Several studies have examined how the associations of built environment attributes with walking behaviors may be moderated by socioeconomic status (SES). Such understanding is important to address socioeconomic inequalities in health through urban design initiatives. However, to date, there is no study examining the moderation effects of SES in the relationships of environmental attributes and walking in non-Western countries. The current study aims to examine associations of environmental attributes with walking behaviors among Japanese adults, and to test whether these associations were moderated by area-level SES. Data on walking were collected from Japanese adults using a nationwide Internet survey (N = 4605). Built environment measures including population density, street density, distance to the nearest public open space, and distance to the nearest commercial destination were calculated using geographic information systems software. An index of neighborhood deprivation was used as an area-level indicator of SES. Logistic regression models adjusted for clustering and sociodemographic variables were used. It was found that more residents in high SES areas walked for commuting, for errands, and for exercise compared with those who lived in low SES areas. When the whole sample was examined, all environmental attributes were associated with walking behaviors (except for street density not being associated with walking for exercise). Associations of environmental attributes with walking behaviors were moderated by area-level SES only in walking for exercise. Walking for exercise was associated with higher population density, higher street density (marginally significant), and shorter distance to the nearest commercial destination only in high SES areas. Our findings showed that the associations of these environmental attributes and walking behaviors were largely consistent across different SES levels. Therefore, urban design interventions focusing on low SES areas may help to reduce socioeconomic disparities in walking.

Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose-response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies.

Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults.
Methods A trained librarian created a search strategy that was peer reviewed for completeness.
Results Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults. This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

AimSocial participation provides health benefits for older adults. However, there is the need to identify whether higher social participation is associated with older adults being more physically active and less sedentary (sitting time). We examined the associations of social participation with physical activity, and sedentary time, in a population-based sample of older Japanese adults.
MethodsA population-based, cross-sectional mail survey carried out in 2010 was used to collect data on social participation, physical activity, sedentary time and sociodemographic characteristics. Data were examined from 1146 community-dwelling, unemployed older adults (mean age 70.1 years, 43% men). Multivariate logistic regression analyses were used to calculate odds ratios (OR) for associations of social participation with physical activity and total sedentary time; and, for associations with passive and mentally-active sedentary (sitting) time.
ResultsFor both men and women, those with higher social participation were more physically active (OR 2.10, 95% CI 1.44-3.06 among men; OR 1.93, 95% CI 1.39-2.68 among women). Total sedentary time had significant associations among men (OR 0.62, 95% CI 0.42-0.90), but not among women (OR 0.80, 95% CI 0.58-1.11). Social participation was associated with less passive sedentary time (OR 0.55, 95% CI 0.38-0.81 for men; OR 0.72, 95% CI 0.51-0.99 for women).
ConclusionsPromoting social participation among older adults could contribute to increasing physical activity and reducing sedentary time, with potential benefits for chronic disease. Further research is required to elucidate the deleterious and beneficial roles of passive and mentally-active sedentary time for older adults. Geriatr Gerontol Int 2017; 17: 1921-1927.

This study aims to compare the outputs of the waist-worn Active style Pro HJA-350IT (ASP; used in studies with Asian populations), the waist-worn ActiGragh (TM) GT3X(+) using the normal filter (GT3X(+)) and the thigh-worn activPAL3 (AP) in assessing adults' sedentary behaviour (total sedentary time, number of breaks) under free-living conditions. Fifty healthy workers wore the three monitors simultaneously during their waking hours on two days, including a work day and a non-work day. Valid data were at least 10 hours of wearing time, and the differences between monitors on the sedentary outputs using the AP as criterion measurement were analyzed by ANOVA. The number of participants who had complete valid data for work day and non-work day was 47 and 44, respectively. Total sedentary time and breaks estimated by the AP were respectively 466.5 +/- 146.8 min and 64.3 +/- 24.9 times on the work day and 497.7 +/- 138.3 min and 44.6 +/- 15.4 times on the non-work day. In total sedentary time, the ASP estimated 29.7 min (95% CI = 7.9 to 51.5) significantly shorter than the AP on the work day but showed no significant difference against the AP on the non-work day. The GT3X(+) estimated 80.1 min (54.6 to 105.6) and 52.3 (26.4 to 78.2) significantly longer than the AP on the work day and the non-work day, respectively. For the number of breaks from sedentary time, on both days, the ASP and the GT3X+ estimated significantly more than the AP: 14.1 to 15.8 times (6.3 to 22.5) for the ASP and 27.7 to 28.8 times (21.8 to 34.8) for the GT3X(+). Compared to the AP as the criterion, the ASP can underestimate total sedentary time and the GT3X(+) can overestimate it, and more so at the lower levels of sedentary time. For breaks from sedentary time, compared to the AP, both the GT3X(+) the ASP can overestimate.

Background
Physical activity and physical performance relate to quality of life, mortality, and morbidity in elderly people. However, little is known about differences in physical performance related to low-intensity light physical activity (LLPA), high-intensity light physical activity (HLPA), and moderate-intensity physical activity (MPA) and how they are separated by sex in elderly populations.
Aims
This study aimed to determine differences in LLPA, HLPA, MPA, and physical performance, and associations between these measures in community-dwelling elderly men and women.
Methods
Physical activity and physical performance such as timed-up-and-go test, one-leg standing time, and maximum gait speed were measured in 181 community-dwelling elderly men (mean age, 75.1 +/- 5.3 years) and 109 women (mean age, 73.4 +/- 4.8 years) in 2013. Physical activity was classified as LLPA (1.6 +/- 1.9 METs of physical activity), HLPA (2.0 similar to 2.9 METs of physical activity), and MPA (over 3 METs of physical activity). The association between the values of these three intensities of physical activity in the participants was assessed by Pearson's correlation coefficients. Multiple linear regression analyses were used to assess the association of physical performance values with the three groups defined by accelerometer- measured physical activity intensity adjusted for sociographic, behavioral, and multiple diseases in the participants.
Results
MPA was beneficially associated with all physical performance indicators in the men (all P < 0.05) and women (all P < 0.05). Only HLPA showed significant associations with the timed-up-and-go test (P = 0.001) and maximum gait speed (P = 0.006) in women. Discussion These results may support the notion that not only HLPA in women but MPA in both sexes appears to improve physical performance in elderly populations. Conclusion The present study findings provide novel epidemiological evidence for the potential benefits of HLPA in women and also reinforce the potential benefits of MPA in both sexes, which is the mainstay of public health recommendations.

Background: Men are generally believed to be more physically active than women when evaluated using current physical activity (PA) guidelines, which count only moderate-to-vigorous physical activity (MVPA) in bouts lasting at least 10 min. However, it remains unclear men are truly more physically active provided that all-intensity PA are evaluated. This population based cross-sectional study aimed to examine gender differences in patterns of objectively-assessed PA in older adults.
Methods: One thousand two hundred ten community-dwelling Japanese older adults who were originally randomly selected from residential registry of three municipalities were asked to respond a questionnaire and wear an accelerometer (HJA-350IT, Omron Healthcare). The prevalence of achieving current PA guidelines, >= 150 min/ week MVPA in bouts lasting at least 10 min, was calculated. Gender differences in volume of each-intensity activity (METs-hour) were assessed by analysis of covariance after adjustment for age and wear time.
Results: Data from 450 (255 men, mean 74 years) participants who had valid accelerometer data were analyzed. Women were less likely to meet the guidelines (men: 31.0, women: 21.5%; p < 0.05). However, women accumulated more light-intensity PA (LPA) and short-bout (1-9 min) MVPA, and thus established higher total volume of PA (men: 22.0 METs-hour/day, women: 23.9 METs-hour/day) (p < 0.05).
Conclusions: Older women were less active when evaluated against current PA guidelines, but more active by total PA. Considering accumulated evidence on health benefits of LPA and short-bout MVPA, our findings highlight the potential for the limitation of assessing PA using current PA guidelines.

We examined whether street layout a key urban design element is associated with walking and sedentary behaviors in the context of a non-Western country; and, whether such associations differ between an urban and a rural area. In 2011, 1076 middle-to-older aged adults living in an urban and a rural area of Japan reported their walking and sedentary (sitting) behaviors. Two objective measures of street layout (intersection density and street integration) were calculated. Participants exposed to more-connected street layouts were more likely to walk for commuting and for errands, to meet physical activity recommendations through walking for commuting, and less likely to drive. These relationships differed between the urban and the rural area. This shows that previous findings from Western countries on associations of street connectivity with travel behaviors may also be applicable to Japan.

Background: Sedentary behaviors (SB) are associated with health indicators; however, there are currently very few studies that have examined these associations, especially in conjunction with psychological factors, in children. The current study examined the independent relationship between objectively assessed SB, and indicators of obesity and psychological, well-being, among Japanese children. Methods: A total of 967 elementary-school children completed a cross-sectional survey. SB was measured with accelerometers for 7 consecutive days. Psychological well-being data (eg, anxiety and behavior problems) were collected via a self-report questionnaire. To determine the relationship of SB with degree of obesity and psychological well-being, linear regression analyses were conducted to relate the indicators of obesity and psychological well-being on SB, adjusted by gender, grade, percentage of moderate-to-vigorous physical activity per day, duration spent wearing the accelerometer, and degree of obesity. Results: SB was significantly related to behavioral/emotional problems (beta = .280, P = .010, R-2 = .015). There was a statistically significant relationship between SB and anxiety (beta = .206, P = .059, R-2 = .007). No significant association with degree of obesity was found. Conclusions: Excess SB relates higher levels of behavioral/emotional problems and anxiety. These results can inspire the development of interventions that promote well-being and enhance psychological health, by focusing on SB in Japanese children.

Background: It is vital to reduce the proportion of sedentary behavior in children. Understanding the duration and behavioral context is needed. The present study examined school-grade and sex differences in domain-specific sedentary times and concurrence with screen-time guidelines among Japanese elementary school children.
Methods: A total of 625 children (330 boys) were surveyed in 2010 and 2014. Using a questionnaire, data regarding participants' grade (first through third grades: lower grades; fourth through six grades: higher grades), sex, weight, and height were collected in addition to the time spent per day engaging in each specific sedentary behavior separately: (1) reading or listening to music, (2) TV or video viewing, (3) TV game use, (4) internet use excluding class, (5) homework, and (6) car travel. Two-way analysis of covariance and logistic regression analyses, adjusted for BMI and moderate to vigorous physical activity, were used to examine school-grade and sex differences in sedentary behaviors and the independent risk of exceeding recommended total daily screen time (< 2 h).
Results: On 625 children, mean minutes (SD) of sedentary behavior per week in (1) - (6) were 90.3 (123.4), 535.0 (356.6), 167.3 (222.1), 23.9 (70.9), 264.9 (185.3), and 33.4 (61.2) in weekdays and 42.1 (70.0), 323.9 (232.0), 123.0 (96.4), 15.8 (49.9), 74.4 (96.4), and 71.3 (84.9) in weekends, respectively. There were differences in the minutes of sedentary behavior between participants of 2010 and 2014; e.g., TV game use and homework in weekdays and weekdays and car travel in weekends. Boys spent more time in TV game use, and girls spent more time reading, listening to music, doing homework, and car travel. Higher-grade students spent more time reading or listening to music, using a computer, and doing homework. Higher-grade students were 2.09 times (95% CI: 1.32 - 3.30) in whole week, 2.08 times (95% CI: 1.45 - 3.00) in weekday, and 1.88 times (95% CI: 1.29 - 2.74) in weekend more likely to spend >= 2 h per day in domains (2) - (4) (screen-time) than lower-grade students.
Conclusions: Time spent engaging in each domain-specific sedentary behavior differed according to sex and school grade. Higher-grade students were less likely to meet screen-time guidelines. These findings highlight the need for domain-focused strategies to decrease sedentary behavior in Japanese school-age children.

Introduction
The most effective type of social participation against psychological distress in older adults is not well documented. The aim of this study was to examine whether different types of social participation are associated with changes in psychological distress level in older men and women in Japan.
Methods
Two thousand seven hundred community-dwelling older adults (aged 65-74 years, 50% women) were randomly selected from the resident registry of three cities. Of these, participants who reported social participation and psychological distress level in the baseline survey in 2010 were followed up. Psychological distress was evaluated based on K6 scales at baseline and follow-up (in 2015). Social participation level was examined using question items from the National Health and Nutrition Survey in Japan. Exploratory factor analysis was used to derive the underlying factor structure. Multiple linear regression analysis was used to examine the association between social participation and changes in psychological distress level after adjusting for covariates stratified by both gender and age group or living arrangement.
Results
Data from 825 community-dwelling older adults (45.3% women) were analyzed. Social participation was categorized into two types using factor analysis: community involvement (volunteer activities, community events, clubs for the elderly) and individual relationship (friendship, communication with family and friends, hobbies). During the 5-year follow-up, 29.5% of participants reported a deterioration in psychological distress. Higher community involvement was independently associated with lower risk of psychological distress for older women (beta = 0.099, p = 0.047), whereas there were no associations with individual relationship for either gender. Furthermore, in older women living with others, higher community involvement was also associated with lower risk of psychological distress (beta = 0.110, p = 0.048).
Conclusion
Community involvement provides older women with mental health benefits regardless of individual relationship level. Promoting community involvement may be an effective strategy for healthy mental aging.

Newspapers could provide effective and comprehensive information about cancer to the public. The present study conducted a content analysis of cancer-related articles in Japanese newspapers published in 2011. In total, 5,314 articles were identified and subsequently coded. Coding variables included cancer type, the cancer continuum, and topic of articles mentioning cancer. Approximately half mentioned at least one specific type of cancer, with the focus mostly on lung, leukemia, and breast. Stomach and colon cancers, which have the highest morbidity, were relatively underreported. The continuum received little attention, and was mentioned in only 11% of articles. Treatment was the most frequently mentioned part of the continuum, with prevention and screening mentioned only rarely. The most frequently mentioned topic was social issues. The findings suggest that cancer-related articles were found regularly throughout the year, meaning that they might be one of the most important sources of cancer information. However, they are affected by social issues and there were some imbalances in both cancer type and continuum. Considering the influence of newspapers, it would be helpful for providing more effective and accurate information to the public if Japanese newspapers increased mentions of specific types of common cancers and the cancer continuum, especially prevention.

Street layout is consistently associated with adults' travel behaviors, however factors influencing this association are unclear.
We examined associations of street layout with travel behaviors: walking for transport (WT) and car use; and, the extent to which these relationships may be accounted for by availability of local destinations. A 24-h travel diary was completed in 2009 by 16,345 adult participants of the South-East Queensland Household Travel Survey, Australia. Three travel-behavior outcomes were derived: any home-based WT; over 30 min of home-based WT; and, over 60 min of car use. For street layout, a space syntax measure of street integration was calculated for each Statistical Area 1 (SA1, the smallest geographic unit in Australia). An objective measure of availability of destinations - Walk Score - was also derived for each SA1. Logistic regression examined associations of street layout with travel behaviors. Mediation analyses examined to what extent availability of destinations explained the associations.
Street integration was significantly associated with travel behaviors. Each one-decile increment in street integration was associated with an 18% (95% CI: 1.15, 1.21) higher odds of any home-based WT; a10% (95% CI: 1.06, 1.15) higher odds of over 30 min of home-basedWT; and a 5% (95% CI: 0.94, 0.96) lower odds of using a car over 60min. Local destinations partially mediated the effects of street layout on travel behaviors. Well-connected street layout contributes to active travel partially through availability of more local destinations. Urban design strategies need to address street layout and destinations to promote active travel among residents. (C) 2016 Elsevier Inc. All rights reserved.

<p>本研究の目的はアクセプタンスおよびマインドフルネスに基づいた介入のスポーツパフォーマンス向上への効果について系統的に概観することであった。国内外の複数のデータベースにて「マインドフルネス」や「パフォーマンス」などの関連する検索語を用いて検索を行い、11件の研究を採択した。日本では該当する研究は見られなかった。ほとんどの研究では（n＝8）スポーツパフォーマンスを高めるうえでポジティブな結果が得られていた。残りの3件のうち2件でもフォローアップ期にはスポーツパフォーマンスが向上していた。本研究の結果より、アクセプタンスおよびマインドフルネスに基づいた介入は、スポーツパフォーマンス向上に効果的であると思われる。ただし、国内では全く研究が実施されていない。今後は日本のアスリートにおいてもアクセプタンスおよびマインドフルネスに基づいた介入研究が必要である。</p>

&nbsp;&nbsp;&nbsp;&nbsp;Considering the benefits of participating in school-based extracurricular sports activities (SBECSA), providing active SBECSA is important. However, heavy burden on teachers in coaching and management of SBECSA has been reported. Additionally, appropriate allowance and role allotment have not been discussed enough. It is necessary to understand the quality and quantity of task-related burdens in coaching and managing SBECSA to promote discussion. Therefore, the purpose of the study was to quantify the temporal, psychological, and economic burdens on teachers in coaching and management of SBECSA. The present study used a mixed-methods approach. Firstly, a semi-structured interview was conducted to clarify the contents of tasks about coaching and management of SBECSA. Participants were 12 teachers who work in junior high school or high school. All interview data was recorded and transcribed verbatim. Through the recording process, 26 contents of SBECSA tasks were grouped. Secondly, a self-completed questionnaire survey was conducted. 200 junior high schools and 200 high schools were recruited. Seventy-three schools agreed to cooperate in the study, and 361 SBECSA teachers answered the questionnaire. Question items were as follows: yearly hours taken for each of the 26 tasks, psychological burdens to do each of the 26 tasks, and yearly expenditure for coaching and management of SBECSA. As results, exact temporal burden for each of the 26 tasks was examined. On average, SBECSA teachers were spending approximately 1,400 hours a year for coaching and management. Regarding psychological burden, there were some tasks which were highly perceived although the temporal burdens were comparatively low. SBECSA teachers were payed approximately 136,000 yen a year to coach and manage SBECSA. In conclusion, SBECSA teachers assumed various tasks for management other than direct coaching. Contents of tasks would affect psychological burden as well as temporal length. Additionally, heavy individual payment for coaching and management of SBECSA was revealed. Increasing support for SBECSA coaching and management is necessary to decrease teachers&rsquo; burden and promote youth sports.

&nbsp;&nbsp;&nbsp;&nbsp;Recently, the carry-over of physical fitness or physical activity from childhood to adulthood has been actively discussed. However, the carry-over effect of participation in organized sports is not well understood, despite the fact that organized sports participation has a number of positive effects on physical, mental, and social aspects. Therefore, the purpose of the present study was to clarify the association of organized sports participation during school age with organized sports participation and sports volunteer participation in adulthood. The data was secondarily obtained from &ldquo;nationwide questionnaire research for promotion of sports activities according to the life stage&rdquo; conducted by the National Recreation Association of Japan. This research was conducted with 1,200 Japanese adults (612 males and 588 females) who were 20-39 years old. Path Analysis was conducted with respect to each sex. Regarding association of organized sports participation in school-age with organized sports participation in adulthood, participation in elementary school was related to that of junior high school, participation in junior high school was related to that of high school and adulthood, and participation in high school was related to that of adulthood in males. By contrast, in females, participation in elementary school was related to that of junior high and high school, participation in junior high school was related to that of high school and adulthood, and participation in high school was related to that of adulthood. With respect to association of organized sports participation in school-age with sports volunteer participation in adulthood, only organized sports participation in high school was affected in males, and only organized sports participation in junior high school was affected in females. There is a possibility that participation in organized youth sports has a carry-over effect for adult sports involvement. In order to promote organized sports participation and sports volunteer participation in adulthood, enhancing organized sports participation in school-age would be valuables.

【目的】本研究は人工膝関節全置換術（TKA）患者の退院後における身体活動量を調査し，その関連する要因について検討した。【方法】対象は変形性膝関節症により初回片側TKAを施行した37例とした。身体活動量は活動量計AM-120（カロリズム）を装着し歩数を算出した。身体機能評価はTimed up and go test（TUG），開眼片脚起立時間，30秒椅子立ち上がりテスト，5 m最大歩行速度，膝伸展筋力を測定した。自己効力感（SE）の評価は虚弱高齢者の身体活動SE尺度を用いた。各測定は術後3ヵ月に実施した。身体活動量と各因子との関連性を検討した。【結果】身体活動量は2,809.7±1,999.2歩であった。身体活動量は非術側膝伸展筋力，5 m最大歩行速度，歩行SEおよび階段SEと有意な相関を認めた。【結論】TKA患者の退院後における身体活動量は極めて低く，非術側膝伸展筋力，移動能力および身体活動SEを高めることが重要であることが示唆された。<br>

<p>【はじめに，目的】</p><p></p><p>膝痛高齢者の代表的な疾患である膝OAは外来リハビリテーションにおいて運動療法が実施され，一定の効果が得られている。しかし，膝痛高齢者は，破局思考や医療行動，不活動など不適切な痛み対処方法を選択することが多く，有効性が示されている運動療法の継続を妨げる。この課題に対して，近年では膝痛高齢者に認知行動療法を取り入れた痛み対処スキルトレーニング（PCST）が実施され，膝痛軽減，身体機能向上，膝痛の自己管理に関連する痛み対処方略や痛みセルフ・エフィカシーの改善が報告されている。しかしながら，これらの先行研究は全て諸外国によるものであり，わが国でのPCSTによる介入効果は明らかにされていない。そこで，本研究では外来リハビリテーションで運動療法を実施している膝痛高齢者に個別でのPCSTをおこない，その効果を明らかにすることとした。</p><p></p><p></p><p>【方法】</p><p></p><p>対象は膝OAの診断を受け，外来リハビリテーションに通院する高齢者で採択基準（3ヵ月以上続く膝痛，VAS30mm以上，K-L分類2以上）を満たし，除外基準（認知症が疑われる者，膝関節の手術予定者，膝関節の手術施行者，移動手段が車椅子の者，膝痛や認知行動療法に関する教室への参加経験者）に該当しない25名（男性4名，女性21名）とした。対象者の介入には医師およびPTが対象者の希望を踏まえて健康状態が両群で均等になるように，個別でのPCSTを実施するPCST群13名，健康講話を個別にて実施する健康教育群12名に振り分けた。介入は週1回8週，約20分の介入をそれぞれ実施した。調査項目は基本属性にBMI，痛み持続期間，教育歴，居住人数，現病歴，既往歴，合併症，K-L分類を調査した。効果判定に痛みの程度及び痛みによる活動制限，痛み対処方略，痛みセルフ・エフィカシー，運動セルフ・エフィカシー，下肢筋力，移動能力，3軸加速度計Active style pro（オムロン社，日本）を使用して身体活動量を調査した。解析では介入前後の2群の変化量の差異を共分散分析にて解析した。なお，共変量に性別，年齢，介入前データを設定し，介入中断者を含めたIntent-to-treat解析を用いた。</p><p></p><p></p><p>【結果】</p><p></p><p>対象者の平均年齢はPCST群で75.1±7.1歳，健康教育群で75.7歳±5.9歳であった。また，全ての基本属性において両群に有意な差異は認められなかった。また，ベースライン値においては，PCST群の破滅思考が健康教育群と比較して有意に高かった（p=0.041）。介入前後でPCST群が健康教育群と比較して有意に改善した項目は痛みセルフ・エフィカシー（p=0.005），運動セルフ・エフィカシー（p=0.042），5回立ち上がりテスト（p=0.004），TUG-t（p=0.027）であった。また，有意な改善傾向が認められた項目は痛みの対処方略の下位尺度である医薬行動（p=0.073），中高強度の身体活動量（p=0.052）であった。</p><p></p><p></p><p>【結論】</p><p></p><p>PCSTは一般的に用いる健康教育より，痛み自己管理能力，身体機能，中高強度身体活動に有効である可能性を示した。</p>

<p>【はじめに，目的】</p><p></p><p>人工膝関節全置換術（TKA）は健康関連QOL（HRQOL）を向上し，術後3ケ月または術後6ケ月時点で著明に改善することが報告されているが，本邦での報告は少ない。運動や身体活動に関するセルフ・エフィカシー（SE）はHRQOLに関係するとされている。しかしながらTKA患者の身体活動SE及びHRQOLの回復過程やHRQOLに影響を及ぼす因子について明らかにされていない。本研究の目的はTKA患者の理学療法介入終了後の身体活動SE及びHRQOLの回復過程を把握し，HRQOLに影響を及ぼす因子について検討した。</p><p></p><p></p><p>【方法】</p><p></p><p>対象は2009年8月から2016年4月までに当院で理学療法を実施した初回片側TKA患者84例84膝，手術時年齢は73.1±7.7歳，BMI26.3±4.2 kg/m²，術後在院日数25.4±6.7日でした。評価は術前，術後3ヶ月と6ヶ月とした。</p><p></p><p>膝の痛みと機能は準WOMAC，身体活動SEは虚弱高齢者の身体活動SE尺度（歩行，階段，重量物）を用いた。HRQOLの評価はSF-36v2の下位8尺度である身体機能，日常役割機能－身体，体の痛み，全体的健康感，活力，社会生活機能，日常役割機能－精神，心の健康を国民標準値に基づいたスコアリングで算出した。また身体的サマリースコア（PCS）と精神的サマリースコア（MCS）と役割/社会的サマリースコア（RCS）を用いた。</p><p></p><p>統計解析は回復過程を一元配置分散分析とBonferroni多重比較，HRQOLに影響を及ぼす因子をステップワイズ法による重回帰分析を行った。統計解析はSPSSver.19.0を用いて，有意水準は5%とした。</p><p></p><p></p><p>【結果】</p><p></p><p>各項目は術前（T1）→術後3ヶ月（T2）→術後6ヶ月（T3）の順に平均値±標準偏差で示した。</p><p></p><p>準WOMACの機能は59.5±20.2→78.4±15.0→79.8±15.2点で，T1と比較してT2とT3で，T2と比較してT3で有意に改善した。歩行SEは12.4±5.0→14.9±6.4→15.9±5.3点，階段SEは9.2±4.6→12.6±5.2→12.9±5.3点，重量物SEは15.8±6.3→18.5±5.7→18.7±5.4点となり，T1と比較してT2とT3で有意に向上した。</p><p></p><p>SF-36v2における下位8尺度は全尺度において，T1と比較してT2とT3で有意に改善した。PCSは19.6±11.9→30.3±12.1→30.8±11.9点でT1と比較してT2とT3で有意に改善した。MCSは55.1±10.8→57.0±9.2→56.0±9.0点で有意差はなかった。RCSは34.2±15.1→36.4±14.4→39.9±11.9点でT1と比較してT3で有意に改善した。</p><p></p><p>重回帰分析の結果，術後6ケ月時点のHRQOLにおいてPCSは準WOMACの機能（β＝0.625），MCSは重量物SE（β＝0.370），RCSは歩行SE（β＝0.424）が影響を及ぼす因子として抽出された。</p><p></p><p></p><p>【結論】</p><p></p><p>TKA患者の身体活動SEとHRQOLは術後3ケ月で有意に改善し，術後6ケ月まで維持されていた。HRQOLに影響を及ぼす因子として機能と身体活動SEが重要であることが示唆された。しかしながらPCSとRCSが術前と比較して有意に改善しているものの国民標準値と比較して低値であることから，HRQOLに関する理学療法介入の余地があるのではないかと考えられる。</p>

