The current situation of aging Japanese population with a focus on physical activity and physical function

( Tomohiro Okura ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1

Japan is predicted to have a super-aged population on a globally unprecedented scale. By 2025, when the baby boomer generation will be aged 75 years or more, it is predicted that: 1) one in every three people will be 65 years or older (compared with one in four at present) and one in every five people will be 75 years or older (one in 10 at present); 2) the number of people with dementia will have increased from 4.6 million at present to 7.0 million; and 3) approximately 30% of all households will be elderly single or couple households. The long-term care insurance system is essential for supporting the daily lives of people needing long-term care. As the nation with the most rapidly aging population, Japan is responsible for creating a society in which elderly people can live with a sense of security by ensuring that the long-term care insurance system remains sustainable. The extension of a healthy life expectancy is a universal goal. A healthy life expectancy is influenced by medical factors and physical functional ability. For example, higher levels of walking ability and muscle function of the lower extremities are undoubtedly associated with a longer healthy life expectancy. To provide a hypothetical example, an individual can acquire higher level of physical functioning by maintaining a high level of physical activity by frequently going outdoors, at least for the last few years. In addition, an individual can maintain higher levels of physical activity if the individual has many chances to travel, shop, engage in hobbies, and participate in various volunteer activities. Furthermore, that individual may be presented with many such chances if he or she is very sociable, i.e., has high-quality interpersonal interactions and relationships. Although the above considerations focus on personal factors only, it is also important to investigate the relationship of health and fitness with environmental factors, such as the geographical environment and social capital. In this symposium young researchers will introduce up-to-date data and their own research findings on physical activity and physical fitness with the purpose of averting the need of nursing care and supporting successful aging.

Evaluation of knee function for whole-body vibration training using three scoring methods

Jieun Yoon,Tomohiro Okura,Akihiro Kanamori,Taishi Tsuji 한국체육측정평가학회 2019 한국체육측정평가학회지 Vol.21 No.3

Whole-body vibration training (WBVT) is an effective resistance training method to strengthen muscle. This study examined the effect of WBVT on knee pain. We evaluated the effectiveness of WBVT and measuring methods by comparing muscle function measurements and three different knee function scoring methods before and after a WBVT program. Subjects were 29 females aged 50-73 years with knee pain. They participated in a WBVT program that we designed mainly to improve knee muscle strength for eight weeks (twenty-four 50 min sessions). All subjects completed the WBVT program with pre- and post-WBVT evaluations: muscle function measurements, the clinically-reported Japanese Orthopaedic Association (JOA) Score, and the self-reported Japanese Knee Osteoarthritis Measure (JKOM) and the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). The JOA Score, JKOM and WOMAC outcomes showed that our WBVT program effectively relieved knee pain. The JOA Score provided more detailed information on the condition of subjects’ knees than the JKOM and WOMAC results. The measure of joint effusion from the JOA Score and the isokinetic flexion peak torque and average power muscle measurements were significantly related to joint effusion and joint flexion angle. This study suggests that for accuracy in measuring knee function, the clinically-reported JOA Score should be evaluated in parallel with muscle function measurements. This approach can provide quantitative information for patients with knee osteoarthritis.

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.

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.

The Effects of Whole-Body Vibration Training on Knee Function and Physical Performance of Middle-Aged and Elderly Woman with Knee Osteoarthritis and Chronic Knee Pain

Jieun Yoon,Taishi Tsuji,Akihiro Kanamori,Kiyoji Tanaka,Tomohiro Okura 아시아건강운동학회 2019 Journal of Asian Society for Health & Exercise Vol.1 No.2

The purpose of this study was to elucidate the effects of whole-body vibration training (WBVT) on knee function and physical performance in middle-aged and older Japanese women who suffered from knee osteoarthritis (OA) and knee pain. Thirty-eight middle-aged and older Japanese women (aged 50-73 years) with knee OA and knee pain were divided into two groups: (1) a WBVT group (n = 29) engaging in WBVT 3 times a week for 8 weeks, and (2) a control group (C group, n = 9) performing exercises at home. The WBVT program consisted of a warm-up, strength training mainly of the quadriceps and their surrounding muscles and cool-down exercises. In the WBVT group, there were no dropouts, and there were significant improvements in the physical function (Cohen’s d = 0.28) and total score (Cohen’s d = 0.25) of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were also statistically significant improvements in all lower-extremity function tests (5-times sit-to-stand, timed up and go, standing time from a long sitting position, sit and reach, 4-way choice reaction time; Cohen’s d = 0.34-1.24). The item that changed significantly in the C group, however, was only the sit and reach (Cohen’s d = 0.52). In addition, all items in the Japanese Orthopaedic Association Score (JOA score) improved significantly (Cohen’s d = 0.63-0.67) in the WBVT group. In conclusion, the 8-week WBVT program can safely improve knee function and physical performance in middle-aged and older Japanese women who suffer from knee OA and knee pain.

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.