The engaging>30 minutes of physical activity (PA) at 4-6 METs has been recommended for the prevention of cardiovascular disease. We determined whether relatively low intensity (i. e., 3-5 METs) PA inhibits the age-related central arterial stiffening, a risk of cardiovascular disease. In the cross-sectional study, the association between carotid arterial properties (via ultrasound system) and daily PA (via electric accelerometer) were studied in 172 normotensive people (41-82 yrs). People engaging>30 min/day of PA corresponding to 3-5 METs had a significantly lower beta-stiffness index than sedentary peers after adjusting for covariates (i. e., age and PA time at more than 6 METs). In the interventional study, beta-stiffness index of nine normotensive postmenopausal women was significantly decreased after the 12-week aerobic training (cycling at 80% of ventiratory threshold, ≈4 METs, 30 min/day, 5 days/week). These results suggest that the increase in daily PA at 3-5 METs inhibits the age-related carotid arterial stiffening.

The purpose of this study was to evaluate the association between subjective usefulness of pedometer and step count, exercise adherence, and the possibility of a pedometer helping exercise adherence.
The subjects were 106 community-dwelling citizens (mean age±SD, 66±5) who were put on an individual exercise program in addition to walking. The targeted step count was 8000 steps/day. Every subject wore a pedometer that registers 7 days of physical activity.
The rate of adherence was 98.1%, and about 73% of subjects answered that using a pedometer is useful for physical activity. There was no difference in exercise habit at baseline between subjects answering useful or not useful.
Only in the case of females, was step count and prevalence of targeted 8000 steps significantly higher in the group who felt a pedometer was useful than in the group who didn't feel it useful. However, in the group of males who felt the usefulness of a pedometer, step count significantly increased during the 3 months. In addition, the females who reached their targeted step count performed better in the 10 m hurdle walk and 6 min walk than those who could not reach the targeted step count.
The awareness of self-health wellness, without the anxiety of physical fitness and adherence to exercise was higher in the subjects who felt a pedometer was useful than in the subjects who didn't.
The subjects who felt a pedometer was useful achieved their targeted number of steps and increased walking ability and tended to adhere better to physical activity.
It is suggested that a pedometer motivates adherence to physical activity and is useful for helping exercise adherence in the future. However, we need a randomized control trial for determining the relationship between exercise adherence and using a pedometer.

Resistance exercise in the elderly and patients with a cardiovascular disorder has been thought to have a high cardiovascular risk, because it has the tendency to cause an excessive rise in blood pressure and induce serious arrhythmia. But recently, resistance exercise has been introduced into physical therapy because the safety of such exercise has been confirmed in subjects without a cardiovascular disorder.
The purpose of this study was to investigate the safety of lower extremity resistance exercise in middle-aged or elderly subjects with hypertension and receiving medical treatment (n=24), and those without hypertension (n=40), by measuring cardiovascular response during resistance exercise of different loads (40% and 60% 1 RM), and usefulness of respiratory guidance during such exercise.
As a result, there was no difference in diastolic blood pressure between those with and without hypertension ; but systolic blood pressure and rate pressure product both at rest and during exercise were significantly greater in patients with hypertension. However, neither group showed symptoms of angina, ischemic signs in ECG, or serious arrhythmia ; and there was no difference in the frequency of excessive rise in blood pressure between the groups (2 subjects with hypertension and 1 subject without hypertension) . Blood pressure during exercise was significantly lowered by respiratory guidance.
These results show that it is important to measure blood pressure during exercise before resistance exercise training regardless of the presence of hypertension, although an excessive rise in blood pressure occurred in only a few subjects. Furthermore, it is important to exhale slowly and not hold one's breath during exercise.

The purpose of this study was to confirm the causal structure model of muscle, motor and living functions utilizing structural equation modeling (SEM) . As subjects, 103 community-dwelling older men and women, aged 65.7±6.9years of age, participated in the study to measure muscle cross-sectional area, maximum voluntary contractions, muscle power, 4 physical performance tests, and 16 questionnaires regarding ability of activities of daily living. The causal structure model of muscle, motor and living functions was hypothesized to be a hierarchical causal structure. The causal structure model of muscle function was hypothesized to be a hierarchical causal structure consisting of 3 sub-domains of muscle mass, muscle strength, and muscle power. Data analysis procedures were as follows : a) testing of construct validity of muscle function variables using confirmatory factor analysis (CFA) in SEM ; b) testing of causal structure using SEM ; c) testing of factor invariance using multi-group analysis for gender. The highest goodness of fit indices was obtained in the causal structure model of muscle, motor and living functions (NFI= .928, CFI= .978, RMSEA =.061) . The causal coefficient of muscle function to motor function was .98 (p<.05), followed by.34 for motor function to living function. From the results of multi-group analysis, the measurement invariance model indicated the highest goodness of fit indices (TLI=.968, CFI .977) . It was concluded that the hierarchical causal relation was among muscle, motor and living functions, and in which muscle function was consisted of 3 sub-domains.

The purpose of this study was to confirm the reliability and validity of a physical fitness questionnaire (PFQ) with self-rating for elderly people applying structural equation modeling (SEM) . As subjects, 105 community-dwelling older men and women aged 67.1±6.1 years participated in the study to measure 13 PFQ items and 13 performance tests. The data analysis procedures were as follows : a) testing reliability of PFQ ; b) testing of construct validity of PFQ using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) ; c) testing of criterion-related validity of PFQ to the performance tests using SEM ; d) testing of correlations of the PFQ to walking ability using SEM. Cronbaeh's alpha coefficient for consistency reliability of the PFQ was .83. Four common factors of muscle strength-power, endurance, coordination, and flexibility were extracted in EFA. The high and enough goodness of fit indices were obtained in the confirmatory factor structure model, and in each sub-domain of criterion-related validity to performance tests and correlation to walking ability models. The criterion-related validity coefficient of muscle strength and power was .77, followed by .66 for endurance, .59 for coordination and .82 for flexibility. The correlation coefficient of muscle strength and power to walking ability was -.51, followed by -.58 for coordination, - .43 for endurance and - . 28 for flexibility. These results indicated that the PFQ consisting of 13 items and 4 sub-domains satisfied reliability and construct validity although criterion related validity to performance tests was insufficient. It was concluded that the PFQ is of useful for physical fitness checking of elderly people.

