The purpose of this study was to systematically review non-randomized controlled trials of balneotherapy effects on locomotorium diseases in order to assess their quality and organize the evidence.
 We searched the databases of PubMed, CINAHL, Web of Science, JDream ll, and lchushi-Web forpapers published from 1990 to December 2, 2008. Eligible studies were non-randomized controlled trials in which balneotherapy exclusive of underwater exercise was the primary intervention. There was no limitation on the language in which the paper was written.
 We found only 4 papers (2 in English, 1 in Croatian, and 1 in Japanese) that fulfilled the eligibility criteria. These papers differed in the type of diseases studied, so a meta-analysis could not be applied. Their individual results showed that hot springs treatment in combination with a comprehensive fitness class was more effective than hot springs treatment alone, and that balneotherapy had therapeutic effects on arthrosis deformans, psoriatic arthritis, and lumbago. However, it was difficult to accurately interpret the effects because these papers were deficient in providing descriptions of important details of the studies.
 To improve the quality of future investigations performed with non-randomized controlled trials, we suggest that investigators design a study based on various checklists, implement interventions, conduct evaluations, finally write papers summarizing their findings.

 The purpose of this study was to systemically review cohort studies of the preventive effects on locomotorium diseases in order to collectively evaluate the evidence.
 We searched the databases of PubMed, CINAHL, and lchushi-Web for papers published from1990 to September 17, 2009. The search was not limited by the language in which the paper was written.
 We found only one article (in Japanese) that fulfilled the eligibility criteria. Results in this article showed that bone fractures were significantly lower in the group with two times or more utilization of the hot spa bathing per year compared to the group with one time or less utilization per year, even after adjusting for the confounding effects of exercise habits and WHO-QOL. However, a metaanalysis could not be applied.
 We propose that it is necessary to conduct more cohort studies in which researchers choose suitable outcome measurements that assess long term effects.

In this study, we investigated whether subjects with a Lower Maximum Step Length (MSL) Percentage (LMP) display unstable locomotion while negotiating an obstacle. Data were collected using a three-dimensional motion analysis system. The toe-obstacle clearance of the leading limb was monitored in 10 young adults while stepping over three height obstacles from 30%, 40% and 50% of MSL. The vertical clearance at the time of the obstacle crossing decreased systematically with more complicated experimental set up. In particular, subjects with LMP showed smaller clearances than subjects with a Higher Maximum step length Percentage (HMP). Furthermore, a significant correlation was observed between the toe-obstacle clearance and MSL. The mean of variance value of toe-obstacle clearance of the leading limb differed between the subjects with LMP and those with HMP. Our findings help to explain the relation of MSL and gait adaption ability to negotiate obstacles safely during obstacles crossing.

Objective: There are many observational and clinical studies on pain treatment in farmers; however, little is known about the effects of interventions based only on randomized controlled trials (RCTs) on diseases of the musculoskeletal system or connective tissue (D-MSCT). This review aimed to summarize evidence on the effects of non-surgical interventions for pain relief and symptom improvement in farmers with D-MSCT.Materials and Methods: We searched seven databases, including MEDLINE, and three clinical trial registries, including the International Clinical Trials Registry Platform, from inception up to February 15, 2021, to identify studies that included at least one treatment group wherein nonsurgical interventions were applied. We focused on 1) pain relief and symptom improvement and 2) quality of life and improvement in physical fitness.Results: Four studies (three on low back pain and one on knee osteoarthritis) met all the inclusion criteria. Overall, the risk of bias was high, and meta-analysis could not be performed due to heterogeneity. However, a participatory ergonomic approach, exercise centered on strength training with a transtheoretical model, and/or a combination of both could be included in effective educational programs, at least in the short term, to prevent and/or reduce exacerbation of D-MSCT in farmers. Based on internal and external validity, we could postulate a future research agenda and a conceptual education model to prevent D-MSCT in farmers.Conclusion: Participatory ergonomic intervention, exercise centered on strength training, and/or a combination of both could be included for effective educational programs to prevent and reduce exacerbation of D-MSCT in farmers. High-quality RCTs with a less risk of bias will be implemented for many agricultural work types in various parts worldwide (especially developing countries and regions) during the COVID-19 pandemic.

 Objective: The objectives of this study were to compare medical expenses for the aged, the index of inter-government differences, nursing care expenses, the percentage of advanced nursing care, life expectancy, and the spa-related variables among rural governments in the same class based on the national criteria, in order to clarify the factors that affect nursing care and medical expenses.  Methods: The Ministry of National Affairs and Communications classifies rural governments into 35 categories based on their population and industry. The subjects of this study were from the category III-0 (population between 100,000 and 150,000, percentage of tertiary industry below 55%) and 11 towns and villages met the eligibility criteria. We used statistical data open to the public in 2007, and calculated the correlation coefficients and multiple regression coefficients using medical expenses for the aged and nursing-care expenses as dependent variable.  Results: Variables that had a significant correlation with medical expenses for the aged were percentage of medical expenses for the aged (r=-0.61, p<0.05), hospital expenses (r=0.88, p<0.05), the index of inter-government differences (r=0.75, p<0.05), and number (per 1,000 people) of spa hotels (r=-0.61, p<0.05). Variables that had significant correlation with nursing care expenses were percentage of people insured (r=-0.65, p<0.05), percentage of people insured who resigned from job(r=0.66, p<0.05), the average life span (r=0.82,p<0.05). Variables that had a significant effect on medical expenses for the aged were hospital expenses (β=0.618, p<0.05), the index of inter-government differences (β=0.334, p<0.05), and (per 1,000 people) of spa hotels (β=-0.210, NS). There was no spa-related variable that had a significant correlation with nursing care expenses, and we did not conduct multiple regression analysis for them.  Conclusion: Although the correlations with the indices for spa among medical expenses for the aged and nursing care expenses were very low, the necessity of clarifying the numerical value of people who used spa actually was shown.