Tomoaki Sakai

Square-stepping exercise versus strength and balance training for fall risk factors.

Background and aims: Feasible and low-cost exercise programmes targeting fall risk factors may decrease the risk of falling in older adults. The purpose of this study was to compare the effects of square-stepping exercise (SSE) training, which is a new and low-cost method designed to improve lower-extremity functional fitness, with strength and balance (SB) training. Methods: The study included 39 community-dwelling adults aged 65 to 74 years. The participants were randomized to either group SSE (n=20) or SB (n=19). They engaged in 70-min group exercise sessions twice a week for 12 weeks. The efficacy of the program was measured with both a 9-item test battery for assessment of physical performance and self-reported scales (fear of falling, pleasure in exercise, perceived health status). Fall incidence was followed up for 14 months. Results: The results of a 2-way ANOVA revealed that the time effect in 7 of the 9 performance tests was significant, although group-by-time interactions were not. No significant changes were observed in the self-reported scales. During the 14-month follow-up period, 7 falls in 6 participants in the SSE group and 12 falls in 11 participants in the SB group were reported. The incidence rate per person in the SSE group (30.0%) was not significantly different from that in the SB group (57.9%). The rate of falls per trip [falls/(falls + trips)] in the SSE group (17.1 %) was significantly lower than in the SB group (50.0%). Conclusions: SSE is as equally effective as SB training in improving lower-extremity functional fitness. SSE may also be recommended for older adults, due to its low cost and effectiveness.

Health benefits associated with exercise habituation in older Japanese men

Background and aims: The purpose of this study was to compare the effects of exercise habituation (3–32 years, mean 13.2 years) on physical vitality among five different groups. Methods: One hundred and two independent, community-dwelling elderly Japanese men, aged 64.6±6.6 years, were recruited as subjects. The vital age test battery consisted of various coronary heart disease risk factors and physical fitness elements. Results: The results of analysis of variance revealed that vital age as an index of physical vitality was youngest in joggers (47.9 yr, N=18), intermediate in trekkers (55.8 yr, N=20) and walkers (59.1 yr, N=18), and oldest (69.6 yr, N=20) in patients with ischemic heart disease (IHD). The difference between chronological age and vital age was approximately 15 years (p<0.05) in joggers, and 8 years (p<0.05) in trekkers and walkers. The vital age of sedentary persons (N=26) was only 1.9 years (NS) younger than their chronological age, which was similar to the difference (vital age of 64.1±8.5 yr vs chronological age of 65.7±5.4 yr) previously observed in similarly aged exercising IHD patients. Conclusions: These results indicate that exercise habituation significantly affects the overall health status of most individuals, irrespective of mode of exercise. Among the three modes of exercise, jogging may be most beneficial. Furthermore, regularly exercising coronary patients may have physical vitality similar to that of sedentary men.