Kazushi Hotta

Sleep Status in Male Wheelchair Basketball Players on a Japanese National Team

Background: Sufficient sleep is required for optimal performance in athletes; however, there is no published information regarding sleep status in top wheelchair basketball players. This study has two objectives: to compare sleep status between the general population of young Japanese males and male wheelchair basketball players, and to examine differences in sleep status by physical disordered conditions of wheelchair athletes. Methods: Study participants included 14 male wheelchair basketball players on a Japanese national team. Sleep status was assessed by the Pittsburgh Sleep Quality Index (PSQI). A higher PSQI score indicates poor sleep quality. To compare sleep status between the general Japanese population and wheelchair athletes, we used data from a previous study that assessed PSQI in the former population. We divided athletes’ disordered conditions into two categories: spinal cord injury (n=9) and skeletal system diseases (n=5). Results: The mean PSQI score was 5.8 ± 3.0 points; six athletes (42.9%) were over the cutoff point (5.5) for insomnia. The wheelchair athletes had significantly higher scores for sleep quality, sleep efficiency, and total PSQI than the general population of young Japanese males. The PSQI score of athletes with skeletal system diseases was significantly higher than athletes with spinal cord injury. Additionally, athletes with skeletal system diseases were significantly more likely to score over the cutoff point for insomnia than those with spinal cord injury. Conclusions: Top male wheelchair basketball players had poorer sleep than the general population of young Japanese men, and athletes with skeletal system diseases more frequently suffered from insomnia compared with athletes with spinal cord injury. Effective methods to improve sleep are needed to help top wheelchair basketball players to achieve optimal performance.

Pedometers Affect Changes in Lower-Extremity Physical Function During a Square-Stepping Exercise Program in Older Japanese Adults.

Background and Purpose:Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. Methods:The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 ± 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. Results:Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. Conclusions:This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

Correlates of shoulder pain in wheelchair basketball players from the Japanese national team: A cross-sectional study

OBJECTIVE To reveal correlates of shoulder pain in wheelchair basketball players from the Japanese national team. METHODS Study participants were 19 males (29.7 ± 5.2 years) and 21 females (29.0 ± 8.2 years) players. We assessed shoulder pain using the wheelchair users shoulder pain index (WUSPI). As potential correlates of shoulder pain, age, ability class, practice time and years of experience in wheelchair basketball were collected. RESULTS The total WUSPI score for men (16.18 ± 17.39 points) was significantly higher than that for women (8.62 ± 15.70 points). In men, higher age was significantly correlated with greater shoulder pain for total WUSPI score and on two WUSPI items. Lower ability in wheelchair basketball was correlated with mens greater shoulder pain on three WUSPI items. In men, there were also significant correlations between longer years of experience and greater shoulder pain for total WUSPI score and on three WUSPI items. For women, there were significant correlations between longer practice time and less pain for total WUSPI score and on four WUSPI items. CONCLUSIONS Because top male wheelchair basketball players have a higher risk of shoulder pain than female players, daily care of shoulder and periodic medical checkups are needed, especially for older male players with lower ability and more experience.

A survey of deep tissue injury in elite female wheelchair basketball players

OBJECTIVE To investigate deep tissue injuries (DTIs) in elite female wheelchair basketball players and identify factors associated with their occurrence. METHODS Study participants were 22 female wheelchair basketball players on the Japanese national team. The sacral and bilateral ischial regions of each participant were examined using ultrasonography to detect DTIs. RESULTS DTIs were found in 15 players (68.2%). DTIs were more frequent in players with a central nervous system disorder (CNSd) (85.7%) than in those with skeletal system disease (SSd) (37.5%, p = 0.020), and in players using a wheelchair in daily life (84.6%) than those using a wheelchair only for basketball (44.4%, p = 0.046). Players with pelvic instability were more likely to have DTIs (90.9% vs. 45.5%, p = 0.017). DTIs were deeper in the ischial region than the sacral region (p = 0.022). Players with CNSd had more DTIs in sacral regions (90% vs. 10%, p = 0.014). Players with DTIs had lower systolic blood pressure (sBP), red blood cell (RBC) count, and serum creatinine levels (sCr) (all p < 0.05). CONCLUSIONS Ischial DTIs were deeper than sacral DTIs. Players with CNSd had more sacral DTIs than those with SSd. CNSd, wheelchair use in daily life, pelvic instability, and lower sBP, RBC, and sCr increased the risk of DTIs.