<p>目的 主要メディアのひとつである新聞に掲載されたがん予防関連記事の掲載頻度およびその内容について検討することを目的とした。</p><p>方法 2011年に発行された全国紙 5 紙（読売，朝日，毎日，日本経済，産経新聞）の朝夕刊に掲載されたがん予防関連記事を対象に，掲載紙，掲載月，朝夕刊，情報元を確認した。その上で，予防記事に対しては，人のがんにかかわる要因の記載の有無，そのうち生活習慣関連要因（喫煙，食物・栄養，飲酒，運動・身体活動，肥満）が記載された記事では予防，リスク，推奨基準の記載の有無，および詳細内容を確認した。検診記事に対しては，検診部位，対象者，受診間隔の記載の有無，および受診を促進する内容であるかを確認した。</p><p>結果 がん予防関連記事は全国 5 紙のべ272件（がん関連記事全体の5.1%）確認され，そのうち予防は208件で取り扱われていた。また，記載された人のがんにかかわる要因では，食物・栄養が56件，持続感染が40件，喫煙が32件と多かった。生活習慣関連要因の中でも飲酒（12件），運動・身体活動（11件），肥満（10件）は少なかった。また，食物・栄養以外では予防よりもリスクの取り扱いが多く，推奨基準の記載はのべ13件であった。一方，検診について取り扱う記事は92件であった。その中では，乳がん検診が31件と最も多く，その他のがん検診は20件に満たなかった。また，検診対象者や受診間隔は7件，検診受診を促進する内容は39件の記事で記載されていた。</p><p>結論 新聞においてがん予防関連記事は取り上げられているものの十分とは言えず，掲載されていた記事においても取り扱われる生活習慣関連要因や検診部位には偏りがあり，具体的な基準を示す記事は少ないことが明らかとなった。新聞の影響力を考えると，今後はいかに，具体的な予防行動やその基準，検診対象者や受診間隔などを含めた記事の取り扱いを増やしてもらうかを検討する必要性が示唆された。</p>

<p>Background: Good quality measures of Japanese adults' sedentary behaviors are needed to accurately assess correlates of specific sedentary behaviors. The present study assessed criterion validity of total sedentary behavior and test-retest reliability of six domain-specific sedentary behaviors.</p><p>Methods: We administered a questionnaire, based on previous studies, that measured domain-specific sedentary behaviors. To examine validity, agreement between self-reported time spent in sedentary behaviors from the questionnaire and objectively-measured sedentary time using accelerometers was compared among 392 adults (aged 40–64 years) in two Japanese cities. For reliability, a 2-week interval test-retest was administered to a convenience sample of 34 participants.</p><p>Results: The correlation between total self-reported and objectively measured sedentary time was significant (all P < 0.001) and fair-to-good for workdays (ρ = 0.57) and whole week (ρ = 0.49), but was low for non-workdays (ρ = 0.23). The difference between the two measures was significant for whole week (z = −2.25, P = 0.03) and non-workdays (z = −5.50, P < 0.001), but was not significant for workdays (z = −0.60, P = 0.55). There was a significant positive association between the difference in the two measures and the average of these two measures (workdays: r = 0.53; non-workdays: r = 0.45; and whole week: r = 0.54, all P < 0.001). There was fair-to-good test-retest reliability of total sedentary time for each domain (workdays: interclass correlation coefficient [ICC] = 0.77, non-workdays: ICC = 0.53, and whole week: ICC = 0.7; all P < 0.01).</p><p>Conclusions: The scale of domain-specific sedentary behaviors is reliable for estimating where and for what purpose Japanese adults spend their sedentary time, and total sedentary time is valid for workdays and the whole week.</p>

Background: This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults. Method: Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport. Results: Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport. Conclusion: Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

Little information exists on the relation between respiratory muscle strength such as maximum inspiratory muscle pressure (MIP) and sarcopenia in elderly cardiac patients. The present study aimed to determine the differences in MIP, and cutoff values for MIP according to sarcopenia in elderly cardiac patients.
We enrolled 63 consecutive elderly male patients aged aeyen65 years with cardiac disease in this cross-sectional study. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People algorithm, and, accordingly, the patients were divided into two groups: the sarcopenia group (n = 24) and non-sarcopenia group (n = 39). The prevalence of sarcopenia in cardiac patients and MIP in the patients with and without sarcopenia were assessed to determine cutoff values of MIP.
After adjustment for body mass index, the MIP in the sarcopenia group was significantly lower than that in the non-sarcopenia group (54.7 +/- A 36.8 cmH(2)O; 95 % CI 42.5-72.6 vs. 80.7 +/- A 34.7 cmH(2)O; 95 % CI 69.5-92.0; F = 4.89, p = 0.029). A receiver-operating characteristic curve analysis of patients with and without sarcopenia identified a cutoff value for MIP of 55.6 cmH(2)O, with a sensitivity of 0.76, 1-specificity of 0.37, and AUC of 0.70 (95 % CI 0.56-0.83; p = 0.01) in the study patients.
Compared with elderly cardiac patients without sarcopenia, MIP in those with sarcopenia may be negatively affected. The MIP cutoff value reported here may be a useful minimum target value for identifying elderly male cardiac patients with sarcopenia.

Background: There is little information on the association of sarcopenia with physical activity in elderly cardiac patients. This study determined differences in physical activity and cutoff values for physical activity according to the presence or absence of sarcopenia in elderly male cardiac patients.
Methods and results: Sixty-seven consecutive men aged &gt;= 65 years with cardiac disease were enrolled. We defined sarcopenia using the European Working Group on Sarcopenia in Older People algorithm. Patients were divided into the sarcopenia group (n = 25) and the non-sarcopenia group (n = 42). In the patients with and without sarcopenia of physical activities were evaluated to determine cutoff values of physical activity.
Results: After adjusting for patient characteristics, both the average daily number of steps (3361.43 +/- 793.23 vs. 5991.55 +/- 583.57 steps, P = 0.021) and the average daily energy expenditure of physical activity (71.84 +/- 22.19 vs. 154.57 +/- 16.18 kcal, P = 0.009) were significantly lower in the sarcopenia versus non-sarcopenia group. Receiver-operating characteristic analysis identified a cutoff value for steps of physical activity of 3551.80 steps/day for 1 week, with a sensitivity of 0.73 and 1-specificity of 0.44 and a cutoff value for energy expenditure of physical activity of 85.17 kcal/day for 1 week, with a sensitivity of 0.73 and 1-specificity of 0.27.
Conclusions: Physical activity in the male cardiac patients with sarcopenia was significantly lower than that in those without sarcopenia. The cutoff values reported here may be useful values to aid in the identification of elderly male cardiac patients with sarcopenia. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Problem Statement: Many youths participate in school-based extracurricular sports activities (SBECSA). These SBECSAs contribute to positive youth development. However, SBECSAs sometimes require the outsourcing of human resources. The major reason is difficulty to manage SBECSAs by employing teachers as the primary coaching resources. Using external coaches is an effective solution for reducing the workload on teachers, and it can contribute to improving teachers’ and students’ knowledge and skills. Because teacher involvement also appears to provide benefits for students, cooperative coaching between external coaches and teachers is essential. However, the lack of evidence regarding the benefits that cooperative coaching offers students may result in inadequate cooperation. Approach: In all, 23 students who participated in SBECSAs were recruited from three junior high schools and three high schools that employed external coaches. An open-ended, semi-structured interview was conducted with each student. The KJ method was used for qualitative analysis of the responses. Purpose: The purpose of this study is to determine how external coaches and teachers impact students’ experiences in SBECSAs, and how external coaches and teachers differ and/or have similar impacts. Results: In terms of benefits from external coaches, six categories and 31 subcategories were identified. The major categories included the following: expert coaching
support for SBECSA teacher
general coaching
human network
improved SBECSA atmosphere
and equipment supply. Benefits from teachers comprised six categories and 22 subcategories. The major categories identified were as follows: general coaching
management and office work
participation in SBECSA
human network
connection with school life
and improved SBECSA atmosphere. Conclusions: Students perceived overlapping and specific benefits from both groups, which indicated that cooperative coaching would be more desirable to students than having only external coaches or teacher instruct their SBECSAs.

Associations between levels of sedentary behavior and depressive symptoms independently and in combination with different levels of physical activity remain unclear.
This study aimed to examine independent and combined associations of physical activity (PA) and sedentary behavior (SB) with depressive symptoms among Japanese adults.
An Internet-based survey collected data on depression levels (Center for Epidemiologic Studies Depression Scale), self-reported time spent in PA and SB (Japanese short version of the International Physical Activity Questionnaire), and sociodemographic variables from 2,914 adults in 2009. Binary logistic regression analyses were conducted to examine the odds ratios (ORs) for being depressed (depression scores a parts per thousand yen16) according to independent PA levels (none, insufficient, sufficient), SB levels (low, moderate, high), and nine combinations of PA and SB categories.
After adjusting for potential confounders, sufficient PA level was found to be related to lower risk of depressive symptoms independently (OR = 0.61), whereas no significant associations were observed between SB levels and depression. In the combined associations, adults in the sufficient PA/high SB (OR = 0.44), sufficient PA/moderate SB (OR = 0.56), and sufficient PA/low SB (OR = 0.57) categories were significantly less likely to have depressive symptoms in comparison with the no PA/high SB category.
Meeting physical activity recommendations is associated with a lower risk of depressive symptoms, regardless of time spent in total sedentary behavior. These results suggest that promoting physical activity may be an effective strategy against depressive symptoms among Japanese adults.

Associations between levels of sedentary behavior and depressive symptoms independently and in combination with different levels of physical activity remain unclear.
This study aimed to examine independent and combined associations of physical activity (PA) and sedentary behavior (SB) with depressive symptoms among Japanese adults.
An Internet-based survey collected data on depression levels (Center for Epidemiologic Studies Depression Scale), self-reported time spent in PA and SB (Japanese short version of the International Physical Activity Questionnaire), and sociodemographic variables from 2,914 adults in 2009. Binary logistic regression analyses were conducted to examine the odds ratios (ORs) for being depressed (depression scores a parts per thousand yen16) according to independent PA levels (none, insufficient, sufficient), SB levels (low, moderate, high), and nine combinations of PA and SB categories.
After adjusting for potential confounders, sufficient PA level was found to be related to lower risk of depressive symptoms independently (OR = 0.61), whereas no significant associations were observed between SB levels and depression. In the combined associations, adults in the sufficient PA/high SB (OR = 0.44), sufficient PA/moderate SB (OR = 0.56), and sufficient PA/low SB (OR = 0.57) categories were significantly less likely to have depressive symptoms in comparison with the no PA/high SB category.
Meeting physical activity recommendations is associated with a lower risk of depressive symptoms, regardless of time spent in total sedentary behavior. These results suggest that promoting physical activity may be an effective strategy against depressive symptoms among Japanese adults.

Background: In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.
Objective: The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.
Methods: The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N= 10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.
Results: We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.
Conclusions: We found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.

Purpose
Both moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point before weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults.
Methods
Data were obtained from the Australian Diabetes, Obesity, and Lifestyle study collected in 1999-2000 (baseline), 2004-2005 (wave 2), and 2011-2012 (wave 3). The study sample consisted of adults age 25 to 74 yr at baseline who also attended site measurement at three time points (n = 3261). Multilevel linear regression analysis examined associations of initial 5-yr changes in MVPA and TV viewing time (from baseline to wave 2) with 12-yr change in waist circumference (from baseline to wave 3), adjusting for well-known confounders.
Results
As categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (P for trend &lt; 0.001). TV viewing time change was not significantly associated with changes in waist circumference (P for trend = 0.06). Combined categories of MVPA and TV viewing time changes were predictive of waist circumference increases; compared with those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2-cm greater increase in waist circumference (P = 0.001).
Conclusion
Decreasing MVPA emerged as a significant predictor of increases in waist circumference. Increasing TV viewing time was also influential, but its impact was much weaker than MVPA.

The promotion of strength training is now recognized as an important component of public health initiatives for older adults. To develop successful communication strategies to increase strength-training behavior among older adults, the identification of effective communication channels to reach older adults is necessary. This study aimed to identify the information sources about strength training that were associated with strength-training behaviors among Japanese older adults. The participants were 1144 adults (60-74 years old) randomly sampled from the registry of residential addresses. A cross-sectional questionnaire survey was conducted. The independent variables were sources of strength-training information (healthcare providers, friends, families, radio, television, newspapers, newsletters, posters, books, magazines, booklets, the Internet, lectures, other sources), and the dependent variable was regular strength-training behavior. Logistic regression analysis was used to identify potential relationships. After adjusting for demographic factors and all other information sources, strength-training information from healthcare providers, friends, books and the Internet were positively related to regular strength-training behavior. The findings of the present study contribute to a better understanding of strength-training behavior and the means of successful communication directed at increasing strength training among older adults. The results suggest that healthcare providers, friends, books and the Internet are effective methods of communication for increasing strength-training behaviors among older adults.

The promotion of strength training is now recognized as an important component of public health initiatives for older adults. To develop successful communication strategies to increase strength-training behavior among older adults, the identification of effective communication channels to reach older adults is necessary. This study aimed to identify the information sources about strength training that were associated with strength-training behaviors among Japanese older adults. The participants were 1144 adults (60-74 years old) randomly sampled from the registry of residential addresses. A cross-sectional questionnaire survey was conducted. The independent variables were sources of strength-training information (healthcare providers, friends, families, radio, television, newspapers, newsletters, posters, books, magazines, booklets, the Internet, lectures, other sources), and the dependent variable was regular strength-training behavior. Logistic regression analysis was used to identify potential relationships. After adjusting for demographic factors and all other information sources, strength-training information from healthcare providers, friends, books and the Internet were positively related to regular strength-training behavior. The findings of the present study contribute to a better understanding of strength-training behavior and the means of successful communication directed at increasing strength training among older adults. The results suggest that healthcare providers, friends, books and the Internet are effective methods of communication for increasing strength-training behaviors among older adults.

【はじめに，目的】地域在住高齢者における足部痛に関連する能力障害（Disabling Foot Pain；DFP）の発生を効果的に予防する方法を明らかにするため，地域在住高齢者が実施する足部自己管理行動とDFP発生状況を分析したので報告する。【方法】地域在住高齢者346名（男性215名，女性131名，第1次調査時平均年齢（S.D.）は74.03（5.21）歳）を対象とした。第1次調査は郵送自記式質問紙調査を行い，人口統計学的指標，生活習慣（飲酒・喫煙・運動習慣），足部痛・DFPの有無（日本語版Manchester Foot Pain and Disability Index；以下MFPDI-Jにより判定），足部自己管理行動に関する項目（「毎日足の状態を観察していますか」等7項目），履き物の選択行動に関する項目（「踵がしっかりとした靴を履いていますか」等靴の種類に関する9項目と「試着をして履き心地を確認していますか」等選択行動に関する4項目）について尋ねた。第1次調査の8か月後に第2次調査として対面自記式質問紙調査を実施し，足部痛・DFPの有無（MFPDI-J）を尋ねた。第1次調査と第2次調査の回答から，DFPなし群，DFP発生群，DFP改善群，DFP持続群の4群に分類し，各群の足部自己管理行動に関する項目の実施数，履き物選択行動に関する項目の実施数について一元配置分散分析を行った。さらに第1次調査時にDFPがなかった271名を抽出し第2次調査時のDFPの有無を従属変数，第1次調査時の足部自己管理行動に関する項目，履き物選択行動に関する項目，運動習慣の有無を独立変数として，多重ロジスティック回帰分析を行った。【結果】DFP発生状況は，DFPなし群244名（70.5%），発生群27名（7.8%），改善群46名（13.3%），持続群25名（13.3%）であった。一元配置分散分析では足部自己管理行動の実施数において有意な差を認め（F=5.86，p＜.01），多重比較の結果，DFP持続群はDFPなし群に比べて足部自己管理行動の実施数が有意に高かった（DFP持続群平均3.79に対しDFPなし群2.14，p＜.01）。多重ロジスティック回帰分析の結果は，履物選択行動に関する項目のうち「デザインや価格以外の要素を考慮して靴を選んでいる」（Odds ratio 2.94，95%CI 1.08-7.97）と「日常的な運動習慣がある」（Odds ratio 0.33，95%CI 0.14-0.80）が有意にDFPの発生に関連した（p＜.05）。【結語】第1次調査時にDFPがあり8か月後にも持続する者の足部自己管理行動の実施数がむしろ多く，足部自己管理行動の実施数はDFP発生・改善に単純には影響しないことがわかった。一方，第1次調査時にDFPがない対象者のみの分析では，足部自己管理行動の実施数や履物選択行動の実施数はDFPの発生に有意な関連はなく，履物の選択時に履物の外観や価格以外の要素を考慮することと日常的に運動習慣があることがDFPの発生を有意に抑制できる可能性が示唆された。履物選択時に考慮するべき内容や習慣化するべき運動内容の仔細は本研究では明らかとならないため，今後の調査・分析の課題とする。

【はじめに，目的】人工膝関節全置換術（TKA）は疼痛や身体機能を改善し，生活の質を高めるために行われる。しかしながら手術前から膝の痛みや身体機能の低下が生じ，健常者よりも身体活動量が低下しており，TKA後も身体活動量は低いといわれている。TKA患者においても三次予防を目的とした身体活動の向上に対する取り組みが重要である。これまでにTKA患者の身体活動量についての報告は散見されるが，TKA患者の退院後における身体活動量とその関連要因については明らかではない。そこで本研究ではTKA患者の身体活動量を調査し，その影響を及ぼす因子について検討した。【方法】対象は変形性膝関節症により初回TKAを施行し，退院後も外来リハビリテーションを実施した患者50例57膝とした。両側例は手術間隔を3ヵ月以上空けて実施した。手術時年齢は73.9±6.2歳，BMI26.1±3.8 kg/m²，術後在院日数25.2±9.6日で，外来リハビリテーションを週1回の頻度で術後3カ月間継続した。その際，自主トレーニングの指導と身体活動量を向上するように促した。身体活動量を歩数と定義し，計測には活動量計AM-120（タニタ社製，カロリズム）を連続7日間装着し平均歩数を算出した。身体機能評価はTimed up and go test（TUG），開眼片脚起立時間，30秒椅子立ち上がりテスト，5m最大歩行速度，膝伸展筋力を測定した。Western Ontario and McMaster Universities OA Index（WOMAC）を用いて，膝関節の痛みと機能について評価した。自己効力感の評価として，虚弱高齢者の身体活動セルフ・エフィカシー（SE）尺度（歩行，階段，重量物）を用いた。各測定は術後3ヵ月に実施した。統計解析は，身体活動量と各検討項目との関連性をSpearmanの順位相関計数にて分析した。さらに身体活動量と相関のあった各因子を独立変数，身体活動量を従属変数としてステップワイズ法による重回帰分析を行った。統計解析はSPSS ver.19.0を用いて有意水準は5%とした。【結果】TKA患者の退院後ににおける身体活動量は2886.5±1847.2歩であった。身体活動量とTUG（r＝-0.264，p＜0.05），術側開眼片脚起立時間（r＝0.312，p＜0.05），非術側開眼片脚起立時間（r＝0.339，p＜0.01），術側膝伸展筋力（r＝0.306，p＜0.05），非術側膝伸展筋力（r＝0.299，p＜0.05），5m最大歩行速度（r＝-0.471，p＜0.01），歩行SE（r＝0.465，p＜0.01），階段SE（r＝0.340，p＜0.05）との間に有意な相関を示した。重回帰分析の結果，身体活動量の影響因子として術側膝伸展筋力（β＝0.416，p＜0.01）と歩行SE（β=0.321，p＜0.01）が抽出された（R＝0.549）。【結論】TKA患者の退院後における身体活動量は極めて低く，その影響因子として身体機能では術側膝伸展筋力と心理的要因として歩行SEが重要であることが示唆された。TKA患者の身体活動量を向上させるためには膝伸展筋力強化のための筋力トレーニングに加え，歩行に関する自己効力感を高める方策が必要であることが示唆された。

【はじめに，目的】外務省海外在留邦人数の調査報告によると，海外で生活している（3か月以上海外に在留）日本人は増加傾向にある（外務省領事局政策課平成27年度要約版）。世界地域別の邦人数は，北米に次いでアジア地域で多い（37万9,498人，約29％）。アジア地域の中でも，マレーシアは，邦人のロングステイ先として，2006年から2013年にかけて世界第一となっている。近年，長時間の座位行動は，肥満，糖尿病，心疾患など種々の健康アウトカムに影響することが示されている（Biswas, et al., 2015）。しかし，海外在留邦人のライフスタイル，とくに座位行動の実態およびその関連要因に関する研究は極めて少ない。本研究の目的は，海外在留邦人における座位行動時間の実態とその関連要因について明らかにすることである。【方法】対象は，マレーシア，ペラ州都イポー市に在留している20歳以上の邦人70人である。70人に対し，現地ボランティアの協力による自記式質問紙の横断調査が実施された。座位行動時間の評価は，生活場面別座位行動尺度（石井ら2015）を用いた。我々は，平日および休日それぞれ6項目（移動2項目・仕事1項目・余暇3項目）の生活場面別座位行動時間の総計より1日あたりの総座位行動時間（分）を算出した。また，社会人口統計学的関連要因は，年齢，性，教育歴，婚姻状況，Body Mass Index（BMI），就労状況について調査した。統計学的手法には，マン・ホイットニーのU検定およびSpearmanの順位和相関係数が用いられた。統計学的有意差判定の基準は5%未満である。【結果】対象者の属性は，年齢57.8歳，男性62.9％，教育歴（＞12年）47.7％，既婚者90.1％，BMI22.5kg/m²，就労者38.6％であった。1日あたりの総座位行動時間は411.3分であった。総座位行動時間は，男性（P＜0.01）と就労者（P＜0.01）で高値を，既婚者（P=0.03）で低値を示した。また，年齢と総座位行動時間には負の相関関係（r=-0.41，P＜0.001）を認めた。【結論】海外在留邦人における1日あたりの総座位行動時間は411.3分であった。また，それに関連する社会人口統計学的要因として，年齢，性，婚姻状況，就労状況等が示された。

<p> 運動部活動は我が国の青少年にとって重要なスポーツ環境であるが、その指導・運営を担う顧問の負担が大きいことが報告されている。顧問の負担軽減のため、部活動指導手当の増額や外部指導者の活用などが検討されているものの、今一歩踏み込んだ議論がなされていないのが現状である。その理由のひとつに、顧問が担っている役割や業務の内容が不明瞭なことが挙げられる。適正な手当や外部指導者との役割分担を議論するには、業務内容を明確化する必要がある。そのため、本研究では運動部活動の指導・運営に関連する顧問の負担を定量化することを目的とした。本研究では、公立の中学校または高等学校の運動部活動顧問672名を対象に郵送法による質問紙調査を行い、運動部活動の指導・運営に関連する時間的・精神的・金銭的負担について回答を得た。その結果、顧問は年間に平均で1400時間程度を指導・運営に費やし、13万円程度の金額を自己負担していることが明らかになった。顧問は実際に練習に参加する時間のほか、多くの時間をマネジメント業務に費やしていた。また、多くの時間を費やしている業務内容が、必ずしも精神的負担も大きいわけではないことが示唆された。</p>

【目的】本研究は人工膝関節全置換術（TKA）患者の退院時における身体活動量の実態を調査し，その関連要因について検討した。【方法】対象はTKA患者で両側手術例1例を含む44例とした。身体活動量は活動量計AM-120（タニタ社製，カロリズム）を装着して，退院前の連続7日間の平均歩数を計測した。身体機能はTimed up and go test（TUG），開眼片脚起立時間，30秒椅子立ち上がりテスト，膝伸展筋力および5 m最大歩行速度を測定した。膝関節の痛みと機能はWestern Ontario and McMaster Universities Osteoarthritis Indexに準じた日本語版を用いた。Spearman の順位相関係数と各身体機能を独立変数，身体活動量を従属変数として重回帰分析を行った。【結果】TKA患者の退院時における身体活動量は2256.5±1576.7歩であった。身体活動量とTUG，術側膝伸展筋力，30秒椅子立ち上がりテストおよび5 m最大歩行速度との間に有意な相関を示した。重回帰分析の結果，身体活動量の関連要因としてTUGが抽出された（β＝－0.415，p＜0.01）。【結論】TKA 患者の退院時における身体活動量は極めて低く，身体活動量の関連要因として移動能力が重要であることが示された。

Background: Physical activity levels in childhood have decreased, making the promotion of children's physical activity an important issue. The present study examined gender and grade differences in objectively measured sedentary behavior, physical activity, and physical activity guideline attainment among Japanese children and adolescents.
Methods: In total, 329 boys and 362 girls age 3-15 years completed the survey. School grade, gender, height, and weight were collected by questionnaires and physical activity objectively measured using an accelerometer (Lifecorder Suzuken Co.). Physical activity level (in MET) was classified as sedentary (&lt;1.5), light (&gt;= 1.5 to &lt;3), moderate (&gt;= 3 to &lt;6), or vigorous (&gt;= 6). Continuous zero accelerometer counts for &gt;= 20 min were censored and a valid accelerometry study required at least 3 days (2 weekdays and 1 weekend day) with &gt;600 min/day total wear time. Two-way analysis of covariance and logistic regression analyses, adjusted for weight status and accelerometer wear time, were used to examine gender and grade differences in physical activity variables and the likelihood of physical activity guideline attainment by gender and grade level.
Results: Participants were sedentary 441.4 (SD, 140.1) min/day or 53.7 % of the average daily accelerometer wear time of 811.2 (118.7) min, engaged in light physical activity 307.1 (70.0) min or 38.4 % of wear time, moderate physical activity 34.6 (14.8) min (4.3 %), vigorous physical activity 28.3 (19.1) min (3.6 %), and took 12462.6 (4452.5) steps/day. Boys were more physically active and took more steps/day than girls. Students in higher grades were less active than those in lower grades. Boys were significantly more likely to meet physical activity guidelines than girls (OR: 2.07, 95 % CI: 1.45-2.96). Preschoolers (6.66, 4.01-11.06), lower-grade elementary school students (17.11, 8.80-33.27), and higher-grade elementary school students (7.49, 4.71-11.92) were more likely to meet guidelines than junior high school students.
Conclusions: Boys and lower-grade students engaged in more physical activity and were more likely to attain guidelines than girls and higher-grade students. These findings highlight the need for effective and sustainable strategies to promote physical activity in Japanese school children.

