The purpose of this study was to investigate the hypothesis that the reduction in walking ability is due to muscle atrophy in the lower limb muscles with aging using equational structure modeling as well as investigate the influence of muscle on walking ability. The subjects consisted of 127 persons (57 males and 70 females) aged 20-84 year, who were grouped into 6 age brackets of 20-39, 40-49, 50-59, 60-69, 70-74, and 75 or older. Using MRI, muscle cross-sectional area was measured on psoas major and thigh muscle (divided into extensor and flexor) . For walking patterns, each subject walked along a 7-m walking passage at normal speed for VTR-recording of the motion. The resulting pictures were used to analyze stride length, trunk inclination and walking speeds. Walking speeds showed a statistically significant decrease in value from the 50's age group in males and the 60's age group in females when compared with the 20-39 age bracket (p<0.05) . In males, a significant co-relationship was observed only between the muscle cross-sectional area of thigh extensor and walking speed (p<0.01) while in females, a significant co-relationship was found between the muscle cross-sectional area of psoas major (p<0.001) /thigh muscle extensor (p<0.01) and walking speed. These results indicate that the muscle atrophy with aging in psoas major and thigh muscle extensor is a factor responsible for the decrease in walking speed. Meanwhile, a difference in sex was observed between the muscle cross-sectional area of psoas major and walking speed. It was considered that the muscle atrophy rate of the female's psoas major being higher than the male's influenced this. Furthermore, it was suggested possibility that the decline of walking ability is due to decreased muscle mass of the lower limbs with aging.

In order to clarify the effect of exercise on the walking performance and the muscle volume in lower limbs, elderly athletes long continuing to be trained and untrained elderly were compared with regard to their muscle cross-sectional area (CSA) of m. psoas major, thigh muscle and crus muscle and their walking ability. The subjects used consisted of thirty-six 80's-aged male and 70's-aged female elderly athletes and twenty-four elders having no regular exercise (control male group : CM, control female group : CF) . The elderly athletes were further divided into two groups in accordance with their results of Japan Fitness Test (high performance male group : HPM, low performance male group : LPM, high performance female group : HPF, low performance female group : LPF) . The walking performance was evaluated by analyzing their walking speed, stride-length and step rate during walking along a 15 m-strip of passage at normal and fast paces using videotaping. The muscle CSA was determined at m. psoas major, thigh muscle (extensors and flexors) and crus muscle (m. tibialis anterior and m. triceps surae) using MRI. As for the walking speed and stride-length at the normal pace, only HPM and HPF showed significantly higher values than CM and CF (male : p<0.05, female : p<0.01) . Meanwhile at the faster pace, HPF and LPF showed significantly higher values than CF in female (HPF : p<0.01, LPF : p<0.05) and in the case of males, only HPM have a higher value only of the walking speed than CM (p<0.05) . The CSA of m. psoas major in HPM and HPF significantly higher than that in CM and CF (all p<0.05), while in CSAs of knee extensor muscles and m. triceps surae, the statistical differences were not consistent among male and female groups. The results suggested that greater muscle mass of m. psoas major could influence higher walking speed in elderly people, and might be affected by regular exercise training.

It has been reported that using of the spine mat increases chest expansion, inspiratory capacity (IC) and maximum inspiratory mouth pressure (PImax). However, no changes were observed in other respiratory functions and the respiratory muscle strength. The purpose of this study was to clarify the effects of pursed-lip breathing lying on the spine mat to the respiratory function and respiratory muscle strength. Forty-two adult male participants were assigned to two groups; an intervention group (IG group) of 21 participants who performed pursed-lip breathing on top of a spine mat and a control group (CG group) of 21 participants who performed pursed-lip breathing only. The intervention period was 5 days, and the respiratory features evaluated were chest expansion, respiratory function, respiratory muscle strength, and spinal alignment. A significant increase between the Pretest and the Posttest in chest expansion at the circumference of the axilla level, of the xiphoid process level and of the 10th rib level was observed only in IG group. For the respiratory function and the respiratory muscle strength, intervention group showed significant increases in percentage of vital capacity (%VC), tidal volume (TV), PImax, and maximum expiratory mouth pressure (PEmax). In the control group, only the TV indicated a significant increase. Regarding changes before and after the intervention, the intervention group showed significantly higher PImax and PEmax than the control group. No significant difference in spinal alignment was observed between the two groups. These results showed that pursed-lip breathing lying on the spine mat would increase the PImax, PEmax and the chest expansion.

Recently, poor posture (hyperkyphosis) has become a problem among children. This study investigated the effectiveness of an intervention (a spine mat) by measuring spinal alignment before and after the intervention in elementary school students. The study included 83 elementary school students. For the intervention, each participant was placed in a supine position on a bed and a spine mat was inserted ensuring that it adhered to the thoracic spine. The primary outcome variables included the thoracic kyphosis angle (TKA), upper thoracic angle, lower thoracic angle, lumbar lordosis angle (LLA), and sacral anteversion angle (SAA) measured in the standing and sitting positions using Spinal Mouse® before and after the intervention. Based on this evaluation, we assigned the participants to two groups: hyperkyphosis (n=25) and non-hyperkyphosis (n=58). Significant differences were observed between the pre-test and post-test TKA in the hyperkyphosis group in the standing position (pre-test: 45.3±4.5° and post-test: 40.8±9.0°, P<0.05). In the non-hyperkyphosis group, significant differences were observed between the pre-test and post-test LLA and SAA in the standing position. However, no significant difference was observed between the pre-test and post-test spinal alignment in the sitting position in both groups. The results of this study indicated that using a spine mat in elementary school children resulted in decreased TKA in the standing position only in the hyperkyphosis group, which exhibited a TKA of 40° or more after the intervention.

