Purpose: Stress urinary incontinence is a postoperative complication occurring in patients with pelvic organ prolapse (POP). Although the 1-hour pad test measures the degree of urinary incontinence qualitatively and quantitatively, some elderly women undergoing POP surgery do not have the daily activities of living to perform the pad test. Therefore, we examined whether the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) could be used as an alternative tool for pad tests. Methods: We retrospectively evaluated 132 patients with POP. In our hospital, 57 patients were treated by laparoscopic sacrocolpopexy (LSC), whereas 75 were treated by transvaginal mesh surgery (TVM). We measured the changes in symptoms preand postoperatively using the ICIQ-SF and 1-hour pad weight testing, and investigated the correlation between the total plus component question scores of the ICIQ-SF and 1-hour pad weight. Results: The preoperative ICIQ total scores in all patients decreased significantly as the amount of leakage on the 1-hour pad weight decreased. The component question scores also decreased significantly with decreasing levels of 1-hour pad weight. The LSC and TVM groups had decreased ICIQ-SF total and component question scores as pad weight decreased. At 12 months postoperatively, the ICIQ total scores in all patients significantly declined as the amount of leakage on the 1-hour pad weight decreased. In the LSC group, the ICIQ-SF total and component question scores also decreased with decreased pad weight, but the differences were not always significant between ICIQ scores and pad weight. In the TVM group, the ICIQ-SF total and component question scores also significantly decreased as the pad weight decreased. Conclusions The ICIQ-SF could be an appropriate substitute for the 1-hour pad weight testing in predicting the severity of urinary incontinence. In the future, we hope to predict the level of urine leakage based on the ICIQ-SF score.

Objective：This study aimed to determine the difference in knee joint range of motion (ROM) and coefficient of variation (CV) during preoperative single-leg squatting in patients who developed ipsilateral lower limb anterior cruciate ligament (ACL) re-injury months after ACL reconstruction and in those who did not have the injury.Methods：Participants included 38 patients with non-contact ACL injuries. All patients underwent single-leg squatting the day before ACL reconstruction. Knee joint ROM and CV were assessed during single-leg squatting using a three-dimensional motion analysis system. We investigated the occurrence of ACL reinjury in the ipsilateral lower limb approximately 30 months after ACL reconstruction. Knee joint ROM and CV were then compared between the postoperative and non-injury groups.Results：The postoperative injury and non-injury groups included 9 and 29 patients, respectively. The knee internal/external rotation ROM and CV of knee varus/valgus ROM were greater in the postoperative injury group than in the postoperative non-injury group.Conclusion：During single-leg squatting before ACL reconstruction surgery, the knee internal/external rotation ROM and CV of knee varus/valgus ROM were suggested to be points of evaluation when considering ACL re-injury prevention.

Objective：This study aimed to determine the difference in knee joint range of motion (ROM) and coefficient of variation (CV) during preoperative single-leg squatting in patients who developed ipsilateral lower limb anterior cruciate ligament (ACL) re-injury months after ACL reconstruction and in those who did not have the injury.Methods：Participants included 38 patients with non-contact ACL injuries. All patients underwent single-leg squatting the day before ACL reconstruction. Knee joint ROM and CV were assessed during single-leg squatting using a three-dimensional motion analysis system. We investigated the occurrence of ACL reinjury in the ipsilateral lower limb approximately 30 months after ACL reconstruction. Knee joint ROM and CV were then compared between the postoperative and non-injury groups.Results：The postoperative injury and non-injury groups included 9 and 29 patients, respectively. The knee internal/external rotation ROM and CV of knee varus/valgus ROM were greater in the postoperative injury group than in the postoperative non-injury group.Conclusion：During single-leg squatting before ACL reconstruction surgery, the knee internal/external rotation ROM and CV of knee varus/valgus ROM were suggested to be points of evaluation when considering ACL re-injury prevention.

BACKGROUND: Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. METHODS: We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. RESULTS: Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714-0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699-0.771). CONCLUSIONS We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.
Aged ; Cohort Studies ; Female ; Geriatric Assessment/statistics & numerical data* ; Humans ; Independent Living/statistics & numerical data* ; Japan ; Male ; Middle Aged ; Nursing Homes/statistics & numerical data* ; Risk Assessment ; Risk Factors