Correlation between sleep and psychological mood states in female wheelchair basketball players on a Japanese national team

[Purpose] Although some studies suggest the importance of getting adequate sleep for enhancing mood, there is not yet sufficient evidence on the relationship between sleep and mood states in athletes, especially for athletes with physical disability. The purpose of this study is to reveal relationships between sleep and psychological mood states in female wheelchair basketball players. [Subjects and Methods] Seventeen female wheelchair basketball players (30.9 ± 9.4 years old) on a Japanese national team participated. Sleep states were assessed with the Pittsburgh Sleep Quality Index (PSQI), and mood states with the Japanese version of the Profile of Mood States short form (POMS-SF). Spearman’s rank correlations were computed. [Results] The mean PSQI score was 5.4 ± 2.6 points, and 9 athletes (52.9%) exceeded the cutoff point (5.5) for insomnia. Higher sleep efficiency (rS=0.58), fewer sleep disturbances (rS=−0.58), and lower total PSQI score (rS=−0.51) were significantly correlated with higher vigor. Lower likelihood of daytime dysfunction was also significantly correlated with lower tension (rS=0.50). [Conclusion] Vigor was the mood state most frequently correlated with sleep variables. Because vigor is a known key psychological factor in optimal performance, the findings are valuable for wheelchair basketball players.

Daily Life Physical Activity Modulates the Effects of an Exercise Program on Lower-extremity Physical Function in Japanese Older Adults

Background and Purpose: Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. Methods: The participants were 46 community-dwelling older adults (mean age, 70.1 ± 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. Results: During the exercise program, 8 participants decreased their daily life PA (early period, 6971 ± 2771; late period, 5175 ± 2132) and 38 participants maintained PA (early period, 6326 ± 2477; late period, 6628 ± 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Discussion: Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participants daily life PA outside the program. Conclusion: Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

Comparison of sleep status among three Japanese national wheelchair basketball teams

[Purpose] Sufficient sleep is required for maximal performance and good mood. Japan has three national wheelchair basketball teams: Top male, Top female, and Under-23 (U23) male teams. Using these team members as model, this study investigated the difference of sleep status of wheelchair basketball players by age and gender. [Subjects and Methods] There were 44 participants: 14 in the Top male team (29.5 ± 5.2 years), 18 in the Top female team (30.6 ± 9.2 years), and 12 in the U23 team (19.1 ± 2.0 years). Sleep status was assessed with the Pittsburgh Sleep Quality Index (PSQI); higher scores indicate poor sleep quality. [Results] PSQI scores in the Top male and female teams were higher than in the U23 team. The Top teams showed shorter sleep duration and worse sleep efficacy than the U23 team. Time spent in bed and sleep duration in the female team were shorter than in the Top male and U23 teams. More male players reported “feel too hot” as the reason for sleep disturbance than female players. [Conclusion] Players in the Top Japanese national wheelchair basketball teams had poorer sleep status than U23 players. Among female players, the reason for insomnia was less sleep duration. For males, the reason for insomnia was “feel too hot.”

Right half-field eye patching may not be an effective approach for chronic hemispatial neglect – a two-case investigation

Right half-field eye-patched glasses intervention was performed in two chronic stroke patients with unilateral spatial neglect. Eye movement on the neglect side, the center of gravity as an index of the internal midline bias, neglect sign tests, and the regional cerebral blood flow (rCBF) were measured before and after intervention. The improvement of eye movement was not shown clearly after intervention. The center of gravity shifted significantly to the right and backward. Letter and star cancellation tests were improved in both the cases. Line bisection test showed improvement in one patient. However, line cancellation and line bisection tests were worsened in the other. The rCBF was not changed after intervention. This case study suggests that right half-field eye patching might not be an effective intervention.