This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.

OBJECTIVE: Galvanic vestibular stimulation (GVS) activates the vestibular afferents, and these changes in vestibular input exert a strong influence on the subject's posture or standing balance. In patients with Parkinson's disease (PD), vestibular dysfunction might contribute to postural instability and gait disorders. METHODS: Current intensity was increased to 0.7 mA, and the current was applied to the patients for 20 minutes. To perform a sham stimulation, the current intensity was increased as described and then decreased to 0 mA over the course of 10 seconds. The patient's status was recorded continuously for 20 minutes with the patient in the supine position. RESULTS: Three out of 5 patients diagnosed with PD with postural instability and/or abnormal axial posture showed a reduction in postural instability after GVS. The score for item 12 of the revised Unified Parkinson's Disease Rating Scale part 3 was decreased in these patients. CONCLUSIONS: The mechanism of postural instability is complex and not completely understood. In 2 out of the 5 patients, postural instability was not changed in response to GVS. Nonetheless, the GVS-induced change in postural instability for 3 patients in our study suggests that GVS might be a therapeutic option for postural instability.
Gait ; Humans ; Parkinson Disease* ; Posture ; Supine Position

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.

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.

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:We compared changes in BMI as well as nutritional and fluid intake in older adult patients who died and survived while in special nursing care facilities, and examined whether trajectories in the death group were effective in predicting prognosis. Methods:We retrospectively extracted data from BMI, nutritional and fluid intake for all older adults admitted to a special nursing care facility between April 2007 and the end of July 2022, searching for changes in the monthly mean values. Results:Data were obtained for 646 patients in the death group and 498 in the survival group. In the death group, BMI, nutrition and fluid intake decreased significantly from 12 months before death compared with the survival group. In the death group, nutrient intake per kilogram of body weight decreased significantly and irreversibly as of 6 months before death, and fluid intake decreased significantly and irreversibly starting 3 months before death compared with the previous month. Discussion:The trajectories of BMI, nutrition and fluid intake decreased simultaneously from 12 months before death, and the significant irreversible decrease in fluid intake followed by nutritional intake per kilogram body weight was effective in predicting the prognosis of elderly patients dying in special care facilities.