation

<p>Abstract</p> <p>Background</p> <p>The mandatory interprofessional education programme at Gunma University was initiated in 1999. This paper is a statistical evaluation of the programme from 1999 to 2007.</p> <p>Methods</p> <p>A questionnaire of 10 items to assess the achievement levels of the programme, which was developed independently of other assessment systems published previously, was distributed, as well as two or three open-ended questions to be answered at the end of each annual module. A multivariate analysis of variance model was used, and the factor analysis of the responses was performed with varimax rotation.</p> <p>Results</p> <p>Over all, 1418 respondents of a possible 1629 students completed the survey, for a total response rate of 87.1%. Cronbach's alpha of 10 items was 0.793, revealing high internal consistency. Our original questionnaire was categorized into four subscales as follows: "Role and responsibilities", "Teamwork and collaboration", "Structure and function of training facilities", and "Professional identity". Students in the Department of Occupational Therapy reached a relatively lower level of achievement. In the replies to the open-ended questions, requests for the participation of the medical students were repeated throughout the evaluation period.</p> <p>Conclusion</p> <p>The present four subscales measure "understanding", and may take into account the development of interprofessional education programmes with clinical training in various facilities. The content and quality of clinical training subjects may be remarkably dependent on training facilities, suggesting the importance of full consultation mechanisms in the local network with the relevant educational institutes for medicine, health care and welfare.</p

Effect of simple home exercise focused on timing and coordination on lower-extremity function in non-disabled older persons: A quasi-randomized controlled trial

Introduction: Lower-extremity function is a predictor of subsequent disability in non-disabled older persons. The present study aimed to determine the effect of simple home exercise focused on timing and coordination of movement on lower-extremity function in community dwelling non-disabled older persons. Materials and methods: Study design was a single-blind quasi-randomized controlled trial. The participants were 66 non-disabled older persons aged 60 years or older who independent activity of daily living and walking indoor and outdoor. They were devilled into intervention group (n=34) and control group (n=32). Participants in the control group participated in routine activities. The intervention group participated in a 1-month of simple home exercise focused on timing and coordination of movement consisted of calf raise, pivot turn and front stepping. Lower-extremity function was assessed by measuring maximum walking speed, figure-of-8 walk test, 3-m zigzag walk test and chair stand five test at baseline and at 1month after starting the intervention. Results: The intervention improved chair stand five test (8.8sec to 7.5sec; p<0.05). There was no significant change in maximum walking speed, figure-of-8 walk test and 3-m zigzag walk test. The mean adherence rate of home exercise was 76.1±17.4%. Conclusion: Simple home exercise focused on timing and coordination of movement is effective to improve lower-extremity function in community dwelling non-disabled older persons

Daytime physical activity patterns and physical fitness in institutionalized elderly women: An exploratory study.

This study investigated the relationship between daytime physical activity patterns and physical fitness in elderly women. The subjects comprised 19 elderly women who resided in a nursing home. Time spent lying, sitting, standing and walking and the number of steps taken during the daytime from 10:00 to 16:00 were measured to determine physical activity patterns. Physical fitness measures included muscle strength, balance, flexibility and physical performance. The elderly women spent 18.3% of their daytime walking, 7.31% in a standing position, 56.9% sitting and 17.4% lying down. Our results showed that the time spent in walking or standing positions was significantly associated with balance and physical performance such as walking speed, while the time spent in a sitting position was inversely associated with muscle strength, balance and physical performance. The results of this study suggest that the time the elderly spend on weight-bearing activities and in sedentary behavior are associated with physical fitness