Purpose Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.

Purpose: Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods: Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results: Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions: Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.

Purpose: Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods: Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results: Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions: Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.

Background: There has been a growing interest in environmental initiatives to reduce sedentary behaviour. A few existing studies on this topic are mostly cross-sectional, focused on the general adult population, and examining neighbourhood walkability. This study examined associations of perceived environmental attributes with change in TV viewing time over seven years among older Australian adults in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.
Methods: The AusDiab study is a population-based study on diabetes and its risk factors in adults. We used the data on 1072 older adults (60+ years at baseline) collected in 2004-05 (baseline) and in 2011-12 (follow-up; 45.4% men, mean age 67.5 years). Generalized linear modelling examined associations with 7 years change in TV viewing time of nine perceived neighbourhood-environment attributes relating to local shops, alternative routes, footpaths, parks, attractiveness, natural features, bicycle/walkway tracks, local traffic, and safety.
Results: On average, participants increased their TV viewing time from 127 min/day to 137 min/day over the 7 years period. Adjusted for baseline TV viewing levels, TV viewing time at follow-up was 8% lower (95%CI: 0.85, 0.99) among those who did not perceive local traffic as a deterrent compared to those who perceived traffic as a deterrent. A trend for significant interaction between working status and the presence of a parks nearby indicated that, for those who were not working, those who reported having parks nearby had a marginal association with lower TV viewing time at follow-up than those who did not (p = 0.048).
Conclusions: Overall TV viewing time increased on average by 10 minutes/day over 7 years among older Australian adults. Local traffic that makes walking difficult or unpleasant may increase older adults' leisure-time sedentary behaviours such as TV viewing, possibly by deterring outdoor activities.

Background: There has been a growing interest in environmental initiatives to reduce sedentary behaviour. A few existing studies on this topic are mostly cross-sectional, focused on the general adult population, and examining neighbourhood walkability. This study examined associations of perceived environmental attributes with change in TV viewing time over seven years among older Australian adults in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.
Methods: The AusDiab study is a population-based study on diabetes and its risk factors in adults. We used the data on 1072 older adults (60+ years at baseline) collected in 2004-05 (baseline) and in 2011-12 (follow-up; 45.4% men, mean age 67.5 years). Generalized linear modelling examined associations with 7 years change in TV viewing time of nine perceived neighbourhood-environment attributes relating to local shops, alternative routes, footpaths, parks, attractiveness, natural features, bicycle/walkway tracks, local traffic, and safety.
Results: On average, participants increased their TV viewing time from 127 min/day to 137 min/day over the 7 years period. Adjusted for baseline TV viewing levels, TV viewing time at follow-up was 8% lower (95%CI: 0.85, 0.99) among those who did not perceive local traffic as a deterrent compared to those who perceived traffic as a deterrent. A trend for significant interaction between working status and the presence of a parks nearby indicated that, for those who were not working, those who reported having parks nearby had a marginal association with lower TV viewing time at follow-up than those who did not (p = 0.048).
Conclusions: Overall TV viewing time increased on average by 10 minutes/day over 7 years among older Australian adults. Local traffic that makes walking difficult or unpleasant may increase older adults' leisure-time sedentary behaviours such as TV viewing, possibly by deterring outdoor activities.

Background Little is known about differences in the risk of poor nutritional status as assessed by the Geriatric Nutritional Risk Index (GNRI) in relation to physical performance in elderly female cardiac inpatients. The present study aimed to determine both differences in physical performance based on the GNRI and physical performance cut-off values according to the GNRI in elderly female cardiac inpatients.
Methods We enrolled 105 consecutive female Japanese inpatients aged a parts per thousand yen65 years (mean age, 74.6 years) with cardiac disease in this cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (a parts per thousand yen92 points) (n = 71) and low-GNRI group (&lt; 92 points) (n = 34). Handgrip strength (HG), knee extensor muscle strength (KEMS), gait speed (GS), and one-leg standing time (OLST) were assessed as indices of hospital physical performance and compared between the two groups to determine cut-off values of physical performance.
Results After adjustment for age and left ventricular ejection fraction, HG, KEMS, GS, and OLST were significantly lower in the low-GNRI versus high-GNRI group. Cut-off values by ROC curve analysis were 16.2 kgf (AUC = 0.66; p &lt; 0.001) for HG, 34.3 % of body weight (AUC = 0.62; p = 0.04) for KEMS, 1.24 m/s (AUC = 0.72; p &lt; 0.01) for GS, and 8.28 s (AUC = 0.62; p = 0.04) for OLST.
Conclusions The risk of poor nutrition, as indicated by a low GNRI, might be a predictor of lower physical performance. Cut-off values determined in this study might be minimum target goals for physical performance that can be attained by elderly female cardiac inpatients.

Maximum gait speed and physical activity (PA) relate to mortality and morbidity, but little is known about gender-related differences in these factors in elderly hospitalized cardiac inpatients. This study aimed to determine differences in maximum gait speed and daily measured PA based on sex and the relationship between these measures in elderly cardiac inpatients.
A consecutive 268 elderly Japanese cardiac inpatients (mean age, 73.3 years) were enrolled and divided by sex into female (n = 75,28%) and male (n = 193, 72%) groups. Patient characteristics and maximum gait speed, average step count, and PA energy expenditure (PAEE) in kilocalorie per day for 2 days assessed by accelerometer were compared between groups.
Gait speed correlated positively with in-hospital PA measured by average daily step count (r = 0.46, P&lt;0.001) and average daily PAEE (r = 0.47, P&lt;0.001) in all patients. After adjustment for left ventricular ejection fraction, step counts and PAEE were significantly lower in females than males (2651.35 +/- 1889.92 vs 4037.33 +/- 1866.81 steps, P&lt;0.001; 52.74 +/- 51.98 vs 99.33 +/- 51.40 kcal, P&lt;0.001), respectively.
Maximum gait speed was slower and PA lower in elderly female versus male inpatients. Minimum gait speed and step count values in this study might be minimum target values for elderly male and female Japanese cardiac inpatients.

Background: Providing information about cancer prevention might increase awareness of prevention and promote preventive behaviours. A better understanding about the prevalence and preferences of obtaining information about cancer might help to identify targeted individuals and design effective strategies for promoting cancer-preventive behaviours. Thus, the present study examined the prevalence and correlates of obtaining information about cancer among Japanese adults, and described preferences including source and content.
Methods: Data were analysed for 3,058 Japanese adults (mean age 45.0 +/- 13.4 years) who responded to an Internet-based cross-sectional survey. The data included whether information about cancer had been obtained, sources, preference for content, sociodemographic variables, health status, and cancer histories. Force-entry logistic regression analysis was used.
Results: Overall, 46.7% of respondents had obtained information about cancer. Gender, age, and education level were statistically significant correlates of doing so. Women were more likely to obtain information (OR = 1.97) as were older age groups (40-49: OR = 1.54, 50-59: OR = 2.27, 60-69: OR = 3.83), those with higher education (2 years college or equivalent degree: OR = 1.31, college graduate or higher: OR = 1.48) and those with having cancer histories (personal: OR = 3.52, family: OR = 1.57, friends/co-worker: OR = 2.09). The most prevalent source of information about cancer was mass media. Content of prevention is most needed among inconsistent contents with the frequently obtained contents.
Conclusions: Less than half of the respondents information about cancer. The finding suggests that better health communication strategies would be necessary to inform Japanese people about cancer. Understanding which subgroups were less likely to obtain information and preferences of information might be effective in promoting cancer prevention.

Background: Providing information about cancer prevention might increase awareness of prevention and promote preventive behaviours. A better understanding about the prevalence and preferences of obtaining information about cancer might help to identify targeted individuals and design effective strategies for promoting cancer-preventive behaviours. Thus, the present study examined the prevalence and correlates of obtaining information about cancer among Japanese adults, and described preferences including source and content.
Methods: Data were analysed for 3,058 Japanese adults (mean age 45.0 +/- 13.4 years) who responded to an Internet-based cross-sectional survey. The data included whether information about cancer had been obtained, sources, preference for content, sociodemographic variables, health status, and cancer histories. Force-entry logistic regression analysis was used.
Results: Overall, 46.7% of respondents had obtained information about cancer. Gender, age, and education level were statistically significant correlates of doing so. Women were more likely to obtain information (OR = 1.97) as were older age groups (40-49: OR = 1.54, 50-59: OR = 2.27, 60-69: OR = 3.83), those with higher education (2 years college or equivalent degree: OR = 1.31, college graduate or higher: OR = 1.48) and those with having cancer histories (personal: OR = 3.52, family: OR = 1.57, friends/co-worker: OR = 2.09). The most prevalent source of information about cancer was mass media. Content of prevention is most needed among inconsistent contents with the frequently obtained contents.
Conclusions: Less than half of the respondents information about cancer. The finding suggests that better health communication strategies would be necessary to inform Japanese people about cancer. Understanding which subgroups were less likely to obtain information and preferences of information might be effective in promoting cancer prevention.

AimNutrition is the focus of a new treatment target in older hospitalized cardiac patients. However, little is known about the differences in nutritional status in relation to physical performance in these inpatients. We determined the differences in physical performance based on the Geriatric Nutritional Risk Index (GNRI) and physical performance cut-off values according to the GNRI in older male cardiac inpatients.
MethodsWe enrolled 251 Japanese male inpatients aged 65 years (mean age 74.7 years) with cardiac disease in the present cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (92 points; n=178) and low-GNRI group (&lt;92 points; n=73). In-hospital physical performance as measured by handgrip strength (HG), knee extensor muscle strength (KEMS), gait speed (GS), and one-leg standing time (OLST) was assessed and compared between the two groups to determine cut-off values of physical performance.
ResultsAfter adjustment for age, HG, KEMS, GS and OLST were significantly lower in the low-GNRI versus high-GNRI group. Cut-off values by receiver operating characteristic curve analysis were 25.75kgf (area under the curve [AUC]=0.740; P&lt;0.001) for HG strength, 46.1% for bodyweight (AUC=0.742; P&lt;0.01) for KEMS, 1.45m/s (AUC=0.782; P&lt;0.01) for GS and 11.32s (AUC=0.705; P&lt;0.01) for OLST.
ConclusionThe risk of poor nutrition, as shown by a low GNRI, could be a useful predictor of physical performance. The cut-off values determined in the present study might be expected minimum target values that can be attained by Japanese older male cardiac inpatients. Geriatr Gerontol Int 2015; 15 189-195.

:Maximum gait speed and physical activity (PA) relate to mortality and morbidity, but little is known about gender-related differences in these factors in elderly hospitalized cardiac inpatients. This study aimed to determine differences in maximum gait speed and daily measured PA based on sex and the relationship between these measures in elderly cardiac inpatients.A consecutive 268 elderly Japanese cardiac inpatients (mean age, 73.3 years) were enrolled and divided by sex into female (n = 75, 28%) and male (n = 193, 72%) groups. Patient characteristics and maximum gait speed, average step count, and PA energy expenditure (PAEE) in kilocalorie per day for 2 days assessed by accelerometer were compared between groups.Gait speed correlated positively with in-hospital PA measured by average daily step count (r = 0.46, P < 0.001) and average daily PAEE (r = 0.47, P < 0.001) in all patients. After adjustment for left ventricular ejection fraction, step counts and PAEE were significantly lower in females than males (2651.35 ± 1889.92 vs 4037.33 ± 1866.81 steps, P < 0.001; 52.74 ± 51.98 vs 99.33 ± 51.40 kcal, P < 0.001), respectively.Maximum gait speed was slower and PA lower in elderly female versus male inpatients. Minimum gait speed and step count values in this study might be minimum target values for elderly male and female Japanese cardiac inpatients.

心理的要因（たとえば、痛み対処方略）が高齢者における運動器疼痛管理に重要な役割を果たすというエビデンスは増加している。それ故に、運動器疼痛管理のために認知行動療法（たとえば、痛み対処スキルトレーニング）を利用することへの興味・関心が高まっている。本稿では、まず初めに運動器疼痛管理における認知行動療法の必要性に関する背景について概観した。次に、痛み対処スキルトレーニングで使用される5つの主な技法（認知再構成、リラクセーション、ディストラクション、快活動の計画、活動ペース配分）に焦点を当てて解説した。さらに、日本人の膝痛高齢者に対する痛み対処スキルトレーニングおよび運動療法に活用するために新しく開発した2つの印刷教材を紹介した。最後に、この領域における研究の今後の方向性について議論した。本総説より、運動器疼痛管理に認知行動療法（痛み対処スキルトレーニング）を応用することの重要性が示された。

School-based extracurricular sports activities are beneficial for positive youth development. However, there is a shortage of appropriate in-school coaches, and therefore recruitment of external coaches has been considered as one solution to this. A previous study has reported 4 model strategies of organizational promotion to recruit external coaches. These 4 models included "compensational support", "staff introduction", "delivery of collegiate students", and "cooperation with company". In order to promote the further development and popularization of these organizational trials, user-side evaluation is necessary. Therefore, the purpose of the present study was to clarify the strengths and problems related to these 4 organizational promotion strategy models when recruiting external coaches for school-based extracurricular sports activities from the viewpoint of teachers. The participants were 12 teachers who worked in public junior high or high schools. All of them had experience of coaching school-based extracurricular sports activities. Face-to-face semi-structured interviews were conducted with the individual participants, and all interview data were transcribed. Then, similar meaning units were grouped into themes with respect to the 4 models, strengths and problems. As a result, many specific themes for each model emerged. For instance, with regard to "compensational support", monetary support was regarded as a strength, although the early application period was a problem. With regard to "staff introduction", adequacy for beginners was a strength, but lack of mediation organization was a problem. With regard to "delivery of collegiate students", regular coaching was seen as a strength, but worry over not choosing a delivered external coach was a problem. With regard to "cooperation with company", high coaching skill was a strength, but an expensive coaching fee was a problem. Additionally, comprehensive opinions about all the models were reported, such as lack of information about the system and the need for educational coaching. These similarities and differences in the results indicated the importance of mediation system design considering the regionality and situation of the school-based extracurricular sports activity. Effective publicity and re-examination of financial manager is also needed. In addition, mediation organization and teachers should arrange previous meetings with external coaches to understand their human qualities and educational attitude. Furthermore, it would be valuable to develop the quality of external coaches through previous training or workshops. Finally, changes in the application period for each mediation system are suggested.<br>

目的：本研究の目的は休み時間に用具を提供することによる小学校児童の身体活動への効果を検討することである．<br>方法：介入校（n＝39）及び統制校（n＝59）の各1校の小学校に在籍する5年生合計98名（男子63名）を対象とし介入研究を行った．介入校にはバレーボールや楕円球などのボールを用具として提供した．身体活動の測定には加速度計を用い，用具提供前とその3ヵ月後に測定を行った．業間休み，昼休み，平日1日の座位行動，低強度身体活動，中等度身体活動，高強度身体活動を評価した．介入校と統制校における用具提供3ヵ月後の身体活動の差を検討するため，性，BMI，用具提供前の身体活動を共変量とした共分散分析を行った．<br>結果：分析対象者は，介入群では業間休みが23名（男子13名），昼休みが25名（15名），1日全体では18名（男子10名），統制群は業間休みが41名（男子28名），昼休みが42名（29名），1日全体では37名（男子26名）であった．業間の休み時間において，介入群は統制群と比較し，有意に座位行動［F（1, 62）＝7.70；p＝0.01］及び高強度身体活動の割合［F（1, 62）＝6.31；p＝0.02］が低く，低強度身体活動の割合［F（1, 62）＝28.73；p＜0.01］が高かった．昼休みでは，介入群は座位行動の割合［F（1, 65）＝18.36；p＜0.01］が低く低強度身体活動の割合［F（1, 65）＝17.11；p＜0.01］が有意に高かった．また，1日全体では介入群の方が統制群よりも有意に中等度身体活動の実施割合［F（1, 53）＝5.06；p＝0.03］が高かった．<br>結論：休み時間に使用できる用具を提供することは，身体活動レベルの高さに影響を与えていた．本研究より，用具の提供は休み時間及び1日の身体活動促進に貢献することが示された．

Outdoor education contributes to positive youth development. Existing outdoor education in Japan has been conducted only in an "episodic" manner with a "single activity" basis in "imitation nature", although regular and various activities in "grand nature" have been considered more valuable for the growth of children. Therefore, the purposes of the present study were to develop and practice an outdoor education program that performed a "plural number" of experiences with "multiple activities" in "genuine nature", and to clarify the availability of the program. For this purpose, the "Buddy Kids Adventure Challenge Program" was developed on the basis of 12 years of practice with the "Buddy Adventure Team (Non-Profit Organization)". An inventory survey was conducted for 49 participants in the Buddy Kids Adventure Challenge Program and 26 participants′ parents to evaluate the program in 2013. Free descriptive answers for the questions with respect to experiences in the program were descriptively analyzed and a model of the growth of the participants in the Buddy Kids Adventure Challenge Program was generated. As results, self-esteem was increased by developing competence. Additionally, outdoor activities in the program and flow experience were associated. Strong relationship between adverse circumstances and flow experience were also demonstrated. The growth model of the present study showed that desiring pleasure in "grand nature" could allow participants to confront adverse circumstances. These adverse circumstances give participants flow experience and confidence by helping them to overcome adverse circumstances. Finally, self-esteem was increased and growth of participants was enhanced.

School-based extracurricular sports activities are beneficial for positive youth development. However, there is a shortage of appropriate in-school coaches, and therefore recruitment of external coaches has been considered as one solution to this. A previous study has reported four model strategies of organizational promotion to recruit external coaches. These four models included "compensational support", "staff introduction", "delivery of collegiate students", and "cooperation with company". In order to promote the further development and popularization of these organizational trials, user-side evaluation is necessary. Therefore, the purpose of the present study was to clarify the strengths and problems related to these four organizational promotion strategy models when recruiting external coaches for school-based extracurricular sports activities from the viewpoint of teachers. The participants were 12 teachers who worked in public junior high or high schools. All of them had experience of coaching school-based extracurricular sports activities. Face-to-face semi-structured interviews were conducted with the individual participants, and all interview data were transcribed. Then, similar meaning units were grouped into themes with respect to the four models, strengths and problems. As a result, many specific themes for each model emerged. For instance, with regard to "compensational support", monetary support was regarded as a strength, although the early application period was a problem. With regard to "staff introduction", adequacy for beginners was a strength, but lack of mediation organization was a problem. With regard to "delivery of collegiate students", regular coaching was seen as a strength, but worry over not choosing a delivered external coach was a problem. With regard to "cooperation with company", high coaching skill was a strength, but an expensive coaching fee was a problem. Additionally, comprehensive opinions about all the models were reported, such as lack of information about the system and the need for educational coaching. These similarities and differences in the results indicated the importance of mediation system design considering the regionality and situation of the school-based extracurricular sports activity. Effective publicity and re-examination of financial manager is also needed. In addition, mediation organization and teachers should arrange previous meetings with external coaches to understand their human qualities and educational attitude. Furthermore, it would be valuable to develop the quality of external coaches through previous training or workshops. Finally, changes in the application period for each mediation system are suggested.<br>

Use of external coaches for school-based extracurricular sports activities has been promoted because of the lack of teachers who can coach expertly and the large burden placed on teachers when coaching and managing such activities. However, it has been reported that securing external coaches through human resources is difficult. To promote the use of external coaches, previous studies have suggested some possible strategies: 1) clarifying the role and status of external coaches, and promoting cooperative coaching with external coaches and teachers; 2) interactive collection and provision of information about external coaches and schools, and improving recognition of the mediation system; 3) improving the way external coaches are recruited, and setting a suitable trial period; 4) moderating institutional limitations for coaching frequency and number of coaches; and 5) holding workshops for external coaches. However, these suggestions were made from only an individual viewpoint (i.e. that of teachers, external coaches, and potential external coaches), and did not consider organizational perspectives. In Japan, there are some organizations that help recruitment of external coaches for school-based extracurricular sports activities. It is necessary to consider the opinions of these organizations to develop more realistic and concrete promotion strategies. Therefore, the present study explored in detail the trials, problems, challenges, and strategies of organizations in order to promote the recruitment of external coaches for school-based extracurricular sports activities. Face to face semi-structured interviews were conducted involving 15 individuals in 11 organizations (2 national and 4 prefectural organizations, 3 schools, 1 university, and 1 company) supporting the recruitment of external coaches for school-based extracurricular sports activities. The interviews contained questions asking details of the recruitment system, problems, challenges and management strategies. All interviews were audio-recorded with agreement from the participants. The transcript data were integrated into 7 trials and their details, problems, challenges, and strategies were described. The results indicated that in order to promote the engagement of external coaches, a number of factors were important, including building human relationships between external coaches and teachers led by teachers that could share information, interactive collection and provision of information through mediator and cooperation with other organizations, collecting information about external coaches and interviewing them before formal acceptance, keeping the coaching non-compensatory, holding workshops and creating feedback to promote communication and learning of external coaches, and considering the continuity of the trial. Knowledge of the various problems, challenges, and strategies from an organizational perspective would contribute to improvement of recruitment strategy. The results of the present study could also provide information that is beneficial for other organizations wishing to conduct similar trials.<br>

In competitive sports, the enhancing of physical abilities, technical skills, and psychological states is vital for excelling in competition. A team' s psychological wellbeing is often the deciding factor in team sport success. Nevertheless, few efficient strategies have been made for boosting teams' psychological states, particularly during matches. Therefore, the aim of this study was to investigate practitioners' perceptions of Enjin (forming a circle) strategies used to enhance a team' s psychological acuity during matches. In addition, motivations to initiate Enjin strategies, content, and changes observed after implementing these strategies were emphasized. The study was conducted following three steps. First, a women' s collegiate basketball team' s Enjin strategies were observed and recorded during an official match. Second, a team coach and four players were interviewed concerning these strategies, after viewing a recording of the match. The participants were requested to provide (1) motivations to implement Enjin strategies; (2) Enjin content; and (3) changes experienced after implementing Enjin strategies. Third, the study results were analyzed following the KJ method. The analysis revealed seven motivations, including "routine," "desire to enhance team cohesion," and "foul play." In addition, four types of Enjin content were identified, including "encouragement," "information on tactics," "apologizing," and "battle cries." Subsequently, eleven changes, including "enhanced team cohesion" , "shared perspectives among team members," and "improved excitement levels," were identified. It was inferred that Enjin strategies enhanced the teams' psychological states, based on these results. However, additional studies involving several teams, games, events, and genders are required to complement these results.

The purpose of this cross-sectional study is to investigate the difference in physical activity among elderly living in different areas in Japan ("Bunkyo Ward in Tokyo" (Bunkyo) and "Fuchu City in Tokyo" (Fuchu) as urban areas, and "Oyama Town in Shizuoka" (Oyama) as a non-urban area). Participants were 1859 community-dwelling residents aged 65-74 years, randomly selected from the residential registry (response rate: 68.9%). A mail survey using self-administered questionnaires was conducted. Multivariate logistic regression analyses were used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) of various types of physical activity (eg, walking (Walking), going out (Going-out), bicycling (Bicycling), exercise habits (Exercise)), according to residential areas (reference category: Fuchu), stratified by gender, adjusting for socio-demographic variables. There was a significant difference in Going-out (ORs = 0.61 (95% CI: 0.44-0.86) for men, 0.48 (0.33-0.69) for women)), and Bicycling (0.04 (0.03-0.07) for men, 0.04 (0.02-0.07) for women) in Oyama compared to Fuchu. Furthermore, for women, there was a significant difference in Walking (0.56 (0.38-0.81)) and Exercise (0.59 (0.41-0.85)) in Oyama compared to Fuchu. There was a significant difference in Bicycling and Going-out for men in Bunkyo compared to Fuchu, but there was not a significant difference in other items. Low physical activity levels were observed in the elderly in the non-urban area compared to urban areas. The association was stronger in women. Regional difference might need to be taken into account for an effective physical activity intervention.

