Kaoru Kuroki

Improving Walking, Muscle Strength, and Balance in the Elderly with an Exergame Using Kinect: A Randomized Controlled Trial

BACKGROUND Many issues prevent elderly individuals from exercising in daily life. There is a need for a system that allows elderly individuals to engage in exercise regularly at a low cost. We developed an exergame that uses a Kinect(®) sensor (Microsoft Corp., Redmond, WA) and conducted a randomized controlled trial of the effects of using this exergame on muscle strength and balance in healthy elderly individuals. SUBJECTS AND METHODS We enrolled 57 healthy elderly individuals and randomly divided them into an intervention group (n=29) and a control group (n=28) using a table of random numbers. All participants underwent gait analyses and were examined using the Berg Balance Scale (BBS), Functional Reach Test (FRT), and the 30-second chair-stand (CS-30) test before the intervention. Participants in the intervention group played the exergame once or twice a week, up to a total of 24 times. The tests were repeated after intervention, and the scores were compared with those obtained before intervention. RESULTS Our results indicated that walking, muscle strength, and motor function improved in participants in the intervention group. Decreased double standing time (P=0.03), minimum foot clearance (P=0.04), BBS scores (P<0.01), CS-30 scores (P<0.01), and FRT scores (P<0.01) significantly improved in the intervention group compared with values in the control group. CONCLUSIONS The Kinect-based exergame developed in this study was found to be effective in improving walking, muscular strength, and balance in elderly people.

Excessive Game Playing Is Associated with Poor Toothbrushing Behavior among Athletic Children: A Cross-Sectional Study in Miyagi, Japan

Dental problems among athletes have been cautioned due to negative impacts not only on their oral health but also on athletic performance. Acquirement of appropriate oral health behavior mainly composed of toothbrushing in childhood can be one of the most important strategies for advancing childrens athletic possibilities. Although habits of screen viewing, including game playing, and TV viewing have direct impacts on childrens health and behavioral development, little is known about the association between these habits and toothbrushing frequency. A cross-sectional survey examining sports activities was conducted using a self-report questionnaire among school-aged athletic children belonging to the Miyagi Amateur Sports Association (n = 6,658). All statistical analyses were performed with SPSS, and P-values less than 0.05 were considered statistically significant. The association between a lower brushing frequency (< 2 times a day) and screen-viewing behavior was examined using multivariate logistic models after adjusting for sex, age, body mass index (BMI), studying time, and sleep duration. After adjustment for all covariates, longer game playing (> 2 hrs a day), but not TV viewing, significantly correlated with lower brushing frequency (P for trend < 0.001). Importantly, longer game-playing behavior was also associated with unhealthy dental behavior defined as a lower brushing frequency regardless of the awareness of dental caries (P for trend < 0.001). In conclusion, this is the first study indicating a type-specific unfavorable impact of screen viewing on oral health behavior among athletic children. Excessive game playing may adversely affect oral health literacy more strongly than TV viewing.

Coexistence of Trunk or Lower Extremity Pain with Elbow and/or Shoulder Pain among Young Overhead Athletes: A Cross-Sectional Study

Elbow or shoulder injuries are common in overhead sports. Because energy derived from the lower extremity passes through the trunk to the upper extremity in overhead motion, a break in such a kinetic chain could lead to arm injuries. However, there is only limited information about the role of the trunk and lower extremity support in preventing elbow or shoulder injuries. This study aimed to explore the association of trunk and lower extremity pain with elbow/shoulder pain among young overhead athletes. We conducted a cross-sectional study using self-reported questionnaires mailed to young athletes belonging to the Miyagi Amateur Sports Association. The final study population comprised 2,215 young athletes playing baseball (n = 1,422), volleyball (n = 546), softball (n = 14), handball (n = 28), tennis (n = 110), or badminton (n = 95). The median age of the participants was 11 years (range: 6 to 15 years). Multiple logistic regression analysis revealed the higher prevalence of elbow and/or shoulder pain in athletes with back pain (OR = 5.52, 95% CI = 3.51-8.69), hip pain (OR = 6.13, 95% CI = 3.35-11.22), knee pain (OR = 2.28, 95% CI = 1.48-3.51), and foot pain (OR = 3.03, 95% CI = 1.95-4.72), compared with those without pain. We propose that trunk or lower extremity pain is significantly associated with elbow or shoulder pain among young overhead athletes. Assessing for pain in trunk or lower extremity, as well as elbow and/or shoulder pain, may help prevent serious injuries in young overhead athletes.

