Hiromi Matsumoto

Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2‐year prospective cohort study of the GAINA study

The purpose of the present study was to investigate whether sarcopenia was associated with future falls in the general Japanese older population.

Locomotive syndrome presents a risk for falls and fractures in the elderly Japanese population

“Locomotive syndrome” is used to designate the condition of individuals with musculoskeletal disease who are highly likely to require nursing care. This article reviews screening, prevalence, causal and related factors, and the relationship between locomotive syndrome and falls and fractures in older adults with this syndrome. A few self-administered questionnaire tools are available to assess individuals for locomotive syndrome. Additionally, screening methods, including a physical functioning assessment, are appropriate for detailed discrimination of locomotive syndrome. The prevalence of locomotive syndrome is significantly higher in women than in men, and tends to increase markedly from 70 years of age. More severe locomotive syndrome is related to knee pain, osteoporosis, sarcopenia, and lumbar disease. The incidence of falling in locomotive syndrome is higher than the incidence for the older population in general. Locomotive training including squats and a unipedal standing exercise has been recommending to prevent locomotive syndrome. This training improves muscle strength and balance function for older people who have a risk for locomotive syndrome.

Accelerometry-based gait analysis predicts falls among patients with a recent fracture who are ambulatory: a 1-year prospective study.

The aim of this prospective study was to assess whether accelerometry-based gait analysis is associated with the incidence of falls among individuals who are ambulatory and recently had a fracture, and to compare the ability to discriminate body function and structure and activity measures. A total of 100 patients who fulfilled our inclusion criteria were enrolled. At hospital discharge, the following outcomes were assessed: timed-up-and-go test, five-times-sit-to-stand test, one-leg standing test, 5-m gait test, and gait analysis using a wireless three-axis accelerometer. Root mean square (RMS) and autocorrelation (AC) values were analyzed on the basis of the acceleration waveform. Follow-up assessment of falls and subsequent fractures was performed 12 months after the fracture. Eighty-five percent of the participants completed the follow-up at 12 months. During the 12 months of follow-up, 61 falls were reported by 34 patients (31 women, three men), for a fall rate of 40.0% (34/85). The fall group had significantly poorer body function and structure and activity measures compared with the no-fall group. In accelerometry-based gait analysis, RMS and AC in the vertical axis and RMS in the anteroposterior axis were significantly lower in the fall group compared with the no-fall group. Multivariate logistic regression analysis showed that only AC in the vertical axis was a significant predictor of falls. This finding suggests that trunk acceleration AC in the vertical axis showed good discriminative ability for predicting the incidence of falls among patients who are ambulatory and recently had a fracture.

Comparison of Healthcare Workers Transferring Patients Using Either Conventional Or Robotic Wheelchairs: Kinematic, Electromyographic, and Electrocardiographic Analyses.

Objectives. The aim of this study was to compare the musculoskeletal and physical strain on healthcare workers, by measuring range of motion (ROM), muscle activity, and heart rate (HR), during transfer of a simulated patient using either a robotic wheelchair (RWC) or a conventional wheelchair (CWC). Methods. The subjects were 10 females who had work experience in transferring patients and another female adult as the simulated patient to be transferred from bed to a RWC or a CWC. In both experimental conditions, ROM, muscle activity, and HR were assessed in the subjects using motion sensors, electromyography, and electrocardiograms. Results. Peak ROM of shoulder flexion during assistive transfer with the RWC was significantly lower than that with the CWC. Values for back muscle activity during transfer were lower with the RWC than with the CWC. Conclusions. The findings suggest that the RWC may decrease workplace injuries and lower back pain in healthcare workers.

Self-care agency, lifestyle, and physical condition predict future frailty in community-dwelling older people: Factors of frailty in older people

The purpose of this 2 year longitudinal study was to identify the relationship between self-care agency, lifestyle, physical condition, and frailty among community-dwelling older people in a rural area of Japan. The participants were 133 older individuals aged 65 years or above. Data collection was conducted via face-to-face interviews using self-administered questionnaires. Background information, such as age, sex, current employment status, family structure, medication use, comorbidities, and knee and lower back pain, were assessed. The definition of frailty was based on the Frailty Checklist. Self-care agency, lifestyle habits, and locomotive syndrome were assessed using specific assessment scores. Logistic regression analysis showed that locomotive syndrome, knee and lower back pain, and stroke are risk factors for frailty. Among the factors associated with frailty, current employment, regular exercise, and self-care agency were recognized as preventive factors of depression, decreased cognitive function, and being housebound. Our findings suggest that enhancing self-care agency, regular exercise, and self-management skills for chronic illness and disability may decrease the progression of frailty among older people.

Response to comments on: Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2-year prospective cohort study of the GAINA study: Response to comment sarcopenia risk factor fall

therapy with donepezil plus cilostazol. Now the clinical trial of cilostazol in dementing disorders is ongoing (https://clinicaltrials.gov/ct2/show/NCT02491268). However, there is no report on such a combinational effectiveness with other acetylcholinesterase inhibitors, nor on a comprehensive three factors, such as cognitive, affective and activities of daily living (ADL) functions for AD patients, nor on both patterns of the combination from acetylcholinesterase or cilostazol monotherapy to the alternative add-on therapy. In the present study, therefore, we analyzed the clinical effects of galantamine or cilostazol monotherapy to the add-on combination therapy on cognitive, affective and ADL functions in patients with AD with asymptomatic lacunar infarction. This is the first report to show the effectiveness of the two-drug combination therapy from both sides of monotherapy for patients with AD plus CVD.

Automated stride assistance device improved the gait parameters and energy cost during walking of healthy middle-aged females but not those of young controls

[Purpose] The aim of this study was to clarify the effects of an automated stride assistance device on gait parameters and energy cost during walking performed by healthy middle-aged and young females. [Subjects and Methods] Ten middle-aged females and 10 young females were recruited as case and control participants, respectively. The participants walked for 3 minutes continuously under two different experimental conditions: with the device and without the device. Walking distance, mean walking speed, mean step length, cadence, walk ratio and the physiological cost index during the 3-minutes walk were measured. [Results] When walking with the stride assistance device, the step length and walk ratio of the middle-aged group were significantly higher than without it. Also, during walking without assistance from the device, the physiological cost index of the middle-aged group significantly increased; whereas during walking with assistance, there was no change. The intergroup comparison in the middle-aged group showed the physiological cost index was lower under the experimental condition with assistance provided, as opposed to the condition without the provision of assistance. [Conclusion] The results of this study show that the stride assistance device improved the gait parameters of the middle-aged group but not those of young controls.