Use of external coaches for school-based extracurricular sports activities has been promoted because of the lack of teachers who can coach expertly and the large burden placed on teachers when coaching and managing such activities. However, it has been reported that securing external coaches through human resources is difficult. To promote the use of external coaches, previous studies have suggested some possible strategies: 1) clarifying the role and status of external coaches, and promoting cooperative coaching with external coaches and teachers; 2) interactive collection and provision of information about external coaches and schools, and improving recognition of the mediation system; 3) improving the way external coaches are recruited, and setting a suitable trial period; 4) moderating institutional limitations for coaching frequency and number of coaches; and 5) holding workshops for external coaches. However, these suggestions were made from only an individual viewpoint (i.e. that of teachers, external coaches, and potential external coaches), and did not consider organizational perspectives. In Japan, there are some organizations that help recruitment of external coaches for school-based extracurricular sports activities. It is necessary to consider the opinions of these organizations to develop more realistic and concrete promotion strategies. Therefore, the present study explored in detail the trials, problems, challenges, and strategies of organizations in order to promote the recruitment of external coaches for school-based extracurricular sports activities. Face to face semi-structured interviews were conducted involving 15 individuals in 11 organizations (2 national and 4 prefectural organizations, 3 schools, 1 university, and 1 company) supporting the recruitment of external coaches for school-based extracurricular sports activities. The interviews contained questions asking details of the recruitment system, problems, challenges and management strategies. All interviews were audio-recorded with agreement from the participants. The transcript data were integrated into 7 trials and their details, problems, challenges, and strategies were described. The results indicated that in order to promote the engagement of external coaches, a number of factors were important, including building human relationships between external coaches and teachers led by teachers that could share information, interactive collection and provision of information through mediator and cooperation with other organizations, collecting information about external coaches and interviewing them before formal acceptance, keeping the coaching non-compensatory, holding workshops and creating feedback to promote communication and learning of external coaches, and considering the continuity of the trial. Knowledge of the various problems, challenges, and strategies from an organizational perspective would contribute to improvement of recruitment strategy. The results of the present study could also provide information that is beneficial for other organizations wishing to conduct similar trials.<br>

身体活動の種類は、日常生活における労働・家事・通勤などの「生活活動」と、体力の維持・向上を目的とした「運動」に大別することができる。今回、国内3地域(東京都文京区、東京都府中市、静岡県駿東郡小山町)に居住する前期高齢者2700名(各地域900名)を対象として「生活活動」「運動」の実施状況を調査し、地域別・男女別で比較検討した。結果、都市型環境の文京区・府中市に比べて非都市型環境の小山町は身体活動が少ない傾向にあった。身体活動の地域間差は、男性では「生活活動」のみ有意差を認め、女性では「生活活動」と「運動」の双方で有意差を認めた。「運動」の種類にも地域間で違いがみられ、男性ではサイクリングとラケットスポーツが小山町で少なく、ゲートボールやハイキングが小山町で多かった。女性では、文京区でゴルフが多く、府中市でウォーキングが多く、小山町でゲートボールが多かった。

This study aimed to examine the association of muscle-strengthening activity with knee and low back pain, falls, and health-related quality of life among Japanese older adults. A cross-sectional survey targeted 3,000 people. The response rate was 52% and 208 respondents did not meet the inclusion criteria. Therefore, 1,351 individuals were analyzed. Muscle-strengthening activity (exercise using equipment and body weight, lifestyle activities), knee and low back pain, falls over the past year, health-related quality of life (SF-8), and potential confounders were assessed. Individuals engaging in exercise using body weight and lifestyle activity (&gt;= 2 days/week) were more likely to have knee pain. Engaging in exercise using equipment and body weight was associated with higher scores of general health. These results indicate that exercise using equipment and body weight might have a positive effect on health-related quality of life, but muscle-strengthening activities are associated with knee pain in older people.

This study aimed to determine the relation between the regression slope relating minute ventilation to carbon dioxide output ((V) over dotE/(V) over dotCO2 slope) and maximum phonation time (MPT), and the MPT required to attain a threshold value for (V) over dotE/(V) over dotCO2 slope of &lt;= 34 in chronic heart failure (CHF) patients.
This cross-sectional study enrolled 115 CHF patients (mean age, 54.5 years; men, 84.9%). (V) over dotE/(V) over dotCO2 slope was assessed during cardiopulmonary exercise testing (CPX). Thereafter, patients were divided into 2 groups according to exercise capacity: (V) over dotE/(V) over dotCO2 slope &lt;= 34 ((V) over dotE/(V) over dotCO2 &lt;= 34 group, n = 81) and (V) over dotE/(V) over dotCO2 slope &gt;34 ((V) over dotE/(V) over dotCO2 &gt;34 group, n = 34). For MPT measurements, all patients produced a sustained vowel/a:/for as long as possible during respiratory effort from the seated position.
All subjects showed significant negative correlation between (V) over dotE/(V) over dotCO2 slope and MPT (r = -0.51, P &lt; 0.001). After adjustment for clinical characteristics, MPT was significantly higher in the (V) over dotE/(V) over dotCO2 &lt;= 34 group vs (V) over dotE/(V) over dotCO2 &gt;34 group (21.4 +/- 6.4 vs 17.4 +/- 4.3 s, F = 7.4, P = 0.007). The appropriate MPT cut-off value for identifying a (V) over dotE/(V) over dotCO2 slope &lt;= 34 was 18.12 seconds.
An MPT value of 18.12 seconds may be a useful target value for identifying CHF patients with a (V) over dotE/(V) over dotCO2 slope &lt;= 34 and for risk management in these patients.

Background Little is known about the differences in the geriatric nutritional risk index (GNRI) status in older patients and their relationship to accelerometer-derived measures of physical activity (PA) levels. We determined both differences in daily measured PA based on the GNRI and related cut-off values for PA in elderly cardiac inpatients.
Methods We divided 235 consecutive elderly cardiac inpatients (mean age 73.6 years, men 70.6 %) into four groups by age and GNRI: older-high group, 65-74 years with high GNRI (&gt;= 92 points) (n = 111); older-low group, low GNRI (&lt; 92 points) (n = 30); very old-high group, &gt;= 75 years with high GNRI (n = 55); and very old-low group with low GNRI (n = 39). Average step count and physical activity energy expenditure (PAEE in kcal) per day for 2 days of these inpatients were assessed by accelerometer and compared between the four groups to determine cut-off values of PA.
Results Step counts and PAEE were significantly lower in the low-GNRI versus high-GNRI groups in the older (2,742.1 vs. 4,198.1 steps, 55.4 vs. 101.3 kcal, P &lt; 0.001), and very old (2,469.6 vs. 3,423.7 steps, 54.5 vs. 79.1 kcal, P &lt; 0.001) cardiac inpatients. Respective cut-off values for step counts and PAEE were 3,017.6 steps/day and 69.4 kcal (P &lt; 0.01) in the older and 2,579.4 steps/day and 58.8 kcal in the very old cardiac inpatients (P &lt; 0.01).
Conclusion Poor nutritional status, as indicated by a low GNRI, may be a useful predictor of step counts and PAEE. The cut-off values determined in this study might be target values to be attained by older cardiac inpatients.

OBJECTIVE: Leisure-time sedentary behaviors (LTSBs) have been associated adversely with health outcomes. However, limited research has focused on different categories of LTSB. We aimed at identifying categories of LTSBs and examining their separate associations with indices of health among Japanese older adults. METHODS: A postal survey collected data on self-reported health, psychological distress, body mass index, moderate-to-vigorous physical activity (MVPA), LTSBs (five behaviors) and socio-demographic characteristics from 1,580 Japanese older adults (67% response rate; 65-74 years) in 2010. Exploratory factor analysis was used to classify LTSBs. Odds ratios (ORs) were calculated for associations of LTSB categories with self-reported health, psychological distress, overweight, and lower MVPA. Data were analyzed in 2013. RESULTS: Two categories of LTSB: passive sedentary time (consisting of TV time, listening or talking while sitting, and sitting around) and mentally-active sedentary time (consisting of computer-use and reading books or newspapers) were identified. Higher passive sedentary time was associated with a higher odds of being overweight (OR: 1.39, [95% CI: 1.08-1.80]), and lower MVPA (1.26, [1.02-1.54]). Higher mentally-active sedentary time was associated with lower odds of lower MVPA (0.70, [0.57-0.86]). CONCLUSIONS: Two types of sedentary time-passive and mentally-active-may play different roles in older adults' well-being.

Objective. Leisure-time sedentary behaviors (LTSBs) have been associated adversely with health outcomes. However, limited research has focused on different categories of LTSB. We aimed at identifying categories of LTSBs and examining their separate associations with indices of health among Japanese older adults.
Methods. A postal survey collected data on self-reported health, psychological distress, body mass index, moderate-to-vigorous physical activity (MVPA), LTSBs (five behaviors) and socio-demographic characteristics from 1,580 Japanese older adults (67% response rate; 65-74 years) in 2010. Exploratory factor analysis was used to classify LTSBs. Odds ratios (ORs) were calculated for associations of LTSB categories with self-reported health, psychological distress, overweight, and lower MVPA. Data were analyzed in 2013.
Results. Two categories of LTSB: passive sedentary time (consisting of TV time, listening or talking while sitting, and sitting around) and mentally-active sedentary time (consisting of computer-use and reading books or newspapers) were identified. Higher passive sedentary time was associated with a higher odds of being overweight (OR: 1.39, [95% CI: 1.08-1.80]), and lower MVPA (1.26, [1.02-1.54]). Higher mentally-active sedentary time was associated with lower odds of lower MVPA (0.70, [0.57-0.86]).
Conclusions. Two types of sedentary time passive and mentally-active may play different roles in older adults' well-being. (C) 2014 Elsevier Inc. All rights reserved.

Background: Although considerable evidence has demonstrated that physical activity is associated with breast cancer prevention, few studies have assessed the level of awareness of this association. Awareness is a key first step to successful of behavior change. Increasing awareness may contribute to promote physical activity and prevent breast cancer at the population level. The present study examined the prevalence and correlates of awareness about the role of physical activity in breast cancer prevention among Japanese women.
Methods: 1,000 Japanese women aged 20-69 years (mean age: 44.3 +/- 13.4 years) who responded to an internet-based cross-sectional survey. Awareness of the role of physical activity in breast cancer prevention, knowledge of breast cancer (symptom, risk factor, screening), exposure to information about physical activity and cancer, a self-reported physical activity, and sociodemographic variables (age, marital status, having a child, education level, employment status, and household income) were obtained. Force-entry logistic regression analysis was used.
Results: The prevalence of awareness was 31.5% (95% CI: 28.6-34.4). Factors significantly associated with awareness included sociodemographic variables, exposure to information, and knowledge of breast cancer. Being married (AOR, 95% CI: 1.75, 1.05-2.92) was positively related to awareness, while having children (0.65, 0.36-0.86) was negatively related. College graduates or those with higher levels of education (1.50, 1.01-2.22) were significantly more likely to be aware than those who had not graduated high school. Moreover, exposure to information (2.11, 1.51-2.95), and high knowledge of symptoms (2.43, 1.75-3.36) were positively associated with awareness. Finally, low knowledge of risk factors (0.30, 0.22-0.40) was negatively associated with awareness.
Conclusions: Japanese women through internet-based study were poorly aware of the role of physical activity in breast cancer prevention. Awareness was especially low among individuals with children and higher knowledge of risk factors whereas high in married women, those with higher educational level, exposure to information, and greater knowledge of symptoms. The findings suggest that strategies to increase the awareness about the preventive role of physical activity are needed for breast cancer prevention in consideration of subgroups with low awareness.

Differences in recess physical activity (PA) according to perceived school environment among elementary school children were examined. Participants were 103 children from two schools in Japan. PA was measured using accelerometry for seven consecutive days. Time spent in sedentary or PA (light, moderate, or vigorous) during their morning recess (25 min) and lunch recess (15 min) was determined. The School Physical Activity Environment Scale (three factors: equipment, facility, and safety) was used to investigate perceived school environment. Environmental factor scores were assigned to low or high groups for each factor by median. An analysis of covariance, with grade as the covariate, was conducted separately by gender to examine differences in PA between two groups. During lunch recess, boys in the high-equipment group spent significantly more time in moderate PA (high: 1.5; low: 0.8 min) whereas girls in this group spent less time in light PA (9.3, 11.0). Boys in the high-facility group spent significantly less time in sedentary (2.3, 3.9) and more time in vigorous PA (2.4, 1.4) during lunch recess, and girls spent more time in moderate (2.1, 1.2) and vigorous PA (1.9, 1.3) during morning recess. Differences were observed in recess PA according to school environment perceptions. The present study may be useful for further intervention studies for the promotion of PA during recess.

Background: Although several studies have examined associations of perceived benefits and barriers with physical activity, no studies have focused on them corresponding to strength-training recommendations for older adults. This study examined the associations among the perceived health benefits of strength training, perceived barriers to strength straining, and stages of change for strength-training behavior in older Japanese adults. Methods: This cross-sectional survey included a random sample of 1144 adults (60-74 years) from the city of Tokorozawa. Stage of change was the independent variable, with perceived health benefits (eg, strength training can reduce body pain) and perceived barriers (eg, facilities are needed for strength training) as dependent variables. Data were analyzed by analysis of covariance and Bonferroni's multiple comparison. Results: After adjusting for demographic variables, the perceived health-benefit score for precontemplation was significantly lower than for the other four stages. The perceived barrier scores in the precontemplation and contemplation stages were significantly higher than those in the preparation and maintenance stages. Conclusions: These results suggest that information about the health benefits for older adults and about the recommended type of strength training might be useful for the development of strategies to promote strength training among older adults.

:This study aimed to determine the relation between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) and maximum phonation time (MPT), and the MPT required to attain a threshold value for VE/VCO2 slope of ≤ 34 in chronic heart failure (CHF) patients. This cross-sectional study enrolled 115 CHF patients (mean age, 54.5 years; men, 84.9%). VE/VCO2 slope was assessed during cardiopulmonary exercise testing (CPX). Thereafter, patients were divided into 2 groups according to exercise capacity: VE/VCO2 slope ≤ 34 (VE/VCO2 ≤ 34 group, n = 81) and VE/VCO2 slope > 34 (VE/VCO2 > 34 group, n = 34). For MPT measurements, all patients produced a sustained vowel/a:/ for as long as possible during respiratory effort from the seated position. All subjects showed significant negative correlation between VE/VCO2 slope and MPT (r = -0.51, P < 0.001). After adjustment for clinical characteristics, MPT was significantly higher in the VE/VCO2 ≤ 34 group vs VE/VCO2 > 34 group (21.4 ± 6.4 vs 17.4 ± 4.3 s, F = 7.4, P = 0.007). The appropriate MPT cut-off value for identifying a VE/VCO2 slope ≤ 34 was 18.12 seconds. An MPT value of 18.12 seconds may be a useful target value for identifying CHF patients with a VE/VCO2 slope ≤ 34 and for risk management in these patients.

:Differences in recess physical activity (PA) according to perceived school environment among elementary school children were examined. Participants were 103 children from two schools in Japan. PA was measured using accelerometry for seven consecutive days. Time spent in sedentary or PA (light, moderate, or vigorous) during their morning recess (25 min) and lunch recess (15 min) was determined. The School Physical Activity Environment Scale (three factors: equipment, facility, and safety) was used to investigate perceived school environment. Environmental factor scores were assigned to low or high groups for each factor by median. An analysis of covariance, with grade as the covariate, was conducted separately by gender to examine differences in PA between two groups. During lunch recess, boys in the high-equipment group spent significantly more time in moderate PA (high: 1.5; low: 0.8 min) whereas girls in this group spent less time in light PA (9.3, 11.0). Boys in the high-facility group spent significantly less time in sedentary (2.3, 3.9) and more time in vigorous PA (2.4, 1.4) during lunch recess, and girls spent more time in moderate (2.1, 1.2) and vigorous PA (1.9, 1.3) during morning recess. Differences were observed in recess PA according to school environment perceptions. The present study may be useful for further intervention studies for the promotion of PA during recess.

BACKGROUND:Although considerable evidence has demonstrated that physical activity is associated with breast cancer prevention, few studies have assessed the level of awareness of this association. Awareness is a key first step to successful of behavior change. Increasing awareness may contribute to promote physical activity and prevent breast cancer at the population level. The present study examined the prevalence and correlates of awareness about the role of physical activity in breast cancer prevention among Japanese women.;METHODS:1,000 Japanese women aged 20-69 years (mean age: 44.3 ± 13.4 years) who responded to an internet-based cross-sectional survey. Awareness of the role of physical activity in breast cancer prevention, knowledge of breast cancer (symptom, risk factor, screening), exposure to information about physical activity and cancer, a self-reported physical activity, and sociodemographic variables (age, marital status, having a child, education level, employment status, and household income) were obtained. Force-entry logistic regression analysis was used.;RESULTS:The prevalence of awareness was 31.5% (95% CI: 28.6-34.4). Factors significantly associated with awareness included sociodemographic variables, exposure to information, and knowledge of breast cancer. Being married (AOR, 95% CI: 1.75, 1.05-2.92) was positively related to awareness, while having children (0.65, 0.36-0.86) was negatively related. College graduates or those with higher levels of education (1.50, 1.01-2.22) were significantly more likely to be aware than those who had not graduated high school. Moreover, exposure to information (2.11, 1.51-2.95), and high knowledge of symptoms (2.43, 1.75-3.36) were positively associated with awareness. Finally, low knowledge of risk factors (0.30, 0.22-0.40) was negatively associated with awareness.;CONCLUSIONS:Japanese women through internet-based study were poorly aware of the role of physical activity in breast cancer prevention. Awareness was especially low among individuals with children and higher knowledge of risk factors whereas high in married women, those with higher educational level, exposure to information, and greater knowledge of symptoms. The findings suggest that strategies to increase the awareness about the preventive role of physical activity are needed for breast cancer prevention in consideration of subgroups with low awareness.

OBJECTIVES:Interviews were conducted with elderly people who had participated in the Care-Prevention Leadership Training Course (CPLTC), and had then established voluntary groups that practice care-prevention activities. This study examined the process and factors associated with the establishment of voluntary groups among subjects.;METHODS:The subjects were ten 62- to 76-year-old community-dwelling elderly in Tokyo who had taken the CPLTC. Data were obtained from 40- to 90-minute semi-structured interviews concerning the process of voluntary-group establishment. The data were then qualitatively analyzed using a modified grounded theory approach. Some of the concepts associated with the voluntary-group establishment were extracted, and organized into categories. These relationships were comparatively reviewed, and a figure for the results was constructed.;RESULTS:Subjects went through the following processes and feelings while establishing voluntary groups: "feelings that encourage participation in the local community," "opportunity for participation in the local community," "recognition of issues in the local community," "recognition of the importance of care prevention," "enhanced motivation for voluntary-group activities," and "recognition of requirements to establish a voluntary-group through its preparation." In addition, related factors were as follows; "past experience," "experience in the local community," "experience in CPLTC," "support in the local community," "support in CPLTC," "support in establishment of voluntary groups," and "feelings that promote or inhibit activities for the voluntary-group establishment." These processes were considered to be core concepts: "feelings and experiences that lead to participation in the local community," "deep understanding through experiences in the community and CPLTC," and "enhancement of motivation and skills for the activities through voluntary-group preparation.";CONCLUSION:The results showed that the community-dwelling elderly experienced gradual changes in their feelings, awareness, and related factors concerning their establishment of voluntary groups. The data showed that three points of view were important in those changes: "participation in the local community," "recognition of issues in the local community," and "enhanced motivation and skills for community activities." With transition-related factors taken into account, it is possible to effectively support elderly who are establishing voluntary groups by promoting involvement in the local community, holding courses, and providing preparatory support for group establishment.

There has been a growing interest in dog ownership and walking as a unique and potential resource to provide physical activity for many individuals in the community. The present study reviewed current trends regarding the studies on dog ownership, dog walking, and human health, and clarified the future direction of research on the topic. There is evidence to suggest that it is not dog ownership itself, but rather dog-walking that contributes to increased physical activity and the likelihood of meeting public health guidelines for physical activity. Also, a growing body of literature indicates that dogs appear to provide an important form of social support, motivation, and obligation that encourages dog owners to walk. Regarding the environmental and policy-related factors associated with dog walking, some literature showed that access to a dog-supportive park/area or living in a walkable neighborhood seems to positively affect dog owners walking with their dog. The evidence is still limited on interventions for promoting dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further evaluation of physical activity, including dog walking and use of an accelerometer, identification of factors related to dog owners' regular/irregular dog walking by means of a longitudinal study, and implementation of an intervention study related to the promotion of physical activity among dog owners with a focus on dog walking are needed.

目的：身体活動・運動実施による大腸がん予防効果への認知とそれに関連する要因を検討した．方法：インターネットによる横断調査を実施し，登録モニター1,964名（平均年齢44.7歳）を分析対象とした．調査項目は，身体活動・運動実施による大腸がん予防効果の認知，大腸がんに関する知識レベルの高低，身体活動・運動実施とがんに関する情報取得，および身体活動・運動実施状況，社会人口統計学的変数であった．解析は，認知を従属変数，その他すべての変数を独立変数として，ロジスティック回帰分析を行った．結果：分析対象者の47.5％が身体活動・運動実施による大腸がん予防効果を認知していた．60歳代（調整オッズ比，95％信頼区間：0.59，0.45-0.79），教育歴が大学・大学院の者（1.32，1.05-1.66），身体活動・運動実施とがんに関する情報取得者（2.07，1.71-2.51），および身体活動・運動実施状況が推奨群の者（1.43，1.12-1.84）に，認知と有意な関連がみられた．結論：身体活動・運動実施による大腸がん予防効果の認知は約半数であり，十分でないことが示された．今後は全体の認知向上を図ると同時に，年齢層や教育歴に配慮した方策を検討していくことが必要である．

Sedentary behavior, defined as participation in activities such as sitting and reclining during waking hours that do not increase energy expenditure substantially, has been gaining increased focus in physical activity research. In the last decade, sedentary behavior has emerged as a new risk factor for physical and mental health, independent of moderate to vigorous intensity physical activity. Especially, older adults spend most of their waking time in sedentary activities. Despite this high exposure, a broader base of evidence on sedentary behavior research in older adults has not yet been well reviewed. To inform future directions on sedentary behavior research among older adults, the present study provides the overview of the evidence from recently-published studies. This review includes evidence on the prevalence of objectively-measured and self-reported sedentary behaviors; the relationships with sedentary behavior (too much sitting) with multiple health outcomes; the effectiveness of interventions to reduce sedentary time and an overview of public health recommendations on reducing and breaking up sedentary time. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.

School-based extracurricular sports activity (SBECSA) is a beneficial activity for positive youth development. However, there are some problems regarding the management of SBECSA, such as the lack of SBECSA teachers who can coach expertly and the great burden for SBECSA teachers. Although the number of external coaches has not been sufficient, recruiting external coaches into SBECSA has been focused on to help resolve these issues. For further effective recruitment of external coaches, approaching the community residents who have motivation to be external coaches is important. Nevertheless, the sociodemographics associated with the motivation still have not been explored. Therefore, the purpose of the present study was to clarify the sociodemographics of community residents who have motivation to become involved in SBECSA as external coaches (potential external coaches) . An Internet-based cross-sectional survey was conducted by a social survey company with 19506 registrants aged 20-69 years. Stratified random sampling was continued till 100 potential external coaches were collected for both genders and every age group. Coaching motivation as an external coach and six sociodemographics (gender, age, occupational status, marital status, teaching credential, and coaching credential) were obtained. As a statistical analysis, logistic regression analysis was performed. Overall, 19239 participants were included in the analysis and 5.9% of them had coaching motivation. Potential external coaches were significantly less likely to be females (OR = 0.42) , people in their 30s (OR = 0.63) , 40s (OR = 0.40) , 50s (OR = 0.30) , 60s (OR = 0.24) than males and people in their 20s. In addition, workers (OR = 1.49) , students (OR = 1.52) , married people (OR = 1.32) , those who have teaching credentials (OR = 1.60) and coaching credentials (OR = 8.13) were more likely to be external coaches. In conclusion, the present study clarified the sociodemographics of potential external coaches. It is suggested in recruiting external coaches into SBECSA, providing promotion strategies which take these sociodemographic factors into account would be effective.