Youth Baseball Players with Elbow and Shoulder Pain Have Both Low Back and Knee Pain: A Cross-sectional Study

Objectives: Serious arm injuries in youth baseball players have been increasing. Though a breakage in the kinetic chain could affect arm injuries, an association between arm injuries and insufficient support of the trunk and lower extremities have not been well understood. The purpose of this study was to investigate the association of low back and knee pain with elbow and/or shoulder complaints among youth baseball players. Methods: Study participants were mostly school-aged athletes belonging to Junior Sports Club Association of Miyagi prefecture (aged 6 to 15 years old). A self-administered questionnaire and informed consent document were mailed to25,469 registered athletes. Of those, 7,333 athletes replied both written informed consent and questionnaire (response rate was 28.8%). Those who did not play baseball (n = 5,577) and played both baseball and the other sports (n = 26) were excluded from this study. Missing data on variables (n = 192) were also excluded. The final study population was comprised of 1,535 players. We used multiple logistic regression analysis to examine the association of low back and knee pain with elbow and/or shoulder pain. Variables considered in the models were sex, age, BMI, years of athletic experience, position, team level, the amount of practice, participating day in team practice and game per week, frequency of participation in games, and practice intensity. Results: The frequency of elbow and/or shoulder pain was 24.8% (n= 393); that of elbow pain, 14.3% (n = 226); that of shoulder pain, 17.3 % (n = 273); that of both elbow and shoulder pain, 6.6% (n = 105); and that of low back and knee pain were 8.4% (n= 134) and 13.1% (n = 208), respectively. The frequency of elbow and/or shoulder pain who had low back and knee pain were 61.2% (n = 82) and 51.9% (n= 108) (p<0.001), respectively. The presence of low back and knee pain were strongly associated with elbow and/or shoulder pain (adjusted ORs (95%CI): 4.23 (2.83 - 6.34), p<0.001 and 3.11 (2.24 - 4.31), p<0.001, respectively), elbow (adjusted ORs (95%CI): 3.19 (1.74 - 5.83), p<0.001 and 2.45 (1.47 - 4.07), p=0.001, respectively), shoulder (adjusted ORs (95%CI): 4.25 (2.59 - 7.29), p<0.001 and 3.31 (2.17 - 5.05), p<0.001, respectively), and both elbow and shoulder pain (adjusted ORs (95%CI): 5.49 (3.08 - 9.79), p<0.001 and 3.52 (2.12 - 5.85), p<0.001, respectively). Conclusion: Both low back and knee pain were significantly associated with elbow and/or shoulder pain in youth baseball players. This result suggests that checking the trunk and lower extremities as well as elbows and shoulders are important for preventing sever injuries in youth baseball players.

Knee pain is associated with lower back pain in young baseball players: a cross-sectional study

PurposeConsiderable research has focused on shoulder and elbow injuries among baseball players; however, although lumbar spine and knee injuries are commonly experienced, they are less frequently studied. During common motions in baseball, such as throwing, hitting, and running, energy is transferred from the lower extremities through the lower back to the upper body. Lower extremity pain, as well as lower back pain (LBP), can disrupt the kinematic chain, and it is important to understand the association between lower extremity complaints and LBP. The purpose of this study was to elucidate the association between knee pain and LBP among young baseball players.MethodsA cross-sectional study was conducted with young baseball players (aged 6–15 years, n = 1,609) using a self-reported questionnaire. Multivariate logistic regression models were used for analyses. Variables considered in the models were sex, age, body mass index, team levels, number of days of training per week, number of hours in practice per day on weekdays and weekend, frequency of participation in games, practice intensity, and player position.ResultsThe point prevalence of LBP and knee pain was 8.4% and 13.1%, respectively. Knee pain was significantly associated with LBP. Using the absence of knee pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 5.83 (3.93–8.65) (p < 0.001) in the presence of knee pain.ConclusionsKnee pain was associated with LBP among young baseball players. Clinicians should pay attention to knee complaints to prevent and treat LBP among young baseball players.Level of evidenceIII.