Arterial compliance progressively decreases with aging. This aging-induced reduction of arterial compliance causes an increase of systolic blood pressure (SBP), whereas regular exercise increases arterial compliance. We hypothesized that an increase in daily physical activity (DPA) produces a beneficial effect on systemic arterial compliance (SAC ; an index of central arterial compliance) and this phenomenon could decrease SBP in the elderly. We investigated the relationship among DPA, SAC, SBP, diastolic blood pressure (DBP), and some other risk factors for cardiovascular and/or cerebrovascular events (total cholesterol, HDL-cholesterol, and HOMA-R) cross-sectionally in 127 elderly persons (42 male, 85 female : aged 74±4 years) . The DPA was estimated by expended calories using an accelerometer. The SAC was calculated from a finger pulse pressure waveform recorded by using PORTAPRES ; and stroke volume obtained from the same pressure waveform based on the volume-clump method. The analyses demonstrated that SBP was directly and decreasingly affected by SAC, and that DPA had an increasing effect on SAC. Furthermore, SBP was directly and increasingly affected by DBP, and DBP was directly and decreasingly affected by both SAC and DPA. Therefore, it is considered that DPA may have suppressive effects on the rise of SBP through the indirect effects of changing SAC and DBP. These findings suggest that an increase in DPA could improve the age-induced reduction of arterial compliance and rise of SBP in elderly humans.

The purpose of this study was to confirm the causal effect model of strength on walking ability development as a result of exercise participation among elderly people in a community, utilizing the latent curve model (LCM) in structural equation modeling (SEM) . Twenty-six male and 57 female subjects, 83 in total, aged 67.8±5.7, 63.9±7.1 and 65.1±6.9 in a pooled sample participated in the exercise program which lasted for two years. Grip strength and sit-ups used in the Japan Fitness Test were measured for muscular strength, 10-m hurdle walk and 6-min walk for walking ability, and the fitness test score for physical ability. The data analysis procedures were as follows : a) analysis of test-retest reliability and construct validity of measurement items, b) analysis of causal structure model of aging, muscular strength and walking ability, c) analysis of variance for repeated measurement of walking performance by sex, age and year, d) analysis of LCM for walking performance development. The highest goodness-of-fit indices of SEM were obtained in the LCM of 10-m hurdle walk performance development (GFI=0.989, AGFI=0.920, CFI=0.998, RMSEA=0.038) . The path coefficient of sit-ups at pre-test effect on the intercept of 10-m hurdle walk performance development was significant (p<0.05) . The path coefficients of age to intercept and slope of 10-m hurdle walk development were also significant (p<0.05) . It was concluded that walking ability development through participation in exercise age and strength level was more effective for maintaining walking ability in older age.

The purpose of this research was to study the effects of exercise program participation on the personal factors of exercise adherence promotion in the middle-aged and elderly by comparing a group and individual exercise program. The personal factors for promoting exercise adherence, the four domains (i, e. initiative attitude, achievement satisfaction, self-recognition, and intrinsic motivation), were hypothesized. Two groups of middle-aged and elderly subjects, who volunteered to participate in different 6-month exercise programs, were examined. Group 1, 33 subjects (aged 67.7 ±4.3 years : mean±SD), participated in a program consisting of an individual exercise program (combination of endurance and resistance exercise, e. g. cycling exercise, dumbbell and machine exercise, once a week) and group exercise program (e, g. dance and ball game, once a week) . Group 2, 27 subjects (aged 65.2±4.Ovears), participated in the same individual exercise program twice a week. After the 6-month exercise program, significant improvements in group 1 were found in the selfassessment of activity score of the initiative attitude domain, the achievement satisfaction score including enjoyment, achievement and satisfaction, and the self-recognition score representing competence. In group 2, the mastery score in the intrinsic motivation domain was reduced, and the curiosity score in the same domain and the achievement score in the achievement satisfaction domain tended to decrease. These results show that a group program might have a more significant effect on the personal factors hypothesized to promote exercise adherence in this study. Hut there should be follow-up study on the subjects to determine the effectiveness of the program over the long term.

Central arterial distensibility decreases with age-related changes in the arterial wall, and as a result, systolic blood pressure and/or pulse pressure (difference of systolic pressure and diastolic pressure) may increase in the elderly. Systolic hypertension and increased pulse pressure are known to be independent risk factors of cardiovascular and cerebrovascular diseases. Decreased distensibility of the central arteries may also cause the deterioration of circulatory function and physical ability in the elderly. Several studies have shown that central arterial distensibility is increased in athletes, and that daily physical activity is positively related to central arterial distensi bility in not only young but also elderly people. It has also been shown that relatively short-term and low-intensity exercise training could improve central arterial distensibility even in the elderly. Thus, physical exercise may have an effect on retarding age-related changes of the central arteries. To establish higher quality of life by preventing cardiovascular and cerebrovascular diseases and by improving circulatory function and physical ability in the elderly, further studies are needed to investigate the detailed mechanism and the appropriate amount and or intensity of exercise in improving central arterial distensibility.