【目的】本研究は人工膝関節全置換術（TKA）患者の30秒椅子立ち上がりテスト（CS-30テスト）の経時的変化と痛みおよびその他の身体機能との関連性について検討した。【方法】対象はTKA患者33例39膝であった。検査項目はCS-30テスト，Timed Up and Go test（TUG），膝伸展筋力，開眼片脚起立時間，Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）の日本語版である準WOMACの膝関節の痛みおよび機能であり，各検査をTKAの術前，術後1ヵ月，術後3ヵ月の3回行った。【結果】CS-30テストは術前より術後3ヵ月，術後1ヵ月より術後3ヵ月で有意に改善した。術前のCS-30テストはTUG，術側および非術側の膝伸展筋力，術側および非術側の膝関節の痛みや機能と有意な相関を認めた。術後3ヵ月のCS-30テストはTUG，術側および非術側膝伸展筋力，術側および非術側開眼片脚起立時間，非術側膝関節の痛みおよび機能と有意な相関を示した。【結論】CS-30テストは術側だけでなく非術側の筋力や痛みなどの影響を受ける。TKA患者におけるCS-30テストは下肢筋力の指標になるだけでなく，痛みや身体機能も反映する有用な指標と考えられた。

目的 介護予防リーダー養成講座（以下，講座）の受講を経て，介護予防活動を実践する自主グループを設立した高齢者を対象にインタビュー調査を行った。本研究では，調査結果を質的に分析し，自主グループ設立に至るまでの対象者の過程およびそれらに関連する要因について明らかにすることを目的とした。<br/>方法 対象者は東京都 A 市在住の高齢者で，講座を受講した者10人とした。対象者の年齢は62–76歳であった。対象者に自主グループの設立に至る過程について40～90分の半構造化された個別インタビューを行い，回答を質的分析方法である修正版グラウンデッド・セオリー・アプローチを用いて分析した。自主グループの設立に関連があると考えられる概念を抽出し，概念をまとめるカテゴリを生成して，それらの関係性を比較検討しながら結果図にまとめた。<br/>結果 対象者は，自主グループ設立に至るまでに「地域コミュニティへの参加を後押しする気持ち」，「地域コミュニティ参加の契機」，「地域コミュニティにおける課題の認識」，「介護予防の重要性の認識」，「活動意欲の向上」，「自主グループ設立準備での課題の認識」といった気持ちや認識の変化の過程を経ていた。その過程には「過去の経験」，「地域コミュニティでの経験」，「講座での経験」などの経験が関連要因として気持ちや認識の変化へ影響していた。同様に，「地域コミュニティでの支援」，「講座受講での支援」，「自主グループ設立での支援」などの支援や「設立活動を促進・阻害する感情」が関連要因として自主グループ設立に至る気持ちや認識の変化に必要であった。この一連のプロセスは「地域コミュニティ参加に至らせる気持ち・経験がある」，「地域コミュニティ・講座を通して課題の認識が深まる」，「設立準備を通して活動意欲・ノウハウが向上する」の 3 つの中心的概念からなっていた。<br/>結論 本研究の結果から，高齢者が自主グループの設立に至るまでには，段階的な気持ちや認識の変化やその変化に関連する要因があることが示された。この一連のプロセスは「地域コミュニティへの参加」，「地域課題の認識」，「活動意欲・ノウハウの向上」の 3 つの段階から構成されており，各段階の移行へ関連する要因を考慮して，高齢者の地域コミュニティへの参加促進，講座開催，自主グループ設立準備支援を進めることで，効果的な高齢者の自主グループ設立支援を行うことができると考える。

目的:身体活動・運動実施による大腸がん予防効果への認知とそれに関連する要因を検討した.方法:インターネットによる横断調査を実施し,登録モニター1,964名(平均年齢44.7歳)を分析対象とした.調査項目は,身体活動・運動実施による大腸がん予防効果の認知,大腸がんに関する知識レベルの高低,身体活動・運動実施とがんに関する情報取得,および身体活動・運動実施状況,社会人口統計学的変数であった.解析は,認知を従属変数,その他すべての変数を独立変数として,ロジスティック回帰分析を行った.結果:分析対象者の47.5%が身体活動・運動実施による大腸がん予防効果を認知していた.60歳代(調整オッズ比,95%信頼区間:0.59,0.45-0.79),教育歴が大学・大学院の者(1.32,1.05-1.66),身体活動・運動実施とがんに関する情報取得者(2.07,1.71-2.51),および身体活動・運動実施状況が推奨群の者(1.43,1.12-1.84)に,認知と有意な関連がみられた.結論:身体活動・運動実施による大腸がん予防効果の認知は約半数であり,十分でないことが示された.今後は全体の認知向上を図ると同時に,年齢層や教育歴に配慮した方策を検討していくことが必要である.(著者抄録)

成人を対象にした座位時間を減らすための介入研究のシステマティックレビューを行った。座位時間を減らすことを主目的とした介入の効果検証を行った研究について文献検索を行った。18編が該当論文として採択され、前後デザインを採用していた研究は5編、準実験デザインを採用していた研究は6編、ランダム化比較試験は7編であった。前後デザイン研究では、ほとんどの研究においては、いずれかの座位行動指標に有意な改善が報告された。準実験デザイン研究において、Adamsらの研究では、客観的および自己報告による座位行動時間で異なった結果がみられたが、他の研究では介入群が対照群と比較して、座位行動指標が有意に改善した。ランダム化比較試験では、勤務形態が異なる3つの組織を対象としたクラスターランダム化比較試験を除くすべての研究において、対照群と比べて介入群は、いずれかの座位行動指標に有意な改善を認めた。

Sedentary behavior, defined as participation in activities such as sitting and reclining during waking hours that do not increase energy expenditure substantially, has been gaining increased focus in physical activity research. In the last decade, sedentary behavior has emerged as a new risk factor for physical and mental health, independent of moderate to vigorous intensity physical activity. Especially, older adults spend most of their waking time in sedentary activities. Despite this high exposure, a broader base of evidence on sedentary behavior research in older adults has not yet been well reviewed. To inform future directions on sedentary behavior research among older adults, the present study provides the overview of the evidence from recently-published studies. This review includes evidence on the prevalence of objectively-measured and self-reported sedentary behaviors; the relationships with sedentary behavior (too much sitting) with multiple health outcomes; the effectiveness of interventions to reduce sedentary time and an overview of public health recommendations on reducing and breaking up sedentary time. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.

Purpose: Poor mental health (MH) is common in chronic heart failure (CHF) patients. No studies have reported a relation between MH status and objectively measured physical activity (PA) in CHF patients. The study aim was to determine self-reported MH-related differences associated with PA and target values of PA for improved MH in CHF outpatients. Methods: We divided 243 CHF outpatients (mean age 57.1 years) into two groups according to MH assessed by Short Form-36 score: high-MH (&gt;= 68 points) group (n = 148) and poor-MH (&lt;68 points) group (n = 95). Average step count (steps) and energy expenditure on PA (EE) (kcal) per day for 1 week of PA were assessed by an accelerometer and compared between groups. PA resulting in high MH was determined by the receiver-operating characteristic (ROC) analysis. Results: PA correlated positively with MH in all patients (steps: r = 0.46, p&lt;0.001; EE: r = 0.43, p&lt;0.001). After adjusting for patient characteristics, steps and EE were significantly lower in the poor-MH versus high-MH group (5020.1 +/- 280.7 versus 7174.1 +/- 221.5 steps, p&lt;0.001; 133.9 +/- 10.8 versus 215.9 +/- 8.4 kcal, p&lt;0.001). Cut-off values of 5590.8 steps and 141.1 kcal were determined as PA target values associated with improved MH. Conclusions: Poor MH status may reduce PA. Attaining PA target values may improve MH status of CHF outpatients.

There has been a growing interest in dog ownership and walking as a unique and potential resource to provide physical activity for many individuals in the community. The present study reviewed current trends regarding the studies on dog ownership, dog walking, and human health, and clarified the future direction of research on the topic. There is evidence to suggest that it is not dog ownership itself, but rather dog-walking that contributes to increased physical activity and the likelihood of meeting public health guidelines for physical activity. Also, a growing body of literature indicates that dogs appear to provide an important form of social support, motivation, and obligation that encourages dog owners to walk. Regarding the environmental and policy-related factors associated with dog walking, some literature showed that access to a dog-supportive park/area or living in a walkable neighborhood seems to positively affect dog owners walking with their dog. The evidence is still limited on interventions for promoting dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further evaluation of physical activity, including dog walking and use of an accelerometer, identification of factors related to dog owners' regular/irregular dog walking by means of a longitudinal study, and implementation of an intervention study related to the promotion of physical activity among dog owners with a focus on dog walking are needed.

Objectives: Although physical activity reduces the risk of diseases such as cancer, diabetes and cardiovascular disease, a large proportion of the population is not sufficiently physically active. Therefore, the present study examined the environmental, social, and psychological correlates for meeting the 2 recommended physical activity criteria: &gt;= 420 min per week of at least moderate-intensity activity (MPA criterion) and &gt;= 210 min per week of vigorous activity (VPA criterion) for colon cancer prevention among Japanese adults.
Design: Cross-sectional study.
Methods: The sample included 2000 Japanese adults aged 20-79 years. An Internet-based survey was used to assess seven sociodemographic variables (e.g., education level, employment status), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising, residential area), social variables (social support), psychological variables (self-efficacy, perceived positive (pros) and negative (cons) aspects of exercise), and physical activity. The adjusted odds of meeting each physical activity criterion by these variables were calculated.
Results: Overall, 22.3% of the study population met the criterion of MPA, and 73% met the criterion of VPA. Having high self-efficacy, fewer perceived cons, possessing home fitness equipment, reporting enjoyable scenery, and living in a rural area were significantly associated with meeting the recommended criteria.
Conclusions: Participants who met the 2 activity recommendations differed by self-efficacy, cons, possession of home fitness equipment, reporting of enjoyable scenery, and residential area. These findings imply that strategies to promote more intense physical activities specifically in terms of these variables may be necessary for colon cancer prevention. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of Sports Medicine Australia. All rights reserved.

BACKGROUND: Physical activity is beneficial for adolescent health. The physical activity patterns of Japanese adolescents are relatively unknown. Therefore, this study aimed to describe the current patterns of physical activity and to identify sex and grade differences among them. METHODS: The participants comprised 714 Japanese adolescents aged 12 to 15years old (boys N=372, girls N=342) from a public junior high school in Okayama, Japan. Physical activity at school, outside of school after hours, and during lunch recess as well as the total leisure time in a usual week was assessed with a 5-item questionnaire. To assess the differences in the physical activity patterns by sex and grade, independent t tests and analysis of variance (ANOVA) were conducted, respectively. RESULTS: Boys spent significantly more time in physical activity both inside and outside of school settings than girls (p&lt
.05). Higher grade students were significantly less active than lower grade students (p&lt
.05). Furthermore, the physical activity patterns across the grades differed between settings (at school, outside of school during the after-school period, lunchtime recess, and at home). CONCLUSION: To increase physical activity levels among Japanese adolescents, implementation of after-school programs or environmental modifications developed within the school setting could be effective strategies. © 2013, American School Health Association.

BACKGROUNDPhysical activity is beneficial for adolescent health. The physical activity patterns of Japanese adolescents are relatively unknown. Therefore, this study aimed to describe the current patterns of physical activity and to identify sex and grade differences among them.
METHODSThe participants comprised 714 Japanese adolescents aged 12 to 15years old (boys N=372, girls N=342) from a public junior high school in Okayama, Japan. Physical activity at school, outside of school after hours, and during lunch recess as well as the total leisure time in a usual week was assessed with a 5-item questionnaire. To assess the differences in the physical activity patterns by sex and grade, independent t tests and analysis of variance (ANOVA) were conducted, respectively.
RESULTSBoys spent significantly more time in physical activity both inside and outside of school settings than girls (p&lt;.05). Higher grade students were significantly less active than lower grade students (p&lt;.05). Furthermore, the physical activity patterns across the grades differed between settings (at school, outside of school during the after-school period, lunchtime recess, and at home).
CONCLUSIONTo increase physical activity levels among Japanese adolescents, implementation of after-school programs or environmental modifications developed within the school setting could be effective strategies.

The purpose of this study was to determine both an association between mortality and physical activity (PA) objectively measured by accelerometer and cutoff values for PA in Japanese outpatients with heart failure (HF). This prospective observational study comprised 170 HF outpatients (mean age, 65.2 years; 77% men). Peak oxygen uptake (VO2) and the relation between ventilation and carbon dioxide production (VE/VCO2 slope) as indices of exercise capacity were measured during cardiopulmonary exercise testing with a cycle ergometer. PA was assessed by accelerometer-measured average step count (steps) per day for 1 week. Study endpoint was cardiovascular-related death. Over an average follow-up of 1,377.1 (median, 1,335) days, 31 cardiovascular-related deaths occurred. Patients were then divided into survivor (n = 139) and nonsurvivor (n = 31) groups. Brain natriuretic peptide level was significantly different between groups. Peak VO2 and steps were also significantly lower and VE/VCO2 slope higher in the nonsurvivors versus survivors. Univariate Cox proportional hazards analysis showed brain natriuretic peptide, peak VO2, VE/VCO2 slope, and steps to be significant prognostic indicators of survival. Multivariate analysis showed PA of &lt;= 4,889.4 steps/day to be a strong and independent predictor of prognosis (hazard ratio: 2.28, 95% confidence interval: 1.31-6.30; p = 0.008). Kaplan-Meier curves after log-rank test showed significant prognostic difference between PA of &lt;= 4,889.4 and &gt;4,889.4 steps/day in the 2 groups (log-rank: 12.19; p = 0.0005). In conclusion, step count as objectively measured by accelerometer may be a prognostic indicator of mortality in Japanese outpatients with HF. (C) 2013 Elsevier Inc. All rights reserved.

BACKGROUND:Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults.;METHODS:A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses.;RESULTS:Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8-1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0-1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours.;CONCLUSIONS:The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed.

OBJECTIVES:Although physical activity reduces the risk of diseases such as cancer, diabetes and cardiovascular disease, a large proportion of the population is not sufficiently physically active. Therefore, the present study examined the environmental, social, and psychological correlates for meeting the 2 recommended physical activity criteria: ≥420 min per week of at least moderate-intensity activity (MPA criterion) and ≥210 min per week of vigorous activity (VPA criterion) for colon cancer prevention among Japanese adults.;DESIGN:Cross-sectional study.;METHODS:The sample included 2000 Japanese adults aged 20-79 years. An Internet-based survey was used to assess seven sociodemographic variables (e.g., education level, employment status), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising, residential area), social variables (social support), psychological variables (self-efficacy, perceived positive (pros) and negative (cons) aspects of exercise), and physical activity. The adjusted odds of meeting each physical activity criterion by these variables were calculated.;RESULTS:Overall, 22.3% of the study population met the criterion of MPA, and 7.3% met the criterion of VPA. Having high self-efficacy, fewer perceived cons, possessing home fitness equipment, reporting enjoyable scenery, and living in a rural area were significantly associated with meeting the recommended criteria.;CONCLUSIONS:Participants who met the 2 activity recommendations differed by self-efficacy, cons, possession of home fitness equipment, reporting of enjoyable scenery, and residential area. These findings imply that strategies to promote more intense physical activities specifically in terms of these variables may be necessary for colon cancer prevention.

BACKGROUND:There are no previous data on factors at multiple levels associated with the stages of change for dog walking. The current study examined psychosocial and environmental correlates of the stages of change for dog walking among Japanese dog owners.;METHODS:Dog owners (N = 1940) completed a self-administered questionnaire that included items about demographics as well as psychosocial (dog attachment, dog obligation, normative belief, social norm, social support, self-efficacy) and environmental (access to areas, neighborhood safety, enjoyable scenery, frequently observing others dog walking, area where dogs are allowed to be off the lead) factors. MANOVA and discriminant functional analysis were used.;RESULTS:The distribution of the dog owners across the stages was as follows: precontemplation (14.7%), contemplation (7.6%), preparation (39.7%), action (2.8%), and maintenance (35.2%). Although differences among the stages were found for all factors in MANOVA, the pattern of distinction among stages differed depending on the factors. Dog obligation and self-efficacy were the best predictors of the stages of change for dog walking.;CONCLUSIONS:Although psychosocial and environmental correlates differed with the stages, psychosocial factors such as the sense of obligation and self-efficacy in dog walking seem to make relatively stronger contributions to distinctions among the stages.

背景：現代社会では，移動や職場，自宅などの様々な生活場面において長時間の座位行動が蔓延している．日常生活における座位時間の多寡が，心血管代謝性疾患のバイオマーカーや2型糖尿病，ある種のがん，早世のような健康アウトカムと関連があるという証拠が急速に蓄積されつつある．重要なのは，これらの関連が身体活動に費やす時間の影響を調整した後でも認められることである．本稿では，成人を対象にした座位行動研究に関する今後の方向性を明らかにするため，近年の研究動向を行動疫学の枠組みを応用することによって概観した．内容：このレビューには，座位行動（座り過ぎ）と健康リスク指標との関連についてのエビデンス，自己報告および機器を用いた座位行動の測度，鍵となる座位行動の分布およびトレンド，座位行動のエコロジカルモデルおよび環境的関連要因，座位時間を減らすための介入の有効性，座位時間を減らすことや中断することに関する公衆衛生勧告の概要を含めた．結論：今後行うべき座位行動研究として，座位時間が健康アウトカムに及ぼす影響を明確に理解するための機器を活用した測度による地域住民を対象にした前向き研究，様々な行動場面における長時間にわたる座位行動の多水準の決定要因を解明するための前向き研究，自宅や職場，移動環境における座位行動を減少および中断させる更なる介入研究，日常生活において座位時間を減らすことに関するメッセージを広めるためのトランスレーショナルリサーチ（マスメディアキャンペーンなど），発症機序および量反応関係を解明するための実験研究などが挙げられる．

目的：本研究は，地域在住高齢者に対する運動介入が，1年後の運動行動に与える影響についてランダム化比較試験を用いて検証した．方法：対象は，65歳以上の地域在住高齢者117人（男性52人，女性65人）で，3カ月間の運動介入群と，講話による健康教室群とし，対象者を無作為に2群に割り付けた．評価は，トランスセオレティカル・モデルの運動行動の変容ステージ（以下，ステージ），身体諸機能（筋力，柔軟性，歩行速度など），身体活動セルフ・エフィカシー，老研式活動能力指標を介入前と介入終了から1年後の2時点で実施した．対象者は，運動トレーニング群60人，健康教室群57人であった．結果：介入前のステージ分布は，両群に有意差は認められなかった．2時点でのステージ変化で，「進行」は両群共に10人，「逆戻り」では運動介入群6人，健康教室群11人で運動介入群の「逆戻り」が有意に少なかった（P<.01）．ロジスティック回帰分析の結果，ステージの「進行」には，介入前後のTimed up & go変化量（AOR=2.7，95％CI 1.0～1.3）と長座位体前屈変化量（AOR 2.7，95％CI 1.3～5.8）が，「逆戻り」には，グループ（AOR=4.6，95％CI=1.1～18.8）と介入前後の身体活動セルフ・エフィカシーの歩行項目の変化量（AOR 1.5；95％CI 1.0～2.3）および重量物挙上項目の変化量（AOR 0.68；95％CI 0.5～0.9）が抽出された．結論：本研究の結果，2時点のステージ変化で運動介入群は1年後のステージの逆戻りが有意に少ないことが示され，運動介入に参加することが運動習慣の維持に有効であることが示された．また，1年後の運動習慣を維持するためには，運動介入に参加し身体機能やセルフ・エフィカシーを向上させることが重要である．

Background : The purpose of the present study was to develop a school physical activity environment scale and to examine the relationship between school physical activity environment and school physical activity among Japanese elementary school children. Methods : Internet-based cross-sectional survey was conducted to 1,074 Japanese guardians who had elementary school children. Sociodemographic attributes,school physical activity environment scale and time of physical activity at school for a usual lunch time recess and after school were assessed. Results：Exploratory factor analyses identified 3 factors (equipment,facility, and safety). Confirmatory factor analyses to examine the factorial validity revealed acceptable fit indices and the reliability of the scale was acceptable. Those who perceived good these environments were significantly more likely to be physically active in school. Conclusion：The school physical activity environment scale was developed in the present study and demonstrated acceptable factorial validity,internal consistency and inter-rater reliability.

背景:現代社会では,移動や職場,自宅などの様々な生活場面において長時間の座位行動が蔓延している.日常生活における座位時間の多寡が,心血管代謝性疾患のバイオマーカーや2型糖尿病,ある種のがん,早世のような健康アウトカムと関連があるという証拠が急速に蓄積されつつある.重要なのは,これらの関連が身体活動に費やす時間の影響を調整した後でも認められることである.本稿では,成人を対象にした座位行動研究に関する今後の方向性を明らかにするため,近年の研究動向を行動疫学の枠組みを応用することによって概観した.内容:このレビューには,座位行動(座り過ぎ)と健康リスク指標との関連についてのエビデンス,自己報告および機器を用いた座位行動の測度,鍵となる座位行動の分布およびトレンド,座位行動のエコロジカルモデルおよび環境的関連要因,座位時間を減らすための介入の有効性,座位時間を減らすことや中断することに関する公衆衛生勧告の概要を含めた.結論:今後行うべき座位行動研究として,座位時間が健康アウトカムに及ぼす影響を明確に理解するための機器を活用した測度による地域住民を対象にした前向き研究,様々な行動場面における長時間にわたる座位行動の多水準の決定要因を解明するための前向き研究,自宅や職場,移動環境における座位行動を減少および中断させる更なる介入研究,日常生活において座位時間を減らすことに関するメッセージを広めるためのトランスレーショナルリサーチ(マスメディアキャンペーンなど),発症機序および量反応関係を解明するための実験研究などが挙げられる.(著者抄録)

Background: There are no previous data on factors at multiple levels associated with the stages of change for dog walking. The current study examined psychosocial and environmental correlates of the stages of change for dog walking among Japanese dog owners. Methods: Dog owners (N = 1940) completed a self-administered questionnaire that included items about demographics as well as psychosocial (dog attachment, dog obligation, normative belief, social norm, social support, self-efficacy) and environmental (access to areas, neighborhood safety, enjoyable scenery, frequently observing others dog walking, area where dogs are allowed to be off the lead) factors. MANOVA and discriminant functional analysis were used. Results: The distribution of the dog owners across the stages was as follows: precontemplation (14.7%), contemplation (7.6%), preparation (39.7%), action (2.8%), and maintenance (35.2%). Although differences among the stages were found for all factors in MANOVA, the pattern of distinction among stages differed depending on the factors. Dog obligation and self-efficacy were the best predictors of the stages of change for dog walking. Conclusions: Although psychosocial and environmental correlates differed with the stages, psychosocial factors such as the sense of obligation and self-efficacy in dog walking seem to make relatively stronger contributions to distinctions among the stages. © 2012 Human Kinetics, Inc.

Objective: To investigate the effect of the self-monitoring of physical activity by hospitalized cardiac patients attending phase I cardiac rehabilitation (CR).
Design: Randomized controlled trial.
Setting: University hospital CR program.
Participants: CR patients (N=126) with a mean age of 59.1 years.
Interventions: Patients were randomly assigned to the selfmonitoring group (group A, n=63) or the control group (group B, n=63). Along with CR, group A patients performed selfmonitoring of their physical activity at the beginning of a phase I CR program (acute in-hospital phase for inpatients) and ending just before they began a phase 11 CR program (postdischarge recovery phase for outpatients).
Main Outcome Measures: Physical activity (averages of daily number of steps taken and daily energy expenditure for lwk) as measured by accelerometer was assessed in both groups at baseline (t1) and before the beginning of phase II CR (t2).
Results: Although there were no significant differences in physical activity values between groups A and B at t1, values of group A at t2 were significantly higher than those of group B (8609.6 vs 5512.9 steps, P&lt;.001; 242.6 vs 155.9kcal, P&lt;.001).
Conclusions: Self-monitoring of patient physical activity from phase II CR might effectively increase the physical activity level in preparation for entering a phase IT CR program. Results of the present study could contribute to the development of new strategies for the promotion of physical activity in cardiac patients.

Background: Dog ownership is emerging as an important correlate of sufficient physical activity and therefore has the potential to positively affect a portion of the population. A growing body of literature indicates that dog-walking contributes to increased physical activity. However, most of the previous studies have been conducted in Australia or the U.S. and have sampled from the general adult population.
Purpose: This study examined the association between dog ownership, dog-walking, and physical activity in older Japanese adults.
Methods: Participants were community-dwelling residents aged 65-74 years who responded to a population-based cross-sectional survey (N = 1926). Physical activity, dog ownership, dog-walking, and sociodemographic attributes were self-reported (collected in 2010; analyzed in 2011). ANCOVAs and multivariate logistic regressions were used.
Results: Overall, 14.0% of older adults were dog owners, with 71% reporting that they walked their dog for an average of 308.5 +/- 300.7 minutes/week. Dog walkers reported more minutes/week of moderate-to-vigorous physical activity (M +/- SE: 241.7 +/- 27.0) and total physical activity (M +/- SE: 698.6 +/- 40.6) than both non-dog walkers (M +/- SE: 110.7 +/- 41.8; M +/- SE: 527.2 +/- 62.9) and non-dog owners (M +/- SE: 164.7 +/- 9.1; M +/- SE: 519.2 +/- 13.7), respectively (p&lt;0.05). Dog walkers also walked more minutes per week (M +/- SE: 508.0 +/- 33.4) than non-dog owners (M +/- SE: 384.5 +/- 11.3; p&lt;0.05). Dog walkers were more likely to be sufficiently active than both non-dog walkers and non-dog owners (p&lt;0.001).
Conclusions: Use of dog-walking may be a potentially viable means of intervention for increasing walking and overall physical activity in older Japanese adults. (Am J Prev Med 2012;43(4):429-433) (c) 2012 American Journal of Preventive Medicine

Background: Exploring the detailed pattern and correlates of dog walking is crucial to designing effective interventions to increase the proportion of dog walkers. The current study examined the prevalence and pattern of dog walking, the association between dog walking and health-related physical activity, and the correlates of dog walking among dog owners in Japan. Methods: Japanese dog owners' (n = 930) responses to an Internet-based cross-sectional survey were analyzed. A self-reported measure of physical activity, dog walking characteristics, and sociodemographic and dog-specific variables were obtained. Analyses of covariance and multivariate logistic regressions were used. Results: Overall, 64.4% of the surveyed dog owners walked their dogs. On an average, they walked their dogs 214.1 +/- 189.5 minutes per week. The dog walkers were 3.47 times more likely to meet physical activity recommendations, were significantly less likely to be unmarried (OR = 0.61), and had higher levels of attachment with their dogs (OR = 2.32) than the nondog walkers. Conclusion: The findings confirmed that dog walking significantly helps dog owners meet physical activity recommendations for health and revealed that dog-specific factors such as dog attachment might be stronger correlates of dog walking than sociodemographic factors.

これまで明らかとされていなかったクローン病(Crohn's Disease : 以下CD)患者の口腔関連QOLの実態,口腔関連QOLと口腔保健行動および,口腔内の自覚症状との関係を調査した.対象は東京都内総合病院に併設の炎症性腸疾患センター外来に通院する患者が利用する薬局へ来局したCD患者60名(20-56歳)である.口腔関連QOLはGeneral Oral Health Assessment Index (GOHAI)を用い評価し,清掃行動,摂食行動,口腔の関心度,受診行動等の口腔保健行動および,口腔内の自覚症状についての質問を行った.その結果,CD患者のGOHAIスコアは性別,年齢階級別による比較において,すべての階級で,国民標準値を下回った.また,良好な口腔保健行動を行っている対象者とそうでない対象者との間でGOHAIスコアとの有意な差は認められず,口腔内の自覚症状の有無でのみGOHAIスコアとの有意な差が認められた(p<0.001).本結果から,CD患者の口腔関連QOLは低く,改善に向けた取り組みと,自覚症状軽減のための対策の必要性が示された.また,口腔関連QOL低下の要因の検討が必要である.

Engaging in physical activity was proved to have positive effects on physical and mental health in children. Built environment is an important correlate of physical activity participation. School recess provides a daily opportunity for children to be active during school day. Therefore, the purpose of the present article was to review literatures regarding 1) physical activity during school recess, 2) the relationship between recess physical activity and school physical environment, 3) intervention for physical activity promotion during recess by changing school physical environment, and to explore trends of current researches and assignments of future research. A review was conducted and included studies published to May 31, 2011. Twenty-two studies were selected in 1) and showed boys often engaged in more physical activity than girls, but the results on differences in physical activity between ages were inconsistent. Six studies were selected in 2) and indicated recess physical activity was associated with playground environments such as equipments, marking, and surface situate. School environment intervention was observed to be a potential method for promoting physical activity in children by 8 studies in 3). Playground environment with marking, additional play equipments, and designated activity zones increased physical activity during recess. Most researches regarding recess physical activity was conducted in U.S., Australia, and Western countries, and confirmed the effectiveness of recess to promote physical activity. However, few studies on this topic were conducted in Japan. Further researches are needed to draw a conclusion about the possibility of recess to promote physical activity among Japanese children.

