2.Physical Functions and Comorbidity Affecting Collapse at 4 or More Weeks after Admission in Patients with Osteoporotic Vertebral Fractures: A Prospective Cohort Study
Takuya UMEHARA ; Ayaka INUKAI ; Daisuke KUWAHARA ; Ryo KANEYASHIKI ; Akinori KANEGUCHI ; Miwako TSUNEMATSU ; Masayuki KAKEHASHI
Asian Spine Journal 2022;16(3):419-431
Methods:
This prospective cohort study analyzed patients with osteoporotic vertebral fractures admitted to the hospital between March 2018 and October 2019. Logistic regression analysis was performed to explore the predictors of vertebral collapse at >4 weeks after admission. Model 1 used basic medical information and physical functions at admission; model 2 used basic medical information and physical function and activity at >4 weeks after admission.
Results:
In the model 1 results of logistic regression analysis, cardiovascular disease (odds ratio [OR], 12.27; 95% confidence interval [CI], 1.28–117.91) was extracted as a factor affecting vertebral collapse at ≥4 weeks after admission. In the model 2 results of logistic regression analysis, cardiovascular disease (OR, 34.57; 95% CI, 2.53–471.74), movement control during one leg standing at 4 weeks (OR, 7.25; 95% CI, 1.36–38.71), and Pain Catastrophizing Scale score at 4 weeks (OR, 1.11; 95% CI, 1.01–1.21) were extracted as factors affecting vertebral collapse at ≥4 weeks after admission.
Conclusions
Our results indicate that physical functions and comorbidity affect collapse at ≥4 weeks after admission in patients with osteoporotic vertebral fractures.
3.Reduced upper and lower limb muscle strengths without reduced skeletal muscle in elderly patients with heart failure
Takuya UMEHARA ; Akinori KANEGUCHI ; Takahiro YAMASAKI ; Nobuhisa KATAYAMA ; Wataru KAWAKAMI ; Daisuke KUWAHARA ; Nobuiro KITO
Journal of Rural Medicine 2023;18(1):8-14
Objective: This study aimed to characterize the muscle strength and skeletal muscle mass of patients with heart failure by investigating hand-grip strength, five times sit-to-stand (5STS) results, and skeletal muscle mass index (SMI).Materials and Methods: Muscle strength was assessed based on hand-grip strength and 5STS, while skeletal muscle mass was assessed using a bioelectrical impedance analyzer. Hierarchical logistic regression analysis was performed to explore the association between patients with heart failure and healthy elderly individuals.Results: Hierarchical logistic regression analysis was performed to examine the muscle strength and skeletal muscle mass characteristics in patients with heart failure. Hand-grip strength and 5STS responses but not SMI outcomes differed significantly between the two groups. The results of the hierarchical logistic regression analysis revealed that the hand-grip strength and 5STS were significant predictors of heart failure. The odds ratios for hand-grip strength and 5STS were 1.44 and 0.53, respectively.Conclusion: Our results suggested that upper and lower limb muscle strengths (handgrip strength and 5STS) in elderly patients with heart failure worsened significantly without a decrease in skeletal muscle mass.
4.Interactive effects of exercise and sleep on frailty severity in community-dwelling older adults: a cross-sectional study
Takuya UMEHARA ; Akinori KANEGUCHI ; Takahiro YAMASAKI ; Akihiro MATSUURA ; Nobuhiro KITO ; Hideki TANAKA ; Kaoru YAMAOKA
Journal of Rural Medicine 2022;17(1):21-28
Objectives: This study examined the effects of the interaction between exercise and sleep on frailty severity in community-dwelling older adults.Materials and Methods: This was a cross-sectional study. Data were collected in July 2019. In total, 2021 adults participated who responded to a questionnaire. Among them, 672 participants (317 men and 355 women) with valid responses were included in the analysis. Ordinal logistic regression analysis was performed to examine the association between frailty severity and the interaction between exercise and sleep. The dependent variable represents three different levels of frailty. The independent variables included basic information and interaction between exercise and sleep.Results: The results of ordinal logistic regression analysis (odds ratio [OR]) showed that the period from the start of exercise (OR=0.96), age (OR=1.00 for participants in their 60 s, OR=1.65 for those in their 70s, and OR=3.13 for those aged >80 years), poor subjective health perception (OR=2.12), poor quality of sleep (OR=1.88), stress (OR=1.62), and exercise–sleep interaction (OR=1.00 based on good-exercise–good-sleep interaction, OR=3.09 poor-exercise–good-sleep interaction, and OR=3.50 poor-exercise–poor-sleep interaction) significantly contributed to the model. The Nagelkerke coefficient of determination adjusted for degrees-of-freedom (R2), which represents the contribution rate of the regression equation, was 0.334.Conclusions: Our results suggest that a combination of good exercise and good sleep is needed to prevent frailty progression in community-dwelling older adults.