Naruki Kitano

Associations of physical activity with neighborhood environments and transportation modes in older Japanese adults

OBJECTIVE We investigated associations of walking and other leisure-time physical activity (LTPA) with environmental characteristics and transportation modes in older Japanese adults. METHODS This cross-sectional study in 2010-2011 used data from 421 community-dwelling older adults aged 65-85 years living in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess walking and other LTPAs, and the International Physical Activity Questionnaire Environment Module for neighborhood environments. RESULTS After adjusting for confounders, we found that good traffic safety and aesthetics were positively associated with high levels of walking (ORs=1.64-2.12); whereas, good access to public transportation was negatively associated with walking (OR=0.64, 95% CI=0.42-0.98). Good access to recreational facilities, presence of sidewalks, absence of hills, seeing people exercise, and aesthetically pleasing surroundings were positively associated with high levels of LTPA except walking (ORs=1.61-2.13). Individuals who rode bicycles more than once per week were more likely to engage in a LTPA except walking (1-3 days: OR=1.72, 95% CI=1.03-2.87; ≥4 days: OR=2.90, 95% CI=1.71-4.93). CONCLUSION This study adds information on correlates of physical activity among older Japanese adults; the positive association between LTPA except walking and the frequency of bicycle travel is an especially new and intriguing finding.

Prospective Study of Physical Activity and Sleep in Middle-Aged and Older Adults

INTRODUCTION Few prospective cohort studies have examined the association between physical activity (PA) and insomnia prevention, and the effective PA intensity remains unclear. This prospective study explores how PA intensity prevents incident short sleep duration and subjective insufficient sleep in middle-aged and older adults. METHODS A self-reported questionnaire gathered data on sleep and PA variables, including moderate low-intensity PA (MLPA); moderate high-intensity PA (MHPA); and vigorous-intensity PA (VPA), during health checkups conducted in Meiji Yasuda Shinjuku Medical Center in Tokyo. This study followed two cohorts from a 2008 baseline survey: (1) participants free of short sleep duration (n=7,061) and (2) participants free of insufficient sleep (n=7,385). They were divided into middle-aged (<60 years; 45.7 [8.8] years for sleep duration and 45.5 [8.8] years for sleep sufficiency) and older adults (both groups aged 65.3 [4.7] years) and followed for a mean 3.4 years until 2013. Data were analyzed in 2014. RESULTS Engaging in MHPA (hazard ratio [HR]=0.81, 95% CI=0.67, 0.98) and VPA (HR=0.83, 95% CI=0.71, 0.97) had a significant preventive effect on incident subjective insufficient sleep among middle-aged adults. For older adults, only MLPA (HR=0.58, 95% CI=0.42, 0.81) had a significant preventive effect on incident insufficient sleep, and PA did not significantly affect incident short sleep duration. CONCLUSIONS Middle-aged adults engaging in MHPA and VPA and older adults engaging in MLPA can effectively maintain sleep sufficiency. When providing an effective PA program to prevent insomnia, the intensity of PA should correspond to the participants age.

Age and gender differences in correlations of leisure-time, household, and work-related physical activity with physical performance in older Japanese adults.

This study aimed to compare relationships of leisure‐time, household, and work‐related physical activity (PA) with physical performance by age and gender in older Japanese adults.

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.

Short-term effects of whole-body vibration on functional mobility and flexibility in healthy, older adults: a randomized crossover study.