PURPOSE: Exercise capacity of fewer than 5 metabolic equivalents (METs) has been associated with high risk of death and poor physical functioning in male patients with heart failure (HF). Therefore, we aimed to determine upper and lower extremity muscle strength levels required to attain an exercise capacity of 5 or more METs in male outpatients with HF.
METHODS: We enrolled 148 male HF patients (age 60.1 +/- 1.0 years). Peak oxygen uptake (peak (over dot)VO2) was assessed by cardiopulmonary exer cise testing (CPX). After CPX, we further divided the patients into groups according to exercise capacity: 5 or more METs (group A, n = 85) and fewer than 5 METs (group B, n = 63). Handgrip strength and knee extensor and flexor muscle strengths were assessed as indices of upper and lower extremity muscle strength, respectively. Receiver operating characteristic curves were used to select cutoff values for upper and lower extremity muscle strength resulting in an exercise capacity of 5 or more METs in these patients.
RESULTS: Exercise capacity of 5 or more METs in male HF patients was equivalent to approximately 35.2 kgf of handgrip strength and 1.70 Nm/kg of knee extensor and 0.90 Nm/kg of knee flexor muscle strengths.
CONCLUSIONS: These upper and lower extremity muscle strength values may be useful target goals for improvement of exercise capacity, risk management, and activities of daily living in male HF patients.

Background: Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese. Method: Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps
females: 5900 steps), the participants were divided into two categories-sufficiently active and insufficiently active. An adjusted logistic regression model was utilized. Results: Totally, 47.4% of the participants (males: 51.5%
females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16
95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43
95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations. Conclusions: The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese. © 12 Bentham Science Publishers.

BACKGROUND:In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables.;OBJECTIVE:The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices.;METHODS:Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age±SD, 39.7±10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models.;RESULTS:eHealth literacy was positively associated with CRC knowledge (β=.116, <.001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI=1.01-1.05) more likely to undergo CRC screening.;CONCLUSIONS:Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.

BACKGROUND:Dog ownership is emerging as an important correlate of sufficient physical activity and therefore has the potential to positively affect a portion of the population. A growing body of literature indicates that dog-walking contributes to increased physical activity. However, most of the previous studies have been conducted in Australia or the U.S. and have sampled from the general adult population.;PURPOSE:This study examined the association between dog ownership, dog-walking, and physical activity in older Japanese adults.;METHODS:Participants were community-dwelling residents aged 65-74 years who responded to a population-based cross-sectional survey (N=1926). Physical activity, dog ownership, dog-walking, and sociodemographic attributes were self-reported (collected in 2010; analyzed in 2011). ANCOVAs and multivariate logistic regressions were used.;RESULTS:Overall, 14.0% of older adults were dog owners, with 71% reporting that they walked their dog for an average of 308.5±300.7 minutes/week. Dog walkers reported more minutes/week of moderate-to-vigorous physical activity (M±SE: 241.7±27.0) and total physical activity (M±SE: 698.6±40.6) than both non-dog walkers (M±SE: 110.7±41.8; M±SE: 527.2±62.9) and non-dog owners (M±SE: 164.7±9.1; M±SE: 519.2±13.7), respectively (p<0.05). Dog walkers also walked more minutes per week (M±SE: 508.0±33.4) than non-dog owners (M±SE: 384.5±11.3; p<0.05). Dog walkers were more likely to be sufficiently active than both non-dog walkers and non-dog owners (p<0.001).;CONCLUSIONS:Use of dog-walking may be a potentially viable means of intervention for increasing walking and overall physical activity in older Japanese adults.

BACKGROUND:Exploring the detailed pattern and correlates of dog walking is crucial to designing effective interventions to increase the proportion of dog walkers. The current study examined the prevalence and pattern of dog walking, the association between dog walking and health-related physical activity, and the correlates of dog walking among dog owners in Japan.;METHODS:Japanese dog owners' (n=930) responses to an Internet-based cross-sectional survey were analyzed. A self-reported measure of physical activity, dog walking characteristics, and sociodemographic and dog-specific variables were obtained. Analyses of covariance and multivariate logistic regressions were used.;RESULTS:Overall, 64.4% of the surveyed dog owners walked their dogs. On an average, they walked their dogs 214.1±189.5 minutes per week. The dog walkers were 3.47 times more likely to meet physical activity recommendations, were significantly less likely to be unmarried (OR=0.61), and had higher levels of attachment with their dogs (OR=2.32) than the nondog walkers.;CONCLUSION:The findings confirmed that dog walking significantly helps dog owners meet physical activity recommendations for health and revealed that dog-specific factors such as dog attachment might be stronger correlates of dog walking than sociodemographic factors.

BACKGROUND:It is still not known whether overweight men have different patterns and socio-demographic correlates of self-reported physical activity (PA) compared with normal-weight men. Thus, this study examined the perceived PA patterns and associated socio-demographic factors among normal-weight and overweight Japanese men.;METHODS:Data were analyzed for 1,420 men (aged 44.4 ± 8.3 years) who responded to an Internet-based cross-sectional survey relating to socio-demographic variables, BMI status, and a short version of the International Physical Activity Questionnaire. Mann-Whitney, chi-square, and binary logistic regression analyses were employed.;RESULTS:Normal-weight men were significantly more likely to attain 150 minutes per week of moderate-to-vigorous PA than overweight men (26.6% vs. 21.3%; p=0.035), whereas there were no significant proportional differences in total PA and walking between the two BMI subgroups. With PA, a significant interaction was observed between BMI status and household income (p=0.004 for total PA; p=0.02 for walking). In the subgroup analyses, having a lower household income (odds ratio, 0.63; 95% confidence interval, 0.41-0.96) was negatively associated with attaining 150 minutes of walking per week among normal-weight men. No significant associations between household income and attaining 150 minutes per week of total PA and walking were found among overweight men.;CONCLUSIONS:The results revealed that patterns and socio-demographic correlates of self-reported PA in overweight men are different from those in normal-weight men. This finding suggests the necessity of developing specific strategies for PA intervention among overweight men. Socio-demographic correlates of PA may be more important for normal-weight than overweight men.

BACKGROUND:Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese.;METHOD:Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps; females: 5900 steps), the participants were divided into two categories - sufficiently active and insufficiently active. An adjusted logistic regression model was utilized.;RESULTS:Totally, 47.4% of the participants (males: 51.5%; females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16; 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43; 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations.;CONCLUSIONS:The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese.

【目的】 心疾患患者や一般人を対象とした先行研究によれば, 運動耐容能が5 metabolic equivalents (METs)未満を下回る場合には生命予後不良であること, さらに, これは日常生活活動（ADL）低下の一要因となりうることが示されている.慢性心不全 (CHF) 患者を対象とした先行研究(2007)において我々は, 運動耐容能の一つとしての運動耐容能と上下肢筋力には正の相関関係があることを報告した. そこで, 本研究では,"慢性心不全患者の運動耐容能5METS未満とそれ以上では, 上下肢筋力には差がある'という仮説を立て, それを検証すべく, 以下の検討を行った. 本研究の目的は, CHF患者における運動耐容能5METsレベルの上下肢筋力について明らかにすることである.【方法】 対象者は, 当院の診療科に外来通院中で医師から心肺運動負荷試験（CPX）の依頼を受け, 上下肢筋力の測定に同意が得られた30歳以上のCHF男性患者148 例（平均年齢61.1歳）である． 除外基準は, 診療記録より各指標の調査不能例, 重篤な不整脈, 呼吸器疾患, 整形外科疾患を有する例であった. 運動耐容能は, 初回CPXで得られた最高酸素摂取量より5METs以上（A：85例）とそれ未満（B：63例）の2群に選別された. また, 上下肢筋力の指標は, 握力, 膝伸展および屈曲筋力とし, 我々は, 各指標の左右最高値の平均をそれらの指標とした. 解析には, AとB群の各指標の比較には患者背景を調整した共分散分析を用いた. また5METsレベルの各指標のカットオフ値の抽出には, 受信者動作特性（ROC）曲線を求め, 感度と特異度より判定した. 統計学的有意差判定の基準は5％未満とした.【倫理的配慮】 本研究を計画するにあたり当大学生命倫理委員会の承認を得た（承認番号340号）．実施に際しては,対象者に本研究の趣旨を説明した後, 全例書面にて同意を得た．【結果】 患者背景は, 年齢, brain natriuretic peptide (BNP)およびNew York Heart Association (NYHA) 心機能分類において両群で差を認めた. これら患者背景を調整した共分散分析を施行後において, A群はB群に比し, 握力（A: 40.90 vs. B: 33.97 kgf, P<0.01), 膝伸展筋力（A: 1.95 vs. B: 1.58 Nm/kg, P<0.01）および屈曲筋力（A: 1.09 vs. B: 0.85 Nm/kg, P<0.01）は全てにおいて高値を示した. また, 5METsレベルのカットオフ値は, 握力は35.2kgf（感度 0.78, 特異度 0.32,曲線下面積 0.81), 膝伸展筋力は1.70 Nm/kg (感度 0.77, 特異度 0.31, 曲線下面積 0.81), そして屈曲筋力は0.90Nm/kg (感度 0.78, 特異度 0.39, 曲線下面積 0.79)であった.【考察】 患者背景は, A群の年齢, BNPはB群に比し低い値を, またNYHA心機能分類は, B群においてより重度であった. また, 上下肢筋力は, A群はB群に比し高値を示した. 以上のことから, 運動耐容能の高低は, 年齢, 重症度に加え, 上下肢筋力の高低にも少なからず影響するという先行研究を支持する結果となった. 一方,心不全患者の生命予後に関する先行研究では, 握力32.2 kgf, 膝屈曲筋力0.68 Nm/kg未満において予後不良であることが示されている. 本研究で得られた, 運動耐容能5METsレベルのカットオフ値はそれらの値を上回る結果となった. また, 膝伸展筋力に関しては, 一般人男性における日常生活活動制限に関する膝伸展筋力からみたリスク層別の1.71 Nm/kgに近似していた. 以上より, 上下肢筋力はCHF男性患者の運動耐容能,リスクおよびADLを予測するための一助となる可能性がある. しかし本研究は, 横断的研究であるため, これらの指標が, 運動容能, 生命予後やADLの向上に直接寄与するのかについては言及できない. したがって今後更なる検討を要するものと思われる.【理学療法学研究としての意義】 本研究は, 上下肢筋力からみたCHF男性患者のリスク層別, 運動耐容能およびADL向上のための一つの目標値となる可能性がある. 以上より, 本研究の成果は, 理学療法学研究における運動指導方策への一助となるものと考えられる.

【はじめに、目的】 健康関連QOL(HRQOL)を向上させる因子の一つとして，身体活動セルフ・エフィカシー(SE)が注目されている。SEとはBanduraによると「ある結果を生み出すために必要な行動をどの程度うまく行うことができるかという個人の確信」と定義されている。特に運動や身体活動に関するSEは，身体活動や行動変容や運動の継続，更にはHRQOLに関係するとされている。しかしながら人工膝関節全置換術(TKA)患者に対して，身体活動SEが身体機能およびHRQOLに及ぼす影響について明らかにされていない。本研究の目的はTKA後のリハ介入における身体機能，HRQOLおよび身体活動SEの回復過程とその関連性について明らかにすることである。【方法】 対象は2010年10月から2011年7月までに当院でTKAを施行した変形性膝関節症患者44例48膝とした。手術時年齢は73.2±7.7歳，BMI26.1±3.5 kg/m2，術後在院日数25.2±5.3日，術後リハは当院プロトコールに準じて術後3ヶ月間外来リハを実施した。身体機能評価としてTimed Up and Go test(TUG)，開眼片脚起立時間，膝伸展筋力を測定した。HRQOLの評価指標としてSF-36の下位8尺度である身体機能(PF)，日常役割機能－身体(RP)，体の痛み(BP)，全体的健康感(GH)，活力(VT)，社会生活機能(SF)，日常役割機能－精神(RE)，心の健康(MH)と身体的サマリースコア(PCS)と精神的サマリースコア(MCS)を用いた。身体活動SEは虚弱高齢者の身体活動SE尺度（歩行，階段，重量物）とその総合得点を用いた。評価は術前，術後1ヶ月(退院時)と3ヶ月(外来通院時)とした。統計解析は回復過程を一元配置分散分析とBonferroni多重比較，身体機能およびHRQOLと身体活動SEとの関連性に関しては各変化量をpearsonの相関係数を用い，有意水準は5%未満とした。【倫理的配慮、説明と同意】 本研究は当院生命倫理委員会の承認(0826)を受け，対象者に研究内容の説明文書を用いて口頭による説明を行い，研究参加への同意を得て実施した。【結果】 各項目は術前(T1)→術後1ヶ月(T2)→術後3ヶ月(T3)の順に平均値±標準偏差で示した。TUGは11.8±3.8→11.7±3.8→10.5±3.3秒となりT1とT3，T2とT3で有意に改善した。開眼片脚起立時間は13.3±19.3→20.8±26.1→23.2±31.8秒となりT1とT3で有意に向上した。膝伸展筋力は0.5±0.2→0.5±0.1→0.6±0.1N・m／kgとなりT2とT3で有意に向上を認めた。SF-36の下位尺度のうち，PFは37.7±20.8→40.6±25.6→52.5±20.3点，BPは35.1±15.3→36.2±19.2→49.8±21.2点，SFは53.9±27.1→56.8±25.3→69.8±23.5点となりT1とT3，T2とT3で有意に改善を認めた。GHは48.8±13.6→53.5±14.5→54.1±16.5点となりT1とT3で有意に改善を示した。PCSは16.5±12.5→15.3±14.6→23.1±16.1点となりT1とT3，T2とT3で有意に改善した。身体活動SEのうち，歩行SEは12.4±5.0→14.9±6.4→15.9±5.3点，階段SEは8.9±5.2→10.4±5.2→12.5±5.1点，重量物SEは14.1±5.9→15.7±5.3→17.3±6.1点となりT1とT3で有意に向上した。身体活動SEの総合得点では35.4±12.5→41.1±13.1→45.6±12.8点となりT1とT2，T1とT3で有意に向上を認めた。身体活動SEの総合得点とHRQOLとの関連性はPF，RP，BP，RP，GH，REおよびPCSと有意な正の相関を示した(r＝0.307～0.508，p＜0.05)。身体活動SEの総合得点と身体機能の各項目とは有意な相関が見られなかった。【考察】 身体機能，HRQOLおよび身体活動SEは時間経過とともに有意に改善を示した。退院時では十分な改善が得られず，退院後もリハの継続が必要になると考える。身体機能と身体活動SEはHRQOLと関連性があり，身体機能とは関連性がないことが示唆された。HRQOLを向上させるためには，身体機能に加え，身体活動SEを高めるような方策を積極的にリハに組み入れていく必要があると考える。【理学療法学研究としての意義】 TKA後のリハは身体活動SEを高めるアプローチを加えることで，TKA患者のHRQOLを向上させることが可能になると考える。

目的：インターネット上の健康情報を適切に活用する能力であるeヘルスリテラシーを対象とした研究を概観することで，先行研究で用いられているeヘルスリテラシーの概念を明らかにし，eヘルスリテラシーを対象とした研究課題を特定すること．方法：キーワードを英語"eHealth literacy"と"e-Health literacy"，"e-literacy"，"eHEALS"，"Health Literacy"<clig:0><cotfcalt:0><clig:><cotfcalt:>& "Internet"とし，日本語「eヘルスリテラシー」，「eHEALS」，「ヘルスリテラシー ANDインターネット」とした．MedlineとCINAHL，ERIC，医中誌で文献を検索し，161件を得た．結果：採択基準を満たした18件のうち12件でLilyモデルに基づくeヘルスリテラシーの概念が引用されていた．12件のうちeヘルスリテラシーを主な研究対象としていた論文は9件あり，概念の提唱に関した論文が1件，評価尺度に関した論文が3件，実践的研究に関した論文が5件だった．結論：多くの先行研究はeヘルスリテラシーをLily モデルに基づく概念で用いていた．今後の研究課題はLilyモデルにインターネット上で相互に情報交流ができる概念であるWeb 2.0を扱う能力も考慮したeヘルスリテラシーの概念となるように改良し，適切な尺度を用いて多様な属性における研究の蓄積が求められる．

目的：子どもを取り巻く物理的環境要因は，子どもの身体活動に長期的に影響を与える．本研究の目的は，日本の小学生における近隣身体活動環境尺度を開発し，学外余暇身体活動および通学中の歩行との関連を検討することである．方法：小学生の子どもを持つ1,074人の20歳から59歳の保護者を対象に，ウェブ調査による横断調査を実施した．社会人口統計学的要因（保護者の性，年齢，子どもの性，年齢，身長，体重）と全16項目から成る近隣身体活動環境尺度，学外余暇身体活動および通学時における身体活動実施時間を調査した．結果：探索的因子分析を行った結果，安全性因子5項目，魅力的な景観因子4項目，治安因子2項目，不快な景観因子2項目の計4因子13項目が抽出された．構成概念妥当性を検討するため，確認的因子分析を行った結果，適合度指標は満足な値を示した（GFI＝0.969, AGFI＝0.949, RMSEA＝0.052, AIC＝288.360）．また，各因子の内部一貫性は良好な値（r＝0.67～0.79）が，安定性の次元の信頼性は中等度の値（r＝0.55～0.68）が得られた．さらに，近隣身体活動環境の安全性が高い，魅力的な景観である，あるいは不快な景観ではないと認知している者は，学外余暇身体活動および通学中の歩行時間が有意に長かった．結論：本研究で開発した近隣身体活動環境尺度は，信頼性および妥当性が認められた．本尺度は，身体活動に関連する近隣環境認知を評価するために信頼でき，日本の小学生に適用可能である．

Most researches on sports spectators have concentrated on how to increase spectating frequencies and they have conducted surveys only on sports spectators. The potential spectator market was reported to be 39.3%, which is equivalent to the actual Japan' s spectators' market. Therefore, it is necessary to conduct research on potential spectators. In the Behavioral Science domain one of the most effective models is the Transtheoretical Model of behavior change (TTM) , which can be applied to various behaviors. The present study examined the application of the TTM to sports spectating behavior, especially in the case of several ball games held in a top sports league. In particular, questionnaires were administered to adults aged 20-69 to assess the reliability and validity of the stages of change for the sports spectating behavior scale. In study I, (reliability test) , data collected from 166 adults through the internet showed a good reliability among the 2-week test-retest [Kappa Index (κ) =.67] . Then, in study II, (validity test) , the relationship between the stages of behavioral changes of sports spectating and the degree of self-reported sports spectating behavior (the annual length of spectating time, intention of spectating) was investigated among adults in A city. The results revealed that sports spectating behavior significantly differentiated among the stages of change. Specifically, participants in the post-adoption stages (preparation, action, and maintenance) reported a significantly greater amount of annual sports spectating time compared to those in pre-adoption stages (pre-contemplation and contemplation) . Moreover, participants in pre-contemplation stages reported a significantly lower score in intention of spectating compared to those in other stages. The TTM, originally developed for various behaviors such as healthy and unhealthy ones, can be generalized for use in evaluating sports spectating behavior.

目的：インターネット上の健康情報を適切に活用する能力であるeヘルスリテラシーを対象とした研究を概観することで，先行研究で用いられているeヘルスリテラシーの概念を明らかにし，eヘルスリテラシーを対象とした研究課題を特定すること．<br>方法：キーワードを英語"eHealth literacy"と"e-Health literacy"，"e-literacy"，"eHEALS"，"Health Literacy"<clig:0><cotfcalt:0><clig:><cotfcalt:>& "Internet"とし，日本語「eヘルスリテラシー」，「eHEALS」，「ヘルスリテラシー ANDインターネット」とした．MedlineとCINAHL，ERIC，医中誌で文献を検索し，161件を得た．<br>結果：採択基準を満たした18件のうち12件でLilyモデルに基づくeヘルスリテラシーの概念が引用されていた．12件のうちeヘルスリテラシーを主な研究対象としていた論文は9件あり，概念の提唱に関した論文が1件，評価尺度に関した論文が3件，実践的研究に関した論文が5件だった．<br>結論：多くの先行研究はeヘルスリテラシーをLily モデルに基づく概念で用いていた．今後の研究課題はLilyモデルにインターネット上で相互に情報交流ができる概念であるWeb 2.0を扱う能力も考慮したeヘルスリテラシーの概念となるように改良し，適切な尺度を用いて多様な属性における研究の蓄積が求められる．

Background: Previous studies have shown associations of sedentary behavior with cardiovascular risk, independent of moderate-to-vigorous physical activity (MVPA). However, few studies have focused on older adults. This study examined the joint associations of television (TV) viewing time and MVPA with overweight/obesity among Japanese older adults.
Methods: A population-based, cross-sectional mail survey was used to collect self-reported height, weight, time spent in TV viewing, and MVPA from 1806 older adults (age: 65-74 years, men: 51.1%). Participants were classified into 4 categories according to TV viewing time (dichotomized into high and low around the median) and MVPA level (dichotomized into sufficient and insufficient by the physical activity guideline level of &gt;= 150 minutes/week). Odds ratios (ORs) for overweight/obesity (body mass index &gt;= 25 kg/m(2)) were calculated according to the 4 TV/MVPA categories, adjusting for potential confounders.
Results: Of all participants, 20.1% were overweight/obese. The median TV viewing time (25th, 75th percentile) was 840 (420, 1400) minutes/week. As compared with the reference category (high TV/insufficient MVPA), the adjusted ORs (95% CI) of overweight/obesity were 0.93 (0.65, 1.34) for high TV/sufficient MVPA, 0.58 (0.37, 0.90) for low TV/insufficient MVPA, and 0.67 (0.47, 0.97) for low TV/sufficient MVPA.
Conclusions: In this sample of older adults, spending less time watching TV, a predominant sedentary behavior, was associated with lower risk of being overweight or obese, independent of meeting physical activity guidelines. Further studies using prospective and/or intervention designs are warranted to confirm the presently observed effects of sedentary behavior, independent of physical activity, on the health of older adults.

Background: Depression, a common mental illness, has a high global incidence. Regular physical activity at recommended levels is inversely associated with depression
however, this association has not yet been studied in the Japanese population. The present study examines the association between recommended physical activity criteria and depression, and depression score differences between physical activity groups and sociodemographic variables among Japanese adults. Methods: Sociodemographic data (gender, age, educational level, employment status, marital status, living conditions, and household income), the Japanese short version of the International Physical Activity Questionnaire (IPAQ), and the Center for Epidemiologic Studies Depression Scale were used to estimate the participants' physical activity and depression levels, respectively, via an Internet-based survey. A representative sample of 3000 Japanese adults answered the survey, stratified by gender and age. The present study followed current Japanese exercise guidelines to categorize respondents as "meeting" or "not meeting" the recommended criteria. Analysis of covariance, logistic regression, and two-way univariate analysis of covariance were performed. Results: Respondents not meeting the recommendations for physical activity had significantly higher depression scores than those meeting the recommendations. Individuals not meeting the recommended criteria had significantly higher depression scores than those meeting the criteria across the following variables: age, marital status, living conditions, and household income in men
and age, marital status, education level, employment status, and household income in women. Men who were unmarried and had low household income levels and women who were young, unmarried, and had lower household income levels had higher depression scores. Conclusion: The present study is one of the first studies to report on the cross-sectional associations among depression scores, physical activity levels, and various sociodemographic factors in the Japanese population. © 2011 Elsevier Ltd. All rights reserved.

Background: Although both insufficient physical activity (PA) and high screen time (ST) are independent risk factors for obesity, how the combination of sufficient/insufficient PA and high/low ST could increase obesity risk among the adult population of Japan is not known. This study examined joint associations of PA and ST with overweight among Japanese adults.
Methods: An Internet-based survey collected data on height, weight, self-reported time spent in PA and ST, and sociodemographic variables from 2832 adults. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST categories as per public PA guidelines and the median of ST. Logistic regression analysis examined the odds ratios (OR) of being overweight (body mass index, &gt;= 25 kg/m(2)) according to the categories of PA and ST.
Results: In comparison with the sufficient PA/low ST category, participants in the insufficient PA/high ST category were significantly more likely overweight (OR, 1.48; 95% confidence interval [95%CI), 1.14, 1.93) after adjusting for sociodemographic variables. A significantly higher OR for overweight (including obesity) among insufficient PA/high ST category was also observed in men, but no significant association was found in women.
Conclusions: Both insufficient PA and prolonged ST contribute to overweight and obesity among Japanese adults. Public health initiatives addressing obesity in Japan need to consider both promoting PA and reducing ST, especially in men.

〔目的〕重度糖尿病教育入院患者における入院前のウォーキング行動に関連した心理的要因および環境的要因を調査した．〔方法〕患者22人（年齢55.3歳）を対象とし，入院時に質問紙調査を実施した．項目は，ウォーキング行動のセルフ・エフィカシー（以下，歩行SE），糖尿病関連領域質問表（PAID），うつ・不安尺度（HADS），ウォーキング行動評価尺度，国際標準化身体活動質問紙環境尺度（IPAQ-E）とした．〔結果〕歩行時間は歩行SEと正の相関を認め，うつ得点と負の相関を認めた．また，歩行時間の下位尺度である「運動のために歩く時間」は環境尺度の「公園，体育館，施設などがある」項目と正の相関を認めた．〔結語〕歩行時間を増加するには歩行SEを高め，うつ状態を軽減させるアプローチが有用である可能性が考えられた．

To determine self-reported sleep quality-related differences in physical activity (PA) and health-related quality of life (HRQOL) and target values of PA for high-quality sleep in chronic heart failure (CHF) outpatients, 149 CHF outpatients (mean age 58 years) were divided into two groups by sleep-quality level determined via self-reported questionnaire: shallow sleep (SS) group (n = 77) and deep sleep (DS) group (n = 72). Steps were assessed by electronic pedometer, HRQOL was assessed with the Short Form 36 (SF-36) survey, and data were compared between groups. PA resulting in high-quality sleep was determined by receiver-operating characteristics curves. All SF-36 subscale scores except that of bodily pain were significantly decreased in the SS versus DS group. A cutoff value of 5723.6 steps/day and 156.4 Kcal/day for 1 week were determined as target values for PA. Sleep quality may affect PA and HRQOL, and attaining target values of PA may improve sleep quality and HRQOL of CHF outpatients. Patents relevant to heart failure are also discussed in this article. © 2011 Bentham Science Publishers.

