Yasuyoshi Asakawa

Associations of muscle stiffness and thickness with muscle strength and muscle power in elderly women

Aim:u2003 The aims of this study were to investigate the influence of age on muscle stiffness and to examine the relationships among muscle stiffness, muscle thickness, subcutaneous fat thickness, muscle strength and muscle power in elderly women.

Daytime physical activity patterns and physical fitness in institutionalized elderly women: An exploratory study

This study investigated the relationship between daytime physical activity patterns and physical fitness in elderly women. The subjects comprised 19 elderly women who resided in a nursing home. Time spent lying, sitting, standing and walking and the number of steps taken during the daytime from 10:00 to 16:00 were measured to determine physical activity patterns. Physical fitness measures included muscle strength, balance, flexibility and physical performance. The elderly women spent 18.3% of their daytime walking, 7.31% in a standing position, 56.9% sitting and 17.4% lying down. Our results showed that the time spent in walking or standing positions was significantly associated with balance and physical performance such as walking speed, while the time spent in a sitting position was inversely associated with muscle strength, balance and physical performance. The results of this study suggest that the time the elderly spend on weight-bearing activities and in sedentary behavior are associated with physical fitness.

Interprofessional Education Initiatives at Gunma University: Simulated Interprofessional Training for Students of Various Health Science Professions

The School of Health Sciences (the “School”) of the Gunma University has a mandate to train and produce advanced, high-quality health professionals. To enhance collaboration among health professionals and to overcome the fragmented nature of specialized medicine, the School has developed a curriculum based fundamentally on holistic medicine and interprofessional work (IPW). The major advantage of the curriculum lies in its training program-simulated interprofessional training—where students work in groups and undergo a series of activities, including group discussions, clinical training at facilities, general meetings, and reporting. This “teamwork training” is the core subject of the education. Its concept is first shared and discussed during the first year of the curriculum, and training is introduced to the third-year students from all departments of the School. All academic staff help implement the training in cooperation with approximately 20 external health care facilities. The training is evaluated every year, and both students and academic staff have evaluated it positively. This “teamwork training” has been in practice for 9 years now. As medical knowledge has expanded and technology advanced, changes have taken place in IPW at clinical settings. To respond to this, deliberate efforts are being made, including: (1) use of updated case scenarios; (2) participation of students from the School of Medicine; and (3) networking for interprofessional education with external medical facilities and other universities.

Association between walking ability and trunk and lower-limb muscle atrophy in institutionalized elderly women: a longitudinal pilot study

BackgroundThe aim of this study was to investigate the association between walking ability and muscle atrophy in the trunk and lower limbs.MethodsSubjects in this longitudinal study were 21 elderly women who resided in nursing homes. The thicknesses of the following trunk and lower-limb muscles were measured using B-mode ultrasound: rectus abdominis, external oblique, internal oblique, transversus abdominis, erector spinae, lumbar multifidus, psoas major, gluteus maximus, gluteus medius, gluteus minimus, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius, soleus, and tibialis anterior. Maximum walking speed was used to represent walking ability. Maximum walking speed and muscle thickness were assessed before and after a 12-month period.ResultsOf the 17 measured muscles of the trunk and lower limbs, age-related muscle atrophy in elderly women was greatest in the erector spinae, rectus femoris, vastus lateralis, vastus intermedius, and tibialis anterior muscles. Correlation coefficient analyses showed that only the rate of thinning of the vastus lateralis was significantly associated with the rate of decline in maximum walking speed (ru2009=u20090.518, pu2009<u20090.05).ConclusionsThis longitudinal study suggests that reduced walking ability may be associated with muscle atrophy in the trunk and lower limbs, especially in the vastus lateralis muscle, among frail elderly women.

Effect of a simple and adherent home exercise program on the physical function of community dwelling adults sixty years of age and older with pre-sarcopenia or sarcopenia

[Purpose] To evaluate the effect of a home exercise program on physical function in community dwelling elderly with pre-sarcopenia or sarcopenia. [Subjects and Methods] Fifty-two community-dwelling individuals, over 60u2005years and meeting the diagnostic criteria for pre-sarcopenia or sarcopenia, were randomly assigned to intervention group (n=34) and control group (n=18). The intervention group completed 6-months home exercise programs, combining walking with lower limb resistance exercises. Body mass index, skeletal mass index, body fat percentage, handgrip strength, single-leg standing, walking speed (comfortable and maximal), and knee extension strength were evaluated at baseline and post-intervention. Activity was assessed using the 25-question Geriatric Locomotive Functional Scale (GLFS-25) and quality of life using the Euro QOL questionnaire. [Results] Pre- and post-training assessments were completed by 76.5% and 77.8% of participants in the intervention and control groups, respectively. The intervention improved single-leg standing (60.5u2005s to 77.2u2005s) and knee extension strength (1.38 Nm/kg to 1.69 Nm/kg). In the control group, maximum walking speed (2.02 m/s to 1.86 m/s) and GLFS-25 score (2.9 to 5.1) worsened. Change of pre-sarcopenia/sarcopenia status was comparable for the intervention (15.4%) and control (14.3%) groups. [Conclusion] A 6-month home exercise program improved physical function in community-dwelling individuals with pre-sarcopenia or sarcopenia.

Relations of morale and physical function to advanced activities of daily living in health promotion class participants.

[Purpose] The aim of this study was to clarify the relations of morale and physical function to the presence/absence of advanced activities of daily living. [Subjects] The subjects were 86 elderly community residents participating in health promotion classes. [Methods] A questionnaire survey on age, gender, presence/absence of advanced activities of daily living, and Philadelphia Geriatric Center Morale Scale score was conducted, in addition to assessment of fitness, consisting of measurement of height, body weight, grip and knee extensor muscle strength, functional reach, one-leg standing time, and Timed Up and Go test. Furthermore, multiple logistic regression analysis was performed with the presence/absence of advanced activities of daily living as a dependent variable. [Results] Grip strength and Timed Up and Go time were identified as variables influencing the presence/absence of advanced activities of daily living. [Conclusion] Physical function represented by grip strength and Timed Up and Go time was higher among subjects performing advanced activities of daily living.

Low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring.

[Purpose] This study examined whether low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring. [Subjects] The subjects were community-dwelling elderly people in a rural area of Japan. [Methods] One group (n = 50) performed group exercise combined with home exercise with self-monitoring. Another group (n = 37) performed group exercise only. Low-frequency group exercise (warm-up, exercises for motor functions, and cool-down) was performed in seven 40 to 70-minute sessions over 9 weeks by both groups. Five items of motor functions were assessed before and after the intervention. [Results] Significant interactions were observed between groups and assessment times for all motor functions. Improvements in motor functions were significantly greater in the group that performed group exercise combined with home exercise with self-monitoring than in the group that performed group exercise only. Post-hoc comparisons revealed significant differences in 3 items of motor functions. No significant improvements were observed in motor functions in the group that performed group exercise only. [Conclusions] Group exercise combined with home exercise with self-monitoring improved motor functions in the setting of low-frequency group exercise for community-dwelling elderly people in a rural area.