The importance of physical activity in promoting health and way to encourage physical activity in older population

( Kenji Tsunoda ),( Taishi Tsuji ),( Jieun Yoon ),( Tomohiro Okura ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1

As reflected in the slogan of the American College of Sports Medicine, “Exercise is Medicine,” it is common knowledge that physical activity provides numerous health benefits. This session aims to reconfirm the various health benefits of physical activity and to think a way to encourage physical activity in older adults. Despite the fact that almost all older adults know that physical activity is effective in improving health, physical activity typically decreases with advancing age. A traditional exercise program is effective in improving the health of older adults; however, this type of high-risk approach can be provided to only a proportion of the population, and its effects are usually short lived. A super- aging society requires an intervention that can be expected to provide long-term results across a wide population. Growing evidence indicates that environmental characteristics, such as access to recreational facilities and public transportation, traffic safety, and esthetics, are associated with increased physical activity in older adults. The impact of environmental factors on an individual’s behavior is smaller than traditional high risk approaches, but the approach to environments could have long-term and wide effects. This session introduces recent researches on the relationships of environmental characteristics with physical activity and certain health parameters. As a way to enhance physical activity, the use of active transportation, such as walking and bicycling, has been encouraged. In contrast to Korea, older Japanese adults traditionally cycle, which together with walking is a necessary mode of everyday transport. However, the distances older adults are willing to travel by walking and bicycling is uncertain. This session presents our recent research data on the distances community-dwelling older adults are willing to travel by walking and bicycling.

Factors Predicting the Presence of Concomitant Enterocele and Rectocele in Female Patients With External Rectal Prolapse

Akira Tsunoda,Tomoko Takahashi,Kenji Sato,Hiroshi Kusanagi 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.4

Purpose: External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP.Methods: Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele.Results: Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele.Conclusion: Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

Precise Synthesis of Dendron-Like Hyperbranched Polymers and Block Copolymers by an Iterative Approach Involving Living Anionic Polymerization, Coupling Reaction, and Transformation Reaction

Hirao Akira,Tsunoda Yuji,Matsuo Akira,Sugiyama Kenji,Watanabe Takumi The Polymer Society of Korea 2006 Macromolecular Research Vol.14 No.3

Dendritic hyperbranched poly(methyl methacrylate)s (PMMA)s, whose branched architectures resemble the 'dendron' part(s) of dendrimer, were synthesized by an iterative methodology consisting of two reactions in each iteration process: (a) a coupling reaction of u-functionalized, living, anionic PMMA having two tert-butyldimethylsilyloxymethylphenyl(SMP) groups with benzyl bromide(BnBr)-chain-end-functionalized PMMA, and (b) a transformation reaction of the introduced SMP groups into BnBr functionalities. These two reactions, (a) and (b), were repeated three times to afford a series of dendron-like, hyperbranched (PMMA)s up to third generation. Three dendron-like, hyperbranched (PMMA)s different in branched architecture were also synthesized by the same iterative methodology using a low molecular weight, functionalized 1,1-diphenylalkyl anion prepared from sec-BuLi and 1,1-bis(3-tert-butyldime-thylsilyloxymethylphenyl)ethylene in the reaction step (b) in each iterative process. Furthermore, structurally similar, dendron-like, hyperbranched block copolymers could be successfully synthesized by the iterative methodology using $\alpha$-functionalized, living, anionic poly(2-(perfluorobutyl) ethyl methacrylate) (PRfMA) in addition to $\alpha$-functionalized, living PMMA. Accordingly, the resulting block copolymers were comprised of both PMMA and PRfMA segments with different sequential orders. After the block copolymers were cast into films and annealed, their surface structures were characterized by angle-dependent XPS and contact angle measurements. All three samples showed significant segregation and enrichment of PRfMA segments at the surfaces.

Evaluation of physical function in older adults at individual and community levels

( Taishi Tsuji ),( Katsunori Kondo ),( Kenji Tsunoda ),( Jieun Yoon ),( Tomohiro Okura ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1

