Purpose: External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP. Methods: Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele. Results: Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele. Conclusion Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

Purpose: External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP. Methods: Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele. Results: Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele. Conclusion Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

This study examined relationships between physical activity and sleep relative to leisure-time, household, and occupational physical activity in community-dwelling, older adults. From 3,000 randomly chosen community-dwelling, adults, aged 65-85 years, we recruited 509 eligible subjects (mean age 73.2 ± 5.1 years). We assessed nocturnal sleep duration, sleep onset latency and subjective sleep quality over the previous month through a questionnaire. Physical Activity Scale for the Elderly was used to assess leisure-time, household, and occupational physical activity. Items pertaining to sleep were expressed as dichotomous variables (good/poor), and each physical activity score was divided into two categories based on activity level. To investigate the relationship between sleep (dependent variable) and physical activity (independent variable), we used a logistic regression analysis, controlling for age, gender, living arrangement, depressive symptoms, and cognitive function. Prolonged sleep latency was significantly related to no participation in low intensity exercise (OR 2.14; 95% CI 1.42-3.21) and muscle strength exercise (OR 1.99; 95% CI 1.06-3.74). Our data suggest that not participating in low intensity exercise or muscle strength exercise may be associated with difficulty initiating sleep in older adults.

The vertical ground reaction force (GRF) parameters in a sit-to-stand movement are useful for measuring lower-limb muscle strength and power in older adults. The purpose of this study was to examine which GRF parameters would be more strongly associated with a person's physical functioning, history of falls, fear of falling and mobility limitations, all of which are known to be related to lower-limb muscle strength and power. We performed cross-sectional analyses on 363 community-dwelling older adults, which included 160 men and 203 women, aged 65-85 years (73.4 ± 5.3 years). Five parameters were measured: peak reaction force, two rate of force development and two time-related parameters. Their rate of force development was relatively higher correlated with results from timed “up and go” tests, standing times from a long sitting position and 4-way choice reaction times (partial r = -0.37 ∼ -0.52); these tests were accompanied with a dynamic movement of lower-limb; than their peak reaction force and time-related parameters. The rate of force development were poorer in subjects reporting falls, a fear of falling or a mobility limitation compared with those reporting no falls, fear of falling or mobility limitation. These results suggest that measuring the rate of force development in a sit-to-stand movement provide a better assessment of lower-limb muscle strength and power.

The purpose of this study was to investigate the relationship between cognitive function and physical performance in Japanese older adults. Ninety four older adults, aged 65 to 87 years (mean age 71.9±5.3 years), were recruited as participants. Cognitive function was evaluated by Five-cognitive Function Test (FCFT). The FCFT, which was developed specially for Japanese older adults, consists of 5 subscale elements: attention, verbal memory, visuospatial cognition, word fluency, and associate learning. Hand dexterity (3 items), muscle strength (2 items), balance (3 items), flexibility (2 items), walking ability (2 items) and reaction ability (2 items) were defined as lifestyle-related physical performances. After adjusting for age, educational level and systolic blood pressure the FCFT score was significantly correlated with observed data of hand dexterity (hand working with a peg board, r=0.485, p<0.001), lower-extremity muscle strength (5-repetition sit-to-stand, r=-0.231, p<0.05), walking ability (5-m habitual walk, r=-0.225, p<0.05; timed up and go r=-0.304, p<0.01), and reaction ability (simple reaction time, r=-0.415, p<0.001; 4-way choice reaction time, r=-0.401, p<0.001). Multiple regression analysis revealed that the FCFT score was explained by the hand working with a peg board (F=42.36, p<0.001) and 4-way choice reaction time (F=29.62, p<0.01). The contribution rate on this model was 42%. These results suggest that cognitive functions were associated with some physical performance. Especially, hand dexterity (hand working with a peg board) and reaction ability (4-way choice reaction time) may be the useful synthetic indicators of cognitive functions in Japanese older adults.