Background: Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults. Methods: The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated. Results: Overall, 23.8% of the study population met the criterion of &gt;= 420 minutes of moderate-intensity activity, and 6.4% met the criterion of &gt;= 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations. Conclusions: Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.

目的:本研究の目的は,健康づくり事業における会員制ウォーキングシステム事業化のためのパートナーシップ形成プロセスを明らかにすることである.方法:M市健康推進課のICウオーク事業(以下,本事業)担当保健師2名を対象とする半構造化インタビューおよび本事業に関する記事を対象とした文書調査を行い,テキストデータの比較分析により,コードを抽出し,サブカテゴリー,カテゴリーに分類した.得られたサブカテゴリーおよびカテゴリーを,その関連や時間的な経過を考慮して構造化し,パートナーシップ形成プロセスを分析した.結果:テキストデータの分析から18のコードが得られ,9のサブカテゴリー(「首長」「議会」「協議会」「自主グループ」「他課予算」「助成金」「民間」「庁舎内連携」「庁舎外連携」)と4のカテゴリー(『政治的意思決定』『事業』『組織化』『予算化』)が抽出された.カテゴリーの関係性は,構造化モデルとして示された.結論:本研究では,自治体の健康づくり事業化のパートナーシップ形成プロセスが構造化された.構造化モデルは,パートナーシップ形成に対する行政担当者自身の意識と行動の結果であることが示唆された.

The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 +/- 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50-3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32-4.85), and observing active people (OR = 2.20, 95% CI = 1.06-4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.

To examine differences in objective and subjective outcomes in outpatients undergoing percutaneous coronary intervention (PCI) performed for acute myocardial infarction versus cardiac surgery (CS) following a phase II cardiac rehabilitation (CR). Longitudinal observational study of 437 consecutive cardiac outpatients after 8 weeks of phase II CR. Patients were divided into the PCI group (n = 281) and CS group (n = 156). Handgrip and knee extensor muscle strength, peak oxygen uptake (VO2), upper- and lower-body self-efficacy for physical activity (SEPA), and physical component summary (PCS) and mental component summary (MCS) scores as assessed by Short Form-36 were measured at 1 and 3 months after PCI or CS. All outcomes increased significantly between months 1 and 3 in both groups. However, increases were greater in the CS versus PCI group in handgrip strength (+12.3 % vs. +8.1%, P &lt
0.01), knee extensor muscle strength (+19.3% vs. +17.5%, P = 0.008), peak VO2 (+20.9% vs. +16.9%, P &lt
0.01), upper-body SEPA (+27.7% vs. +9.2%, P = 0.001), and PCS score (+6.5% vs. +4.1%, P = 0.001). Although this relatively short-term phase II CR increased all outcomes for both groups, outcomes showed the recovery process was different between the PCI and CS groups, slightly favoring CS patients. Furthermore, patents in the field of CR are presented. © 2011 Bentham Science Publishers.

Although it is crucial to examine the environmental correlates of physical activity (PA) for developing more effective interventions for overweight populations, limited studies have investigated differences in the environmental correlates on body mass index (BMI). The purpose of the present study was to examine the perceived environmental correlates of PA among normal-weight and overweight Japanese men. Data were analyzed for 1,420 men (aged 44.4 +/- 8.3 years), who responded to an internet-based cross-sectional survey of answering the short version of the International Physical Activity Questionnaire and its Environment Module. Binary logistic regression analyses were utilized to examine the environmental factors associated with meeting the PA recommendation (150 minutes/week) between the normal-weight and overweight men. After adjusting for socio-demographic variables, common and different environmental correlates of PA were observed among normal-weight and overweight men. Furthermore, significant interactions regarding PA were observed between BMI status and two environmental correlates: access to public transportation (P = 0.03) and crime safety during the day (P = 0.01). The results indicated that BMI status is a potential moderator between perceived environmental factors and PA and suggested that different environmental intervention approaches should be developed for overweight populations.

Background Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity.Purpose The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults.Methods An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender.Results The respondents' mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females.Conclusion The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan.

OBJECTIVES:With the rapid developing an internet society, ehealth literacy, defined as the ability to seek, find, understand, and appraise and apply the knowledge gained to addressing or solving a health problem, becomes important to promote and aid health care at the individual level. However, the eHealth Literacy Scale (eHEALS) was only a scale developed to assess the ehealth literacy. Thus, the present study was conducted to evaluated the validity and reliability of a Japanese version of the eHEALS (J-eHEALS), and examine the association of ehealth literacy with demographic attributes and characteristics on health information searching among Japanese adults.;METHODS:Data were analyzed for 3,000 Japanese adults (males: 50.0%,mean age: 39.6 + 10.9 years) who responded to an Internet-based cross-sectional survey. The J-eHEALS, 6 demographic attributes, resources for obtaining health information (health resources), and contents of health information obtained from internet (ehealth contents) were obtained with a questionnaire. Confirmatory factor analysis and correlation with the communicative and critical health literacy scale were utilized to assess construct validity and criterion validity. Cronbach alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Also, differences in J-eHEALS scores with each demographic attribute were examined with ANOVA and the independent t-test. Finally, chi-square tests were used to determine differences in the proportions of ehealth literacy groups (high or low) classified with a median split within health resources and ehealth contents.;RESULTS:Principal components analysis produced a single factor solution and confirmatory factor analysis for the 8-items model demonstrated high indices (GFI = .988, CFI = .993, RMSEA= .056). A significant positive correlation was found between the J-eHEALS and communicative and critical health literacy scores. Cronbach alpha was 0.93 (P < .01), and test-retest reliability was r = 0.63 (P < .01). The J-eHEALS scores were significantly higher in women, the 40-and 50-year age group, those with high income, and individuals with a high frequency of internet searching. Furthermore, the high ehealth literacy group used many health resources and obtained a greater variety of ehealth contents as compared with the low literacy group. The most frequent resource was the internet in the high group, and television/radio in the low group. However, these results could be subject to bias because of the non-representative nature of the Internet population.;CONCLUSION:The results indicate the J-eHEALS to be a highly validated and reliable scale. The present study suggests that enhancement of ehealth literacy will be important to utilize the increasing amount of health information on the internet effectively and appropriately.

BACKGROUND:Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults.;METHODS:The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated.;RESULTS:Overall, 23.8% of the study population met the criterion of ≥ 420 minutes of moderate-intensity activity, and 6.4% met the criterion of ≥ 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations.;CONCLUSIONS:Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.

:The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 ± 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50-3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32-4.85), and observing active people (OR = 2.20, 95% CI = 1.06-4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.

OBJECTIVES:According to the interim report "National Health Promotion in the 21st Century (Healthy Japan 21)", the Exercise and Physical Activity Guide for Health Promotion 2006 (EPAGH2006) is an im-portant resource in the field of physical activity in Japan. A previous study (Higo & Nakamura, 2008) showed that although the awareness level of EPAGH2006 was lower than for other health pro-motion policies (e.g., Healthy Japan 21), the proportion of people who walked regularly was higher in the EPAGH2006 awareness group than in the no-awareness group. This result indicates that pro-motion of EPAGH2006 would contribute to increase in the number of physically active people. The purpose of the present study was to identify longitudinal change in awareness of EPAGH2006, and to examine the relationship with levels of physical activity.;METHODS:The subjects were 1,100 Japanese adults (mean [SD], 39.8 [10.1 years) recruited from among the registrants of a Japanese social research company. This longitudinal study was conducted using online questionnaires in surveys in November 2007 (T1) and December 2008 (T2). The awareness level of EPAGH2006 was assessed with 3 choices, i.e., good understanding, awareness and no-awareness. The International Physical Activity Questionnaire short Version (Craig et al., 2003; Murase et al., 2002) was used to estimate the amount of physical activity that the subjects engaged in. The Mann-Whitney test was utilized to assess inter-group differences in changes in the amount of physical activity between the understanding and no-awareness groups.;RESULTS:The proportion of those who fully understood EPAGH2006 was 1.4% at T1 and 2.2%0 at T2 and did not significantly increase. The physical activity level in the understanding group at T2 was significantly decreased compared with the no-awareness groups at both T1 and T2 (p=0.013).;CONCLUSION:The lack of increase in the awareness level between the two time points suggests that dissemination of EPAGH2006 has not been effective. A more strategic approach would appear to be required. However, the results also did not indicate that the awareness level of EPAGH2006 had a positive in-fluence on physical activity. Further studies, conducted when the awareness levels improve, may elucidate the relationship between the levels of EPAGH2006 awareness and physical activity.

【目 的】<BR> 身体活動(PA)は, 生命予後あるいは健康関連QOL(HRQL)に関与する. 先行研究(2005)にて我々は, 回復期心臓リハビリテーション(リハ)におけるself-monitoring(自己監視)が維持期におけるPAの促進に貢献することを報告した. 一方, 入院期の患者教育の強化は, 退院後の再発予防に寄与することが知られている. そこで本研究では, "入院期の心疾患患者に対するPA促進のためのself-monitoringは, 退院後のPAを促進させる'という仮説を立て, それを検証すべく以下の検討を行った. <BR>本研究の目的は, 心疾患患者に対する入院期のself-monitoringが退院後のPAに及ぼす影響について検討することである. <BR>【方 法】<BR>1. 対象<BR>対象は, 2008年から2010年の間に当院リハ部に心大血管疾患にて依頼のあった入院患者連続1061例中, 病棟から運動療法室でのプログラムに移行後, 入院期(T1)においてPAの測定に同意が得られた心疾患患者351例である. 除外基準は, 1）年齢30歳未満, 2）診療記録より各指標の調査不能例, 3）重篤不整脈, 大血管疾患, 高次能機能障害および整形外科疾患を有する例である. この351例をself-monitoring(A)群と対照(B)群の2群に割り付けした. また351例中, A群64例およびB群62例の計126例に対し, 退院後(T2)在宅でのPAの測定を試みた.なお T2でのPAの測定は, 外来診察時から8日間施行した. <BR>2. 患者背景に関する情報<BR>年齢, 性, 基礎疾患, Body mass index(BMI), 左室駆出率(LVEF), 投薬内容など患者背景に関する情報は, 診療記録より調査した. また病前運動習慣の有無に関しては, 先行研究(2004)の基準に基づき調査した. なお退院日からPA測定までの期間(日数)は, 後述するLifecorder返却後に検者にて算出(PA測定日－退院日)された. <BR>3. PA<BR>PAの指標は歩数とした. 測定にはLifecorderを用い, その装着部位は腰部とした. 患者はT1およびT2において, それを入浴, 就寝中を除く24時間, 8日間装着した. 測定終了後, 検者は, 初日を除く7日間の歩数の平均値(日歩数)を算出した. <BR>4．self-monitoring<BR>検者は, T1でのPA測定後, PAのフィードバックと退院後のPAの目標設定をA群に対し行った. 患者は, それに基づき, 在宅でのPAを促すべくself-monitoringを施行するよう求められた. <BR>5. 解析<BR>両群における患者背景およびPAの差の検定には, T検定およびχ²<BR>検定を用いた.介入の有無によるT1とT2 におけるPAの変化は, 群と時期による二元配置分散分析を用いた. 統計学的有意差判定の基準は5%とした. <BR>【説明と同意】<BR> 本研究を計画するにあたり当大学生命倫理委員会の承認を得た(承認番号1480号). 実施に際しては, 対象者に本研究の趣旨を説明した後, 同意を得た. <BR>【結 果】<BR>1. 最終対象者<BR>126例中23例は, PAの測定あるいは解析が不能であり対象から除外した. 従って最終対象者は, A群52例, B群51例の計103例(急性心筋梗塞47例, 開心術後24例, 心不全32例, 年齢59.1歳, 男性82.5%)であった. <BR>2. 患者背景は,年齢, 性, 基礎疾患, BMI, LVEFおよび投薬内容において2群間に差はなかった。また, 病前運動習慣の有無についても2群間で差はなかった. 退院日からPA測定までの期間(日数)は, A群28.0日, B群26.1日(p＝0.66)であり差はなかった. <BR>3. PA<BR>T1での日歩数は, A群は4588.0歩, B群は5155.2歩(p＝0.21)で2群間に差はなかった. T2での日歩数は, A群は8609.6歩, B群は5512.9歩(p＜0.0001)にてA群はB群に比し高値を示した. またAB群間で, PAの変化に差があるのかを検討すべく, 分散分析を施行した.その結果, A群のPAにおいて時期の主効果(p<0.0001)および群×時期の交互作用(p<0.0001)を認めた.<BR>【考 察】<BR>本研究は, 入院期の心疾患患者に対しPAを促進するためのself-monitoringが, 退院後のそれに対する影響について検討した. 患者背景は, 2群間に差を認めなかった. また病前運動習慣の有無とPAの測定時期について調査した結果, 双方ともに両群間で差はなかった. 以上より, T1およびT2に対するPAの差異にこれらが影響する可能性は少ないものと考えられる.<BR>T1でのPAの平均値は, 4588.0から5155.2歩であり2 群間に差はなかった.しかし分散分析の結果, A群はB群に比しT2におけるPAは高値を示した. 以上より入院期の心疾患患者に対するPAを促進するためのself-monitoringの導入は, 退院後のPAの向上に少なからず貢献する可能性があるものと考えられる. <BR>本研究結果は, それが再発やHRQLおよび生命予後に直接寄与するか？については言及できない. したがって今後更なる検討を要するものと思われる. <BR>【理学療法学研究としての意義】<BR>本研究結果は心疾患患者に対する退院時の患者教育の一つとして, 運動指導方策の一助となる可能性がある. <BR>

【目的】<BR> 変形性膝関節症(膝OA)患者は加齢や膝痛のため、立ちすわりや歩行などの機能的バランス能力が低下する。高齢者の機能的バランス能力を評価するために臨床で最も簡便な評価方法として、Timed Up and Go test(TUG)が用いられている。TUGの遅延は歩行、階段昇降、屋外活動などの日常生活動作能力の低下を示す。しかしながら人工膝関節全置換術(TKA)患者のTUGの遅延が健康関連QOL(HRQOL)の回復過程に及ぼす影響については報告されていない。本研究の目的はTKA後におけるHRQOLの回復過程について術前の機能的バランス能力の影響について検討することである。<BR>【方法】<BR> 2008年8月から2010年6月までに当院でTKAを施行した膝OA患者40例を対象にした。運動器不安定症の診断基準である11秒をカットオフ値としてTUG11秒未満(TUG良好群)と11秒以上(TUG遅延群)に分けた。内訳はTUG良好群19例(70.8±6.8歳)、TUG遅延群21例(76.8±7.3歳)であった。HRQOLの評価指標として、準WOMACの痛みと機能、SF-36の下位8尺度である身体機能(PF)、日常役割機能－身体(RP)、体の痛み(BP)、全体的健康感(GH)、活力(VT)、社会生活機能(SF)、日常役割機能－精神(RE)、心の健康(MH)を用いた。評価時期は術前、術後1ヶ月(退院時)と3ヶ月(外来通院時)とした。<BR>統計解析は、各群の経時的変化は一元配置分散分析とBonferroni多重比較を、両群における各指標の比較は二元配置分散分析とBonferroni多重比較を用いて分析した。SPSS 15.0を用い、危険率の判定は、5％未満を有意とした。<BR>【説明と同意】<BR> 対象者に研究内容の説明文書を用いて口頭による説明を行い、研究参加への同意を書面にて得た。なお、本研究は当院生命倫理委員会の承認(0826)を受けて実施した。<BR>【結果】<BR> 各項目は術前(T1)→術後1ヶ月(T2)→術後3ヶ月(T3)の順に平均値で示した。TUGではTUG良好群は9.4→9.7→8.6秒、TUG遅延群は15.6→14.5→12.2秒であり、各群間においてT1とT3、T2とT3で有意に改善した。TUG良好群とTUG遅延群の経時的変化の間では、交互作用を示した。TUG良好群とTUG遅延群に群間差を示し、T1からT3、T2からT3で測定時間が短縮した。<BR> 準WOMACの痛みではTUG良好群は50.3→59.2→75.0点、TUG遅延群は39.2→57.3→75.7点であり、TUG良好群ではT1とT3、T2とT3で有意に痛みが軽減し、TUG遅延群ではそれに加えてT1とT2においても有意に軽減した。準WOMACの機能ではTUG良好群は74.8→68.5→80.8点、TUG遅延群は52.7→62.0→72.6点であり、TUG良好群ではT2とT3で有意に機能が向上し、TUG遅延群ではそれに加えてT1とT3においても有意に向上した。TUG良好群とTUG遅延群の経時的変化の間では、交互作用を示した。TUG良好群とTUG遅延群に群間差を示し、T1からT3、T2からT3で機能が向上した。<BR> SF-36のPFではTUG良好群は39.9→54.6→54.6点、TUG遅延群は36.0→52.7→52.7点であり、両群においてT1と比較してT2とT3に有意な改善を示した。BPではTUG良好群は43.3→50.9→50.9点、TUG遅延群は29.5→55.1→55.1点であり、TUG良好群ではT1と比較してT2とT3で改善傾向を示したが、TUG遅延群では有意な向上を示した。GHではTUG良好群は53.0→63.7→63.7点、TUG遅延群は51.8→58.0→58.0点であり、TUG良好群ではT1と比較してT2とT3で有意な改善を示し、TUG遅延群では有意差を認めなかった。SFではTUG良好群は66.4→75.7→75.7点、TUG遅延群は49.4→67.3→67.3点であり、TUG良好群では有意差を認めなかったが、TUG遅延群ではT1と比較してT2とT3で有意な改善を示した。なお、SF-36でのRP、VT、RE、MHの下位尺度項目では、経時的な群間差を認めなかった。<BR><BR>【考察】<BR> 膝の痛みと機能に関しては、術前に機能的バランス能力が低い患者は、改善効果が高いことが示唆された。術前に機能的バランス能力が高い患者ではTKAと術後リハにより、自覚的にも健康を感じることができる。それに対して、術前に機能的バランス能力が低い患者ではTKAと術後リハにより、社会的交流が向上することが明らかとなった。<BR><BR>【理学療法学研究としての意義】<BR> 理学療法はHRQOLの向上に貢献したものと考える。TKA術前の機能的バランス能力の状態により、TKA術後の回復過程や改善項目が異なる。理学療法アプローチ方法を検討する必要があると考える。<BR>

目的 インターネット上の健康情報を有効に活用するためには，適切に健康情報を検索し，評価し，活用していく能力（e ヘルスリテラシー）が必要であるが，我が国では e ヘルスリテラシーを測る尺度すらないのが現状である。本研究では，欧米で開発された eHealth Literacy Scale (eHEALS）の日本語版を作成し，その妥当性と信頼性を検討するとともに，e ヘルスリテラシーと社会人口統計学的特性およびインターネット上の健康情報に対する利用状況との関連を検討した。<br/>方法 社会調査会社にモニター登録している3,000人（男性：50.0%，年齢：39.6±10.9歳）にインターネット調査を実施した。eHEALS 日本語版 8 項目，社会人口統計学的特性 6 項目，インターネット上での健康情報に関する変数 2 項目を調査した。探索的因子分析による項目選定後，構成概念妥当性は，確証的因子分析による適合度の確認，基準関連妥当性は，相互作用的•批判的ヘルスリテラシー尺度との相関により検討した。また，内部一貫性（クロンバックの α 係数）および再検査による尺度得点の相関により信頼性を検証した。さらに eHEALS 得点と社会人口統計学的およびインターネット上での健康情報に関する変数との関連の検討には，t 検定，一元配置分散分析，χ2 検定を用いた。<br/>結果 eHEALS 日本語版は 1 因子構造であり，確証的因子分析では一部修正したモデルで GFI=.988, CFI=.993, RMSEA=.056と良好な適合値が得られた。また，eHEALS 日本語版得点は，相互作用的•批判的ヘルスリテラシー尺度得点と正の相関を示した（r=.54, P<.01）。信頼性については，クロンバックの α 係数は.93であり，再調査による尺度得点の相関係数は r=.63 (P<.01）であった。eHEALS 日本語版得点は男性より女性，20代よりも40, 50代，低収入世帯よりも高収入世帯，インターネットでの情報検索頻度が少ない者より多い者で有意に高かった。また，eHEALS 日本語版得点の高い者は，健康情報を得るために多くの情報源を利用しており，その中でも特にインターネットを活用し，インターネットから取得している健康情報の内容も多様であった。<br/>結論 eHEALS 日本語版は我が国における成人の e ヘルスリテラシーを評価するために十分な信頼性と妥当性を有する尺度であることが確認された。今後も増加するインターネット上の健康情報を個人が適切に活用するためには e ヘルスリテラシーが重要であることが示唆された。

目的 健康日本21の中間報告書では，身体活動•運動分野の重点課題の 1 つとして「エクササイズガイド2006の普及」が挙げられている。一方，肥後•中村（2008）によれば，エクササイズガイド2006の認知者の割合は，他の健康づくり施策よりも低いものの，エクササイズガイド2006認知者の方が歩行習慣者の割合が多いことが報告されている。本研究の目的は，エクササイズガイド2006の認知度の経時変化を検討することと，エクササイズガイド2006の認知と身体活動量との関連性を縦断的に検討することであった。<br/>方法 対象は，社会調査モニター1100人（39.8±SD10.1歳）であった。2007年11月（T1），2008年12月（T2）の計 2 回，インターネットを用いた質問調査を縦断的に実施した。エクササイズガイド2006の認知度は，「内容を知っている」，「聞いたことはあるが内容は知らない」，「聞いたことがない•今回の調査で始めて知った」の 3 段階で評価した。週当たりの身体活動量（METs•時/週）は，IPAQ–SV（Craig et al., 2003；村瀬他，2002）を用いて推定した。Mann–Whitnney 検定を用いて，期間中にエクササイズガイド2006を認知した者と，認知しなかった者の身体活動量の変化量を比較した。<br/>結果 エクササイズガイド2006の内容を知っていた者の割合は，T1 で1.4%，T2 で2.2%であり，認知度の有意な経時変化は認められなかった。調査期間中にエクササイズガイド2006を知った者の方が，両時点とも知らなかった者と比較して，身体活動量が低下傾向にあった（P=0.013）。<br/>結論 1 年間で認知度は向上しておらず，我が国においてエクササイズガイド2006の普及は進んでいないことが示唆された。エクササイズガイド2006の戦略的な普及方策の検討が求められる。ただし，先行研究とは異なり，エクササイズガイド2006を認知することが，身体活動の促進に対して肯定的な影響を与える可能性は示されなかった。普及が進み，認知度が向上した段階で検討を行うことで，両者の関係がより明確となるだろう。

〔目的〕人工膝関節全置換術（TKA）による回復過程を検討するために，身体機能および健康関連QOL（HRQOL）を調査した．〔対象〕TKA術後リハを実施した変形性膝関節症患者40膝とした．〔方法〕身体機能評価にはTimed Up and Go test（TUG），膝伸展筋力，開眼片脚起立時間を測定し，HRQOL評価には準WOMACとSF-36を用いた．〔結果〕身体機能の全項目において術後3ヶ月で有意に改善した．準WOMACの痛みとSF-36の身体機能，体の痛み，全体的健康感，社会生活機能は術後1ヶ月で有意に改善し，さらに術後3ヶ月で準WOMACの機能も有意に改善した．開眼片脚起立時間を除く身体機能とHRQOLの全項目は，変化量と初期値との間に有意な負の相関を認めた．〔結語〕TKAによりHRQOLは術後1ヶ月で改善し，術後3ヶ月では身体機能が改善することが示唆された．

Objective:The present study examined physical activity(PA)levels and differences in PA by gender and grades during school recess periods. Method:PA levels of two hundred and thirty children(55% boys, 42%younger)from two elementary schools in Japan were measured with accelerometry for seven consecutive days. Time spent in sedentary, light PA, moderate PA, vigorous PA during break(25 minutes)and lunch recess(15 minutes), and total recess(40 minutes)was determined. Two-way analysis of variance was used to examine differences in PA variables by gender and grades. Results:Data of one hundred and eighty four children(52% boys, 56% younger)was available. Time spent in sedentary, light PA, moderate PA, and vigorous PA was 8.5±4.9, 12.9±3.8, 1.6±1.2, and 2.9±2.8 minutes during break, and 3.5±2.5, 9.5±2.2, 1.4±0.9, and 1.6±1.4 minutes during lunch recess, respectively. There were no significant interactions between gender and grades. Significant main effects of PA variables were found for gender and grades. Boys had fewer sedentary time(p=0.017)and higher vigorous PA time(p<0.001)than girls during total recess. Younger engaged in more sedentary(p=0.045)and less light(p=0.023)and moderate PA(p=0.006)than older at break. On the other hand, at lunch recess, younger had significantly longer light(p=0.015)and vigorous PA(p<0.001)and shorter sedentary time(p<0.001)than older. Conclusion:Overall, boys were less sedentary and engaged in PA at higher intensity levels than girls during school recess. Different pattern in PA was shown between break and lunch recess by grades.

The present case study evaluated an environment-focused project for promoting walking, which included the development of walking courses (using public spaces, parks, roads) with stations for smart cards in the community and an interfaced internet-based self-monitoring system. The project was started in 2008 in Misato City of Saitama Prefecture. In this project, individuals can participate by paying a registration fee (500 yen) and obtaining their own cards. If registrants walk the course, holding their cards over a scanner at 3-4 stations, the smart card records their data (e.g. distance and time spent in walking) from one to the other station and transfers these to a self-monitoring system. As a result, registrants could check their data online. From June 2008 to November 2009, a total of 631 individuals (62% female) who obtained the information from newspaper, magazines, website, or some local events, registered for this project. From walking data collected automatically in the database through the self-monitoring system, it was found that 445 registrants (63% female) used this system at least once, and most of the registrants were 40 years old or more. This suggests that the project in this study might have been effective in promoting walking only among older people. Also, most of the registrants lived around the courses. In particular, the courses in the area surrounded by beautiful nature and residential areas were often used. To expand this idea to other age groups, new attempts, including a point supplying system based on the distance of walking are under development.