Purpose: We aimed to develop a novel physical performance test to easily evaluate lower limb muscle function and risk of their functional disability in a clinical setting. Community-level evaluation is also needed to identify a “high-risk community” and to promote a community-level approach for the prevention of functional disability. In this presentation, we will share the outline of our research project evaluating physical function in older adults at individual and community levels. Method: To evaluate physical function, we measured ground reaction force (GRF) during a sit-to-stand movement and calculated two parameters: peak reaction force per body weight and rate of force development per body weight (RFD/w). We investigated the validity of these parameters using data from the Kasama Study. For community-level evaluation, we performed ecological analyses using data from the Japan Gerontological Evaluation Study (JAGES), a nationwide research project including a questionnaire survey on aging, with over 100,000 participants in 2010 and 2013. We calculated the prevalence of physical function decline in 31 municipalities from the JAGES 2010 survey and investigated relevant factors affecting the prevalence. Result: We found that in older adults, two GRF parameters negatively correlated with age, had good criterion-related validity with lower limb muscle strength and power, and had relationships with physical function, history of fall, and ability to perform mobility activities. Further, we found that RFD/w declined with increase in incidences of falls and could predict onset of mobility limitations. Community-level analyses revealed that the prevalence of physical function decline varied from 14.6% to 32.2% in the 31 municipalities. Higher frequencies of participation in sports and hobby groups in a municipality were found to negatively correlate with the prevalence of physical function decline (r = .0.58 and .0.74, respectively). Conclusion: Measuring the GRF parameters during a sit-to-stand movement might provide a better evaluation of an older individual’s physical function, with sufficient validity. Recently, we have developed a specialized weight scale for measuring GRF more easily in a clinical setting. Further, we found that regional variations exist in the physical function of older adults. Community intervention with increasing participation in sports or hobby groups in a community might be an effective way to reduce these variations.

Precise Synthesis of Dendron-Like Hyperbranched Polymers and Block Copolymers by an Iterative Approach Involving Living Anionic Polymerization, Coupling Reaction, and Transformation Reaction

Akira Hirao,Yuji Tsunoda,Akira Matsuo,Kenji Sugiyama,Takumi Watanabe 한국고분자학회 2006 Macromolecular Research Vol.14 No.3

Whole-body vibration training with maslinic acid on knee function and muscle strength in older adults with knee pain: A randomized, double-blind, placebo-controlled trial

( Jieun Yoon ),( Tomohiro Okura ),( Taishi Tsuji ),( Kenji Tsunoda ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1

Introduction: Whole-body vibration training (WBVT), a neuromuscular training approach, is an efficient resistance training method. According to the latest systematic reviews and meta-analyses, WBVT significantly improves knee function and muscle strength in older adults with knee pain. Furthermore, maslinic acid (MA) from olives has been proven to reduce inflammation and swelling. This study aimed to compare the effects of WBVT alone with those of WBVT in conjunction with MA on the knee function and muscle strength of older adults with knee pain. Methods: Forty older adults (aged 65.81 years) with knee pain were distributed into two groups: (1) a WBVT plus MA group (n = 20) and (2) a WBVT plus placebo group (n = 20). All individuals took part in 50-min sessions of WBVT, twice a week for 20 weeks. Both groups also took a capsule containing either MA (50 mg) or placebo once per day. The Japanese Orthopaedic Association (JOA) score and knee isokinetic peak torque were used to evaluate observer-reported knee function and muscle strength, respectively. Results: There were no dropouts, with all 40 subjects completing the study up to the post-test. The JOA score showed significant improvement in knee function in the WBVT plus MA group but not in the WBVT alone group. Knee extension and flexion peak torque and power also improved significantly in WBVT plus MA group. In contrast, only knee extension and flexion peak torque improved in the WBVT alone group. Conclusions: These results suggest that WBVT helps improve knee extension and flexion peak torque of participants with knee pain. In particular, the WBVT plus MA group improved remarkably in knee function as well as knee extension power and flexion peak torque. Therefore, it is suggested that a WBVT program in combination with MA is very effective in improving knee function in older adults.

Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan

Yoichi Iizuka,Haku Iizuka,Tokue Mieda,Daisuke Tsunoda,Tsuyoshi Sasaki,Tsuyoshi Tajika,Atsushi Yamamoto,Kenji Takagishi 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.6

Study Design: A cross-sectional study. Purpose: To clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations. Overview of Literature: Most studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP. Methods: We obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables. Results: The prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits (p =0.049, odds ratio [OR]=2.594), low back pain (p <0.001, OR=0.974), lumbar function (p =0.001, OR=0.967), and social function (p =0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score (p =0.024, OR=0.068), low back pain (p =0.007, OR=0.981), lumbar function (p =0.001, OR=0.963), walking ability (p =0.001, OR=0.968), and social function (p =0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP. Conclusions: CNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL.

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle- Aged and Elderly Asian Individuals

Takanori Kitagawa,Yoichi Iizuka,Hiroki Kobayashi,Tokue Mieda,Daisuke Tsunoda,Atsushi Yamamoto,Tsuyoshi Tajika,Haku Iizuka,Kenji Takagishi 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.6

Study Design: Cross-sectional study. Purpose: The purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population. Overview of Literature: Measuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult. Methods: Standing coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays. Results: The present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson’s correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1−0.77×(SFP angle) in the total group, PT=62.8−0.80×(SFP angle) in the female group, and PT=51.5−0.64×(SFP angle) in the male group. Conclusions: A significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population.