Poor posture (thoracic hyperkyphosis) in children is reportedly caused by changes in their living environment. A previous study (conducted 30 years ago) reported that the position of the center of pressure (COP) in a child with an upright posture was approximately 40% from the heel. The present study aimed to determine the position and characteristics of the COP while standing in children aged 6–12 years. This study enrolled 83 elementary school students. A Win-Pod (Medicapteurs) platform was used to measure the COP. The COP position was expressed as a percentage from the heel as a relative ratio with a foot length of 100%. Spinal Mouse® was used to measure thoracic kyphosis, lumbar lordosis, sacral anteversion, and trunk inclination angles in the standing position. The COP position was 30.3±8.9% from the heel. We found positive correlations between the COP position, height, and weight. Further, the COP position was significantly more anterior in 28 upper elementary grade children (35.1 ± 9.2%) than in 25 middle (29.5 ± 8.6%) and 30 lower grade children (26.5 ± 6.7%). Regarding sex differences, the COP position was significantly more anterior in 46 boys (32.3 ± 9.8%) than in 37 girls (27.9 ± 6.9%). There was a weak positive correlation between the COP position and trunk inclination angle (r=0.251, p<0.05). Thus, we found that the COP position in modern children aged 6–12 years while standing was 30.3 ± 8.9% from the heel, indicating a shift toward the heel (backward) compared to that reported in previous studies.

Previous studies have reported that poor posture can induce various musculoskeletal disorders. Recently, poor posture in children has become a problem. This study aimed to determine the characteristics of sagittal spinal alignment in standing and sitting positions in elementary school students and how spinal alignment changes from standing to sitting position. Moreover, it clarifies how poor posture (hyperkyphosis) in the standing position affects sitting posture. This study was conducted among 83 elementary school students. The Spinal-Mouse® System was used to measure the thoracic kyphosis angle (TKA), upper thoracic angle (UTA), lower thoracic angle (LTA), lumbar lordosis angle (LLA), and sacral anteversion angle (SAA) in the standing and sitting positions. Hyperkyphosis was defined as a thoracic kyphosis angle of >40°. Participants were assigned to two groups: hyperkyphosis and non-hyperkyphosis. Significant differences were noted in all spinal alignment characteristics in both the positions. When spinal alignment was changed from standing to sitting, ΔUTA and ΔLTA correlated with ΔLLA and ΔSAA, respectively. A strong negative correlation was noted between ΔLLA and ΔSAA. In the sitting position, TKA, UTA, and LLA were significantly higher in the hyperkyphosis group than in the non-hyperkyphosis group. ΔUTA was significantly higher in the hyperkyphosis group than in the non-hyperkyphosis group when spinal alignment was changed from standing to sitting. The characteristics of sagittal spinal alignment in the sitting position were significantly different from those in the standing position. The study findings suggest that poor posture (hyperkyphosis) in the standing position affects the sitting posture.

Calcaneal inclination in children may influence their standing posture. However, the calcaneal inclination of modern children is unclear. This study aimed to clarify the characteristics of calcaneal inclination and its effects on spinal alignment and the center of pressure (COP) position in children. The study included 402 elementary school children (208 boys, 194 girls). The variables measured included calcaneal inclination, lower leg lateral inclination angle, spinal alignment, and COP position. The mean calcaneal inclination was 4.40 ± 3.5°, indicating mild eversion. Calcaneal inclination was classified into calcaneal eversion (+), calcaneal introversion (-), and a mid-heel position. Overall, 3.7% (15/402) of the subjects had bilateral calcaneal introversion (-), 18.2% (73/402) had unilateral calcaneal introversion (-), and 21.9% (88/402) had calcaneal introversion (-). An examination of the relationship between calcaneal inclination and each measured variable showed a significance level of <5% between calcaneal inclination and age, height, and body weight, but the correlation coefficients were <0.2 each, indicating little correlation. However, a significant correlation was found between right and left calcaneal inclination and the right and left lower leg lateral inclination angles. Overall, 21.9% (88/402) of the elementary school children had calcaneal inclination in a standing posture. These results suggest that calcaneal inclination may not affect spinal alignment and COP position.

Objective: Several evidence-based practice guidelines have been developed to better treat bipolar disorder. However, the articles cited in these guidelines were based on clinical or basic studies with specific conditional settings and were not sufficiently based on real-world clinical practice. In particular, there was little information on the doses of mood stabilizers. Methods: The MUlticenter treatment SUrvey on BIpolar disorder in Japanese psychiatric clinics (MUSUBI) is a study conducted to accumulate evidence on the real-world practical treatment of bipolar disorder. The questionnaire included patient characteristics such as comorbidities, mental status, treatment period, Global Assessment of Functioning (GAF) score, and details of pharmacological treatment. Results: Most patients received mood stabilizers such as lithium (n = 1,317), valproic acid (n = 808), carbamazepine (n = 136), and lamotrigine (n = 665). The dose of lithium was correlated with age, body weight, number of episodes, depression and GAF. The dose of valproic acid was correlated with body weight, number of episodes, presence of a rapid cycle and GAF. The dose of carbamazepine was correlated with age, mania, and the presence of a rapid cycle. The dose of lamotrigine was correlated with the number of episodes, depression, mania, psychotic features, and the presence of a rapid cycle. Doses of coadministered mood stabilizers were significantly correlated, except for the combination of valproic acid and lamotrigine. Conclusion The dose of mood stabilizers was selectively administered based on several factors, such as age, body composition, current mood status and functioning. Further prospective studies are required to confirm these findings.