BACKGROUND: To let the early elderly live well, understanding how lifestyle and psychosocial factors related to a decline in competence in daily living is important. METHODS: We investigated the associations between lifestyle and psychosocial factors at age 64 years and a decline in the Tokyo Metropolitan Institute of Gerontology Index of Competence score of ≥ 2 points at age 70 years among the participants in comprehensive medical check-ups living in a city in Japan. Multivariable logistic regression analyses were performed separately for men and women. RESULTS: Of the 1113 eligible men and 1203 eligible women, 110 men and 80 women showed a deteriorated competence in daily living during the 6 years. In men, risk was increased with ≥ 2 nighttime awakenings (multivariable odds ratio [mOR] 2.14, 95% confidence interval [CI] 1.19-3.86) and living alone (mOR 4.68, 95% CI 1.22-18.0), whereas risk was significantly decreased with a medium or fast gait (mOR 0.37 and 0.21, 95% CI 0.21-0.67 and 0.08-0.58) and high academic achievement (mOR 0.32 and 0.43, 95% CI 0.19-0.53 and 0.25-0.72). In women, risk was decreased with high life satisfaction (mOR 0.39, 95% CI 0.16-0.91) and participation in community activities (mOR 0.50, 95% CI 0.29-0.86) but increased with depressive mood (mOR 1.86, 95% CI 1.09-3.18). CONCLUSION Living alone for men and low life satisfaction for women at age 64 years were markedly associated with the risk of a subsequent declining competence in daily living.
Activities of Daily Living ; psychology ; Aged ; Cohort Studies ; Community-Based Participatory Research ; Female ; Geriatric Assessment ; Healthy Aging ; Humans ; Independent Living ; psychology ; statistics & numerical data ; Japan ; Life Style ; Male ; Middle Aged ; Physical Functional Performance ; Protective Factors ; Risk Factors ; Surveys and Questionnaires

Objective：We aimed to examine the criterion-related validity of observable items of gait abnormality in patients with knee osteoarthritis (OA) using three-dimensional gait analysis and to assess the test-retest reliability.Methods：The items of gait abnormality were pooled from a prior study and rated using a 3-point scale. Content validity was examined by four experts in knee OA research and accepted when there was an agreement among at least three experts. Correlation between abnormality rating and three-dimensional gait analysis data was examined. The test-retest reliability of the agreement rate was then assessed in the same subject twice.Results：Eleven items were pooled, and all met the criterion of content validity. Eight items showed adequate correlation with the three-dimensional gait analysis data and had test-retest reliability exceeding 0.61.Conclusion：In patients with knee OA, observable items of gait abnormality had good test-retest reliability and criterion-related validity according to the three-dimensional gait analysis data.

Objective：We aimed to examine the criterion-related validity of observable items of gait abnormality in patients with knee osteoarthritis (OA) using three-dimensional gait analysis and to assess the test-retest reliability.Methods：The items of gait abnormality were pooled from a prior study and rated using a 3-point scale. Content validity was examined by four experts in knee OA research and accepted when there was an agreement among at least three experts. Correlation between abnormality rating and three-dimensional gait analysis data was examined. The test-retest reliability of the agreement rate was then assessed in the same subject twice.Results：Eleven items were pooled, and all met the criterion of content validity. Eight items showed adequate correlation with the three-dimensional gait analysis data and had test-retest reliability exceeding 0.61.Conclusion：In patients with knee OA, observable items of gait abnormality had good test-retest reliability and criterion-related validity according to the three-dimensional gait analysis data.

Objective：To elucidate factors associated with physical function and clarify the actual condition of functional deterioration in patients with knee osteoarthritis (OA) prior to total knee arthroplasty (TKA)．

Methods：We enrolled 467 patients with severe knee OA and preoperatively assessed the following parameters：background factors (sex, age, BMI, K-L grade, and pain) and physical function (muscle strength of knee extensors and flexors, and knee joint angles). A multiple regression analysis was performed to determine the relationship between the independent background factors and dependent physical functions. The median of preoperative function based on selected factors of physical function was calculated.

Results：Based on the multiple regression analysis, sex, BMI, K-L grade, and pain statistically significantly correlated with muscle strength of knee extensors and flexors. Sex and BMI statistically significantly correlated with knee joint flexion angle. K-L grade statistically significantly correlated with knee joint extension angle. The median of muscle strength for knee extension was 0.98/0.92 Nm/kg (Grade 3/Grade 4) for males and 0.70/0.59 Nm/kg for females. The median of muscle strength for knee flexion was 0.53/0.45 Nm/kg for males, 0.36/0.30 Nm/kg for females. The median for knee joint flexion angle was 130° for males and 120° for females. The median for knee joint extension angle was -5°/-10° (Grade 3/Grade 4)．

Conclusion：We clarified the degree of muscle strength and range of motion before TKA in patients with knee OA. We believe that the findings obtained in this study will contribute to explaining the functional deterioration of patients with knee OA.

BACKGROUND/AIMS: Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the hepatic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD. METHODS: A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diagnosing fibrosis ≥F3–4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify variables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio. RESULTS: The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confidence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associated with the L/R ratio (coefficient, 0.121; p<0.0001). CONCLUSIONS: The L/R ratio, which is not influenced by pathological parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD.
Body Mass Index ; Fibrosis* ; Humans ; Liver Cirrhosis ; Magnetic Resonance Imaging ; Methods ; Non-alcoholic Fatty Liver Disease* ; Retrospective Studies ; ROC Curve