Background and Purpose:Whole-body vibration (WBV) training is a relatively new approach for enhancing muscle strength, physical performance, and flexibility. The aim of this study was to examine whether short-term WBV training by using the triple-plane vertical vibration device (ie, acceleration training [AT]) improves functional mobility and flexibility in healthy, older adults. Methods:Eighteen healthy, older adults (9 men and 9 women; mean age 69.1 years; standard deviation, 2.5 years) participated in this randomized, crossover study. Two static stretching positions, half-squatting and hamstrings stretching, were performed with (AT) and without (control [Con]) vibration stimulus (frequency, 40 Hz; amplitude, 2-4 mm). The intervention consisted of stretching for 30 seconds per set × 3 sets per position, alternating between the 2 stretching positions. The Timed Up and Go (TUG) test was measured to determine functional mobility, which is closely linked to lower extremity muscle function. Sit-and-Reach and Functional Reach tests were performed to evaluate flexibility. Results:Only the TUG test demonstrated a significant time × intervention interaction: TUG test results improved significantly immediately and 30 minutes after the AT but not after the Con intervention. We found significant main effects of time on the Sit-and-Reach and Functional Reach results. Furthermore, the improvement rates after the AT intervention were greater than the improvement rates after the Con intervention at the immediate and 30-minute posttests. Conclusion:Short-term WBV training by using the triple-plane vertical vibration device elicited a significantly larger improvement in functional mobility than training without WBV. The effect on flexibility was similar with and without vibration stimulus, but there was a greater tendency to improve with WBV training in healthy, older adults. In addition, these short-term effects were maintained for about 30 minutes.

Relationship between built environment attributes and physical function in Japanese community-dwelling older adults

To explore the relationships between the built environment and older adults’ physical function.

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.

Change in hand dexterity and habitual gait speed reflects cognitive decline over time in healthy older adults: a longitudinal study

[Purpose] There is a relationship between physical and cognitive functions; therefore, impairment of physical function would mean cognitive decline. This study aimed to investigate the association between change in physical and cognitive functions. [Subjects and Methods] Participants were 169 healthy community-dwelling older adults who attend the survey after three years from baseline (mean age, 72.4 ± 4.8 years). Grip strength, one-leg standing balance, five-times-sit-to-stand test, timed up and go, 5-m habitual walk, and a peg-moving task were used to evaluate physical performance. Five cognitive function tests were used to assess attention, memory, visuospatial function, verbal fluency, and reasoning. Cognitive function was defined as the cumulative score of these tests. [Results] At baseline, five-times-sit-to-stand test, timed up and go, and hand dexterity were independently associated with cognitive function. In longitudinal analyses, changes in habitual walking speed and hand dexterity were significantly associated with change in cognitive function. [Conclusion] Deterioration of specific physical function, such as hand dexterity and walking ability, may be associated with progression of cognitive decline. Decreasing extent of daily functions, such as hand dexterity and walking ability, can be useful indices to grasp changes in cognitive function.

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.

Effects of aerobic and resistance training combined with fortified milk on muscle mass, muscle strength, and physical performance in older adults: A randomized controlled trial

ObjectivesFortified milk and resistance training (RT) increase muscle mass, muscle strength, and physical performance in older adults, but it remains unclear whether RT combined with aerobic training (AT) would have stronger effects on these outcomes. The purpose of this study was to examine the effects of aerobic and resistance training (ART) combined with fortified milk consumption on muscle mass, muscle strength, and physical performance in older adults.DesignOpen-labeled randomized controlled trial. Setting: University of Tsukuba.ParticipantsFifty-six older adults aged 65-79.InterventionParticipants were randomly allocated into resistance training (RT + fortified milk, n = 28) and aerobic and resistance training (ART + fortified milk, n = 28) groups. All participants attended supervised exercise programs twice a week at University of Tsukuba and ingested fortified milk every day for 12 weeks. Skeletal muscle index ([SMI]: appendicular lean mass/ height2) was assessed using dual-energy X-ray absorptiometry as a muscle mass measure. One-repetition maximum strength was measured using four kinds of resistance training machines (chest press, leg extension, leg curl, and leg press) as muscle strength measures. Sit-to-stand and arm curl tests were also assessed as physical performance measures.MeasurementsThe primary measurements were muscle mass and strength. The secondary outcomes were physical performance, blood samples, habitual diet, habitual physical activity, and medication use.ResultsAlthough the muscle strength and physical performance measures significantly improved in both groups, SMI significantly improved in only the RT group. There was no significant difference in the change in SMI and muscle strength measures between the two groups. However, the change in sit-to-stand and arm curl measures in the ART group were significantly higher than those in the RT group.ConclusionsThese results suggest that AT before RT combined with fortified milk consumption has similar effects on skeletal muscle mass and strength compared with RT alone, but it may be a more useful strategy to improve physical performance in older adults. Although the mechanism of our intervention is uncertain, our program would be an effective prevention for sarcopenia in older adults.