The purpose of this study was to examine whether volunteering as exercise instructors over a continuous period of time affected the physical and cognitive functions of community-dwelling, elderly women. Longitudinal analysis was conducted on data from 18 volunteer leaders (Leader group) aged 65-79 years (69.6 ± 3.9 years) and 18 age-matched survey participants (Control group). We evaluated physical function using 8 physical performance tests along with their standardized total score, and we evaluated cognitive function using the Five Cognitive Function Test. We used two-way ANOVA to examine the effectiveness of engaging in a yearlong volunteer activity and Cohen's d for effect size. There were significant interactions in timed up and go, hand working with pegboard, standardized score of performance tests and the Five Cognitive Function Test score (P < 0.05). The Leader group improved significantly in sit and reach (d = 0.55), 5-repetition sit-to-stand (d = 0.77), timed up and go (d = 0.77), 5-m habitual walk (d = 0.88), 4-way choice reaction time (d = 0.86), standardized score of performance tests (d = 0.96) and the Five Cognitive Function Test score (d = 0.93). Although the Control group also improved significantly in some tests, the effect size tended to be lower: sit and reach (d = 0.49), hand working with pegboard (d = 0.57), standardized score of performance tests (d = 0.38) and the Five Cognitive Function Test score (d = 0.54). These results suggest that volunteering as an exercise instructor improves volunteers' physical and cognitive functions.

STUDY DESIGN: A cross-sectional study. PURPOSE: To clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations. OVERVIEW OF LITERATURE: Most studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP. METHODS: We obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables. RESULTS: The prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits (p=0.049, odds ratio [OR]=2.594), low back pain (p < 0.001, OR=0.974), lumbar function (p=0.001, OR=0.967), and social function (p=0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score (p=0.024, OR=0.068), low back pain (p=0.007, OR=0.981), lumbar function (p=0.001, OR=0.963), walking ability (p=0.001, OR=0.968), and social function (p=0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP. CONCLUSIONS: CNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL.
Aged* ; Asian Continental Ancestry Group ; Back Pain ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Hypertension ; Japan* ; Logistic Models ; Low Back Pain* ; Mass Screening ; Odds Ratio ; Pathology ; Prevalence* ; Quality of Life ; Smoke ; Smoking ; Spinal Stenosis ; Spine ; Walking

STUDY DESIGN: Cross-sectional study. PURPOSE: The purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population. OVERVIEW OF LITERATURE: Measuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult. METHODS: Standing coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays. RESULTS: The present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson's correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1−0.77×(SFP angle) in the total group, PT=62.8−0.80×(SFP angle) in the female group, and PT=51.5−0.64×(SFP angle) in the male group. CONCLUSIONS: A significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population.
Adult ; Aged* ; Asian Continental Ancestry Group* ; Congenital Abnormalities ; Cross-Sectional Studies ; Diagnosis ; Female ; Head ; Humans ; Linear Models ; Male ; Pelvis ; Spine

Health issues with workers include many aspects that scientific research in physical fitness and sports medicine can contribute to. Nevertheless, in Japan, there are few studies on the health problems in workers reported in the field of physical fitness and sports medicine. One reason could be the difficulty of obtaining cooperation in research from companies. This paper introduces results of epidemiological studies on health problems in workers by the Physical Fitness Research Institute. Our research serves as an example of physical fitness and sports medicine studies, including methods for securing fields for research. For the last decade, various epidemiological studies on worker’s mental health, sleep, non-alcoholic fatty liver disease, and labor related issues have been conducted in our research institute. Most of these studies indicated that lack of physical activity is associated with these indicators in Japanese workers. In recent years, we have also been conducting observational and interventional studies focusing on sedentary behavior in workers. Physical activity is deeply linked to worker’s health, therefore, the important approach to start a research in occupational health is to plan research that solves the company’s health challenges. In occupational health, the needs to promote physical activity and to reduce sitting time are growing under the movement of “Health and Productivity Management” and burden of the COVID-19 pandemic. We believe that current challenges provide an opportunity to advance physical fitness and sports medicine research in occupational health.