&lt;B&gt;Purpose&lt;/B&gt; : To understand the factors associated with the initiation and maintenance of strength training among older people, a qualitative approach would be useful. The purpose of the present study was to explore the initiation processes involved in strength training, and the facilitators and barriers to maintain strength training among people aged 60-74 years.&lt;BR&gt;&lt;B&gt;Methods&lt;/B&gt; : Semi-structured interviews were conducted with 15 members of a sports club. The interview consisted of questions related to initiation processes, facilitators, and barriers of strength training. Transcripts of the interviews were reviewed and categorizations were conducted.&lt;BR&gt;&lt;B&gt;Results&lt;/B&gt; : The initiation processes consisted of &quot;coping with physical inactivity or health problems,&quot; &quot;encouragement from others,&quot; &quot;increase in leisure time,&quot; &quot;feeling good program,&quot; &quot;interests in physical activity,&quot; and &quot;enjoyment of other sports,&quot; The common categories between facilitators and barriers were &quot;physical factors,&quot; &quot;psychological factors,&quot; &quot;social factors,&quot; and &quot;environmental factors.&quot; In addition, &quot;daily life factors&quot; and &quot;other factors&quot; were categorized as facilitators, and &quot;unco

The purpose of this study was to develop a Social Support Scale for Sports and to clarify the differences in evaluations of social support according to differences in the frequency of participation in sports.<BR>    The survey was carried out by a questionnaire mailed to 5,000 people aged 18 and over, randomly selected from the Basic Resident Register in "city A" .<BR>    Using factor analysis, 2 factors were extracted : "instrumental support" and "emotional support." The results showed that both factors' social support scores showed higher values as the participation in sports became more frequent. <BR>    The results suggest that the Social Support Scale for Sports has validity for sports.

The present case study evaluated an environment-focused project for promoting walking, which included the development of walking courses (using public spaces, parks, roads) with stations for smart cards in the community and an interfaced internet-based self-monitoring system. The project was started in 2008 in Misato City of Saitama Prefecture. In this project, individuals can participate by paying a registration fee (500 yen) and obtaining their own cards. If registrants walk the course, holding their cards over a scanner at 3-4 stations, the smart card records their data (e.g. distance and time spent in walking) from one to the other station and transfers these to a self-monitoring system. As a result, registrants could check their data online. From June 2008 to November 2009, a total of 631 individuals (62% female) who obtained the information from newspaper, magazines, website, or some local events, registered for this project. From walking data collected automatically in the database through the self-monitoring system, it was found that 445 registrants (63% female) used this system at least once, and most of the registrants were 40 years old or more. This suggests that the project in this study might have been effective in promoting walking only among older people. Also, most of the registrants lived around the courses. In particular, the courses in the area surrounded by beautiful nature and residential areas were often used. To expand this idea to other age groups, new attempts, including a point supplying system based on the distance of walking are under development.

目的:本研究の目的は、健康づくり事業における会員制ウォーキングシステム事業化のためのパートナーシップ形成プロセスを明らかにすることである。方法:M市健康推進課のICウオーク事業(以下、本事業)担当保健師2名を対象とする半構造化インタビューおよび本事業に関する記事を対象とした文書調査を行い、テキストデータの比較分析により、コードを抽出し、サブカテゴリー、カテゴリーに分類した。得られたサブカテゴリーおよびカテゴリーを、その関連や時間的な経過を考慮して構造化し、パートナーシップ形成プロセスを分析した。結果:テキストデータの分析から18のコードが得られ、9のサブカテゴリー(「首長」「議会」「協議会」「自主グループ」「他課予算」「助成金」「民間」「庁舎内連携」「庁舎外連携」)と4のカテゴリー(『政治的意思決定』『事業』『組織化』『予算化』)が抽出された。カテゴリーの関係性は、構造化モデルとして示された。結論:本研究では、自治体の健康づくり事業化のパートナーシップ形成プロセスが構造化された。構造化モデルは、パートナーシップ形成に対する行政担当者自身の意識と行動の結果であることが示唆された。(著者抄録)

学校の休み時間における児童の身体活動実施状況を客観的測定により検討した。小学校1〜6年生184例を対象とした。性または学年の主効果は、昼休みの中等度身体活動および合計休み時間の低強度身体活動以外の項目で認めた。性差は、すべての休み時間帯において高強度身体活動は女子と比較して男子が有意に長かった。中休みにおける低強度身体活動、昼休みおよび合計休み時間における座位活動は女子のほうが有意に長かった。学年差は、各休み時間帯で異なる傾向を認めた。中休みにおいて、低強度身体活動および中等度身体活動は高学年のほうが座位活動は低学年のほうが有意に長かった。昼休みにおいては、低強度身体活動および高強度身体活動は低学年のほうが、座位活動は高学年のほうが有意に長かった。合計休み時間では、中等度身体活動は高学年、高強度身体活動は低学年において有意に長かった。

Purpose : To understand the factors associated with the initiation and maintenance of strength training among older people, a qualitative approach would be useful. The purpose of the present study was to explore the initiation processes involved in strength training, and the facilitators and barriers to maintain strength training among people aged 60-74 years.<BR>Methods : Semi-structured interviews were conducted with 15 members of a sports club. The interview consisted of questions related to initiation processes, facilitators, and barriers of strength training. Transcripts of the interviews were reviewed and categorizations were conducted.<BR>Results : The initiation processes consisted of "coping with physical inactivity or health problems," "encouragement from others," "increase in leisure time," "feeling good program," "interests in physical activity," and "enjoyment of other sports," The common categories between facilitators and barriers were "physical factors," "psychological factors," "social factors," and "environmental factors." In addition, "daily life factors" and "other factors" were categorized as facilitators, and "uncontrollable factors" were categorized as barriers.<BR>Discussion : These results indicate that 1) the initiation of strength training would be associated with interests in health problems and physical activity, increase of leisure time, encouragement from others, or presence of a good program, and that 2) the maintenance of strength training would be associated with environmental factors and daily life factors as well as physical and psychosocial factors.

目的 健康日本21の中間報告書では，身体活動•運動分野の重点課題の 1 つとして「エクササイズガイド2006の普及」が挙げられている。一方，肥後•中村（2008）によれば，エクササイズガイド2006の認知者の割合は，他の健康づくり施策よりも低いものの，エクササイズガイド2006認知者の方が歩行習慣者の割合が多いことが報告されている。本研究の目的は，エクササイズガイド2006の認知度の経時変化を検討することと，エクササイズガイド2006の認知と身体活動量との関連性を縦断的に検討することであった。<br/>方法 対象は，社会調査モニター1100人（39.8±SD10.1歳）であった。2007年11月（T1），2008年12月（T2）の計 2 回，インターネットを用いた質問調査を縦断的に実施した。エクササイズガイド2006の認知度は，「内容を知っている」，「聞いたことはあるが内容は知らない」，「聞いたことがない•今回の調査で始めて知った」の 3 段階で評価した。週当たりの身体活動量（METs•時/週）は，IPAQ–SV（Craig et al., 2003；村瀬他，2002）を用いて推定した。Mann–Whitnney 検定を用いて，期間中にエクササイズガイド2006を認知した者と，認知しなかった者の身体活動量の変化量を比較した。<br/>結果 エクササイズガイド2006の内容を知っていた者の割合は，T1 で1.4%，T2 で2.2%であり，認知度の有意な経時変化は認められなかった。調査期間中にエクササイズガイド2006を知った者の方が，両時点とも知らなかった者と比較して，身体活動量が低下傾向にあった（P=0.013）。<br/>結論 1 年間で認知度は向上しておらず，我が国においてエクササイズガイド2006の普及は進んでいないことが示唆された。エクササイズガイド2006の戦略的な普及方策の検討が求められる。ただし，先行研究とは異なり，エクササイズガイド2006を認知することが，身体活動の促進に対して肯定的な影響を与える可能性は示されなかった。普及が進み，認知度が向上した段階で検討を行うことで，両者の関係がより明確となるだろう。

[目的]重度糖尿病教育入院患者における入院前のウォーキング行動に関連した心理的要因および環境的要因を調査した。[方法]患者22人(年齢55.3歳)を対象とし、入院時に質問紙調査を実施した。項目は、ウォーキング行動のセルフ・エフィカシー(以下、歩行SE)、糖尿病関連領域質問表(PAID)、うつ・不安尺度(HADS)、ウォーキング行動評価尺度、国際標準化身体活動質問紙環境尺度(IPAQ-E)とした。[結果]歩行時間は歩行SEと正の相関を認め、うつ得点と負の相関を認めた。また、歩行時間の下位尺度である「運動のために歩く時間」は環境尺度の「公園、体育館、施設などがある」項目と正の相関を認めた。[結語]歩行時間を増加するには歩行SEを高め、うつ状態を軽減させるアプローチが有用である可能性が考えられた。(著者抄録)

The purpose of this study was to evaluate the effects of a group-based walking program on physical activity and mediators of activity in middle-aged and older adults. Fifty-six community residents (mean age = 60.3 years) participated in either a walking program (WP: n = 39) or health information program (IP: n = 17) for 2 months. The WP included: 1) instruction in walking technique; 2) participating in group walks; and 3) practicing behavioral skills. The IP consisted of: 1) information about the importance of diet and physical activity; 2) participating in easy exercise; and 3) practicing behavioral skills. After the programs, participants were provided a daily self monitoring and goal setting sheet to be completed over a 4-month period. Letters were sent to participants four times during the follow-up period. Physical activity and mediators of activity were assessed at baseline, 2 months, and 6 months. For the WP participants, daily step count and moderate and vigorous physical activity significantly increased during the 6-month period. There was a significant group-by-time interaction for physical activity, but no interaction for mediators of activity. These results suggest that the group-based walking program played an important role in increasing daily physical activity.<br>

Background: An understanding of the contributing factors to be considered when examining how individuals engage in physical activity is important for promoting population-based physical activity. The environment influences long-term effects on population-based health behaviors. Personal variables, such as self-efficacy and social support, can act as mediators of the predictive relationship between the environment and physical activity. The present study examines the direct and indirect effects of environmental, psychological, and social factors on walking, moderate-intensity activity excluding walking, and vigorous-intensity activity among Japanese adults.
Methods: The participants included 1,928 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, education level, employment status), psychological variables (self-efficacy, pros, and cons), social variables (social support), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising), and the International Physical Activity Questionnaire were assessed via an Internet-based survey. Structural equation modeling was conducted to determine associations between environmental, psychological, and social factors with physical activity.
Results: Environmental factors could be seen to have indirect effects on physical activity through their influence on psychological and social variables such as self-efficacy, pros and cons, and social support. The strongest indirect effects could be observed by examining the consequences of environmental factors on physical activity through cons to self-efficacy. The total effects of environmental factors on physical activity were 0.02 on walking, 0.02 on moderate-intensity activity excluding walking, and 0.05 on vigorous-intensity activity.
Conclusions: The present study indicates that environmental factors had indirect effects on walking, moderate-intensity activity excluding walking and vigorous-intensity activity among Japanese adults, especially through the effects on these factors of self-efficacy, social support, and pros and cons. The findings of the present study imply that intervention strategies to promote more engagement in physical activity for population-based health promotion may be necessary.

目的 介護予防の一環として，足趾•爪のケアに関する事業が行われ始めている。しかし，わが国において，高齢者における足趾•爪に関する問題やそのケアが介護予防に果たす役割については，十分検討されていないのが現状である。本研究の目的は，わが国の地域在住高齢者を対象に，足趾•爪に関する問題と転倒経験および転倒不安との関連性について検討することであった。<br/>方法 地域在住の高齢者10,581人（75.2±5.60歳）を対象に，自記式による質問紙調査を実施した。足趾•爪に関する質問項目は，足白癬，皮膚の炎症•むくみ•変色，爪の肥厚•変形，足趾の血流障害•機能障害，足趾•爪のケアの実施，および適切な靴の着用•靴の調整の実施であった。過去 1 年間の転倒の有無または転倒不安の有無を従属変数，足趾•爪に関する項目を説明変数，年齢，有病状況，老研式活動能力指標得点（実施状況），および下肢機能障害を調整変数としたロジスティック回帰分析を，男女別に行った。<br/>結果 男性の46.0%，女性の39.0%の者が，足趾•爪に関する問題を，少なくとも 1 つ以上回答していた。ロジスティック回帰分析の結果，男女ともに，「足白癬」（男性：調整オッズ比=1.37[95%信頼区間=1.15-1.63]，女性：1.29[1.08-1.53]），「皮膚の炎症•むくみ•変色」（男性：1.66[1.32-2.10]，女性：1.37[1.13-1.66]）「爪の肥厚•変形」（男性：1.72[1.45-2.05]，女性：1.48[1.26-1.74]）「足趾の血流障害•機能障害」（男性：2.42[1.91-3.05]，女性：1.66[1.36-2.04]）を有している者の方が，過去 1 年間に転倒を経験していることが示された。また，転倒不安に関しても，それぞれの足趾•爪に関する問題の保有が関連していた（足白癬[男性：1.37[1.15-1.62]，女性：1.25[1.07-1.47]]，皮膚の炎症•むくみ•変色[男性：1.42[1.13-1.80]，女性：1.62[1.34-2.00]]，爪の肥厚•変形[男性：1.41[1.19-1.68]，女性：1.46[1.25-1.70]]，足趾の血流障害•機能障害[男性：2.05[1.61-2.60]，女性：2.10[1.69-2.60]]）。また，女性においては，足趾•爪の定期的なケアの実施者の方が，転倒不安者が有意に低かった（0.81[0.71-0.92]）。<br/>結論 本研究によって，足白癬，皮膚の状態，爪の肥厚，血流障害や機能障害など，足部に関する問題の改善に注目することが，転倒経験•転倒不安の軽減に有効である可能性が示された。今後，足部の問題の客観的な評価を行った前向き研究により，足部の問題と転倒•要介護状態との関連性を検討し，本研究の結果を裏付けることが求められる。

〔目的〕本研究の目的は，ホームエクササイズ（Home-exercise：以下，HE）により術後治療成績の向上を図るため，HE継続率と関連している要因を明らかにすることであった。〔対象〕腰椎疾患により単椎間Laminotomyを施行した者17名。〔方法〕調査期間中のHE継続率により，高群と低群の2群に分けられた。セルフ・エフィカシーや発症前身体活動度，運動課題に対しての認識程度などについて調査を行った。〔結果〕2群間において発症前身体活動度，セルフ・エフィカシー，運動課題に対しての認識程度に有意差を認めた。〔結語〕腰椎疾患術後患者のHE継続率に影響を及ぼし得る因子が抽出でき，術後治療成績向上のためのHE指導法の指針が示唆された。

The purpose of this study was to explore patterns of lifestyle walking behavior among Japanese adults aged 30-49 and to identify their sociodemographic characteristics.A sample of 5,009 was collected from registrants of a social research company. The study was a cross-sectional survey using the Internet. Measured variables were walking behavior in five domains (commuting, working, shopping, exercising and other movement) and sociodemographic characteristics. Hierarchical cluster analysis was utilized to identify walking patterns.Four walking behavior clusters were identified: cluster 1 (N=1,089) walking while commuting, working and shopping; cluster 2 (N=381) walking while commuting; cluster 3 (N=1,257) walking for exercise; cluster 4 (N=1,161) walking while shopping. Cluster 1 had the highest proportion of walkers who met physical activity recommendations. Also it had a high proportion of women who were unmarried, employed, without children, or finished university or graduate school. Cluster 2 showed a high proportion of men who were married, with children, with high household income, or finished university or graduate school, and women who were married, employed, without children, with high household income, or finished university or graduate school. Cluster 3 had a high proportion of women aged 40-49. Cluster 4 showed a low proportion of men with high household income and a high proportion of women who were married, unemployed, or with children.This study indicated that walking behavior patterns in both genders was different depending on marital status, number of children, educational level and household income. In addition, the employment status of women had apparent effects on these patterns.

Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity.Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults.Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire.Results: Of all respondents to the survey, 2,032 (mean age: 43.8±9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the other hand, crime safety was associated with the active commute in female.Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults.

PURPOSE:Although a foot care program for long-term care prevention has been launched in Japan, few studies have examined its effectiveness. The purpose of the present investigation was to examine the association of foot problems with fall experience and fear of falling among Japanese community-dwelling elderly people.;METHODS:The participants were 10,581 community-dwelling elderly people (75.2 +/- 5.6 years) and the study design was cross-sectional using a questionnaire. Self-reported tinea pedis, skin problems (inflammation, swelling, or discoloration), nail problems (thickening or deformities), impairment (in function or blood flow), regular foot care, and wearing of appropriate shoes were selected as parameters of foot problems and their care. Logistic regression analysis was conducted to examine whether these were related to fall experience (in the past 1 year) and fear of falling adjusted for age, the Tokyo Metropolitan institute of gerontology index of competence, medical conditions, and lower limb functions.;RESULTS:Forty-six percents of males and 39.0% of females reported at least one foot problem. After adjusting for covariates, tinea pedis (male: adjusted odds ratio = 1.37[95% confidence interval= 1.15-1.63], female: 1.29[1.08-1.53]), skin problems (male: 1.66[1.32-2.101, female: 1.37[1.13-1.66]), nail problems (male: 1.72[1.45-2.051, female: 1.48[1.26-1.74]), and functional impairment (male: 2.42[1.91-3.05], female: 1.66[1.36-2.04]) were significantly associated with fall experience. Also, each problem was negatively associated with fear of falling (tinea pedis[male: 1.37 [1.15-1.62], female: 1.25[1.07-1.47]], skin problems[male: 1.42[1.13-1.801, female: 1.62[1.34-2.00]], nail problems[male: 1.41[1.19-1.68], female: 1.46[1.25-1.70]], functional impairment [male: 2.05[1.61-2.60], female: 2.10[1.69-2.60]]). In addition, regular foot care (0.81[0.71-0.921) was a significant correlate of fear of falling in females.;CONCLUSIONS:These results imply that focusing on foot problems (i.e., tinea pedis, skin problems, nail problems, functional impairment) would be one of means for fall preventions. Well-designed prospective studies evaluating foot problems objectively are now needed to confirm the relationships indicated by this study.

【目 的】<BR>睡眠の質の低下は,不安や抑うつに影響する要因として知られている.大学生を対象とした先行研究において荒井ら(2006)は,身体活動（PA)が主観的な睡眠の質と部分的に関連することを示した. また, Izawa et al(2004）は,日常生活におけるPAの高低は,心疾患患者の健康関連QOL(HRQOL)に関連することを報告している. 以上より睡眠の質の程度は,PAやHRQOLに少なからず影響を及ぼす可能性があるものの,慢性心不全(CHF)患者における睡眠の質の違いがそれらに及ぼす影響については明らかではない. 本研究の目的は,睡眠の質の相違がPAおよびHRQOLに及ぼす影響について検討し,CHF患者に対する生活指導のための方策を得ることである.<BR>【方 法】<BR>1.対象<BR>対象は,2004年11月から2009年5月の間に当院リハ部に心肺運動負荷試験(CPX)目的に来院した連続979件のうち,除外基準を除き, かつ睡眠の質に関する調査,PAおよびHRQOLの測定に同意が得られた外来通院中のCHF患者161例である. 除外基準は1）年齢30歳未満,2）NYHA心機能分類 IV度,3）診療記録より各指標の調査不能例,4）重篤不整脈,残存大動脈瘤,高次能機能障害,呼吸器疾患を有する例である. <BR>2.患者背景<BR>年齢, 性, 基礎疾患, 最近のアルコール摂取の有無および投薬内容など患者背景に関する情報および左室駆出率など各指標は, 診療記録より調査した。<BR>3.睡眠の質に関する調査<BR>睡眠の質に関する調査は,自己記入式にて行った. その内容は1）「どちらかというと浅い眠り」, 2）「どちらかというと深い眠り」である. 判定方法は二者択一である. 調査終了後,全対象者は,睡眠が浅い群(A群)と睡眠が深い群(B群)の2群に選別された. <BR>4.PA<BR>本研究におけるPAの指標は歩数と消費カロリーとした. 測定にはLifecorderを用い, その装着部位は腰部とした. <BR>患者はそれを入浴，就寝中を除く24時間，連続8日間装着した。測定終了後検者は, 初日を除く7日間の歩数および消費カロリーの平均値(日歩数およびkcal)を算出した. <BR>5HRQOL<BR>HRQOLの指標には, SF-36日本語版を用いた. 本研究では, SF-36の身体的側面(PCS)と精神的側面(MCS)のサマリースコアをHRQOLの指標とした.<BR>6.解析<BR>各指標は平均値±標準偏差で示した. 両群における患者背景および睡眠の質の違いによるPAとHRQOLの差の検定には, 正規性を確認した後, T検定およびカイ二乗検定を用いた. 睡眠の質の相違によるPAとHRQOLのカットオフ値の算出にはROC曲線を用いた. なお統計学的判定の有意水準は5%とした.<BR>【説明と同意】<BR>本研究を計画するにあたり当大学生命倫理委員会の承認を得た(承認番号340号). 実施に際しては,全対象者に本研究の趣旨を説明した後,書面にて同意を得た.<BR>【結 果】<BR>1.最終対象者<BR>161例中12例は,PAの連続測定あるいはHRQOLの解析が不能であり対象から除外した. 従って最終対象者は,149例(年齢57.7歳,男性85%)であった. <BR>2.患者背景は,アルコール摂取のみA群 はB群 に比し高い割合を示した(59% vs.40%,カイ二乗=6.18,p=0.01). なお, その他の指標に差は認めなかった.<BR>3.PA <BR>日歩数は, A群は5543.6±2410.3, B群は6815.0±2794.7日歩数(t=-2.97,p<0.001)であった. 消費カロリーは,A群は161.7±101.1, B群は199.9±113.4 kcal(t=-2.09,p=0.03)であり,PAは両指標ともにA 群はB群に比し低値を示した.<BR>4.HRQOL<BR>PCSは,A群は46.2±8.0, B群は45.9±7.2(t=0.22,p=0.82)であった. MCSは A群は46.1±10.0, B群は52.6±8.4(t=-4.21,p<0.001)であり,HRQOLのMCSにおいてA群はB群に比し低い値を示した. <BR>5.各指標のカットオフ値<BR>睡眠の質(どちらかというと深い眠り)をアウトカム, 日歩数, 消費エネルギーおよびMCSを独立変数とした場合の各指標のカットオフ値は, 日歩数(5723.6 歩), 消費エネルギー(156.4kcal)およびMCS(48.9)であった. <BR>【考 察】<BR>患者背景に関しては, 睡眠の質の相違はアルコール摂取の有無を除く各指標において差を認めなかった. 以上よりCHF患者におけるアルコール摂取の有無は, 睡眠の質に関わる一要因となりうるものと考えられる. <BR>また, 睡眠の質の相違はPAやHRQOLのMCSに差異を生じることが明らかとなった. すなわち,睡眠の質の低下は患者のPAに加え, HRQOLのうち精神的側面の低下に影響する可能性がある. さらに,睡眠の質からみたCHF患者のPAおよびHRQOLの目標値は, それぞれ日歩数(5723.6歩),消費エネルギー(156.4kcal)およびMCS(48.9)が望ましいと考えられた. <BR>【理学療法学研究としての意義】<BR>睡眠の質はCHF患者のPAおよび精神的側面の低下にも影響する可能性がある. 本研究結果は,睡眠の質の相違がアルコール摂取, PAおよびHRQOLの精神的側面に少なからず影響を及ぼすことを示した. 以上より,CHF患者に対する生活指導方策の一助となるものと思われる. <BR>

【目的】人工膝関節置換術(Total Knee Arthroplasty;以下TKA)後は,筋力など身体機能の回復だけでなく,術後の疼痛の程度に左右される印象を持つ.我々は「自分自身で痛みをうまく管理する」といった痛み対処方略(pain coping strategy)に着目した.入院生活とは異なる自宅生活での機能改善と痛み対処方略の関連を把握することは退院時指導のヒントとなる.そこで我々は、TKA後3カ月の身体機能および患者の痛み対処方略がどのように変化し,痛み対処方略の変化が及ぼす術後の身体機能との関連を検討した.<BR>【方法】対象は当院にて変形性膝関節症に対しTKAを施行した患者22名23脚(平均年齢72.8±6.8歳, BMI27.8±4.6kg/m²)であった.測定項目は等尺性膝伸展筋力体重比(機器:アニマ社製μ-tas), Timed up and go test(以下TUG),10m歩行時間であった.調査項目は日本版変形性膝関節患者機能評価表（Japanese Knee Osteoarthritis Measure:以下JKOM ),痛みの評価はVisual Analogue Scale(以下VAS)とした.痛み対処方略の評価はCoping Strategy Questionnaire日本版(以下CSQ),認知面からみた身体活動の評価に,歩行に関するself efficacy(以下歩行SE),疼痛がどの程度軽減できるかという対処方略の全体評価に,痛みに対するself efficacy(以下疼痛SE)を採用した.CSQのうち認知的対処方略には,「注意の転換」,「思考回避」,「自己教示」,「無視」,「願望思考」,「破滅思考」の下位尺度があり,行動的対処方略には,「痛み行動の活性化」と「他の行動の活性化」の下位尺度がある.得点が高いほどその対処方略を採用していることを示す (最高12点,最低0点) .測定時期は術前と術後約3ヶ月であった.統計学的解析は,各項目の前後の差の検定にはWilcoxonの符号付き順位検定を,各項目の変化量と痛み対処方略の変化との関連には単回帰分析を使用し,有意水準は5％未満とした.<BR>【説明と同意】本研究は聖マリアンナ医科大学倫理委員会の承認を得て実施された.（承認番号第1313号）<BR>【結果】術前→術後の順に中央値(四分位偏差)で示す.術側膝伸展筋力体重比は0.26(0.09)→0.27(0.06)kgf/kg,非術側は0.35(0.08)→0.36（0.06）kgf/kgであった.TUGは10.98(2.33)→9.84(2.13)秒,10m歩行時間は9.28(2.29)→7.98(1.08)秒であった.JKOMは46(17)→27(9)であった. VASは59.5(17.75)→13.5(19)であった.有意な改善は10m歩行時間,JKOM，VASでみられた (p＜0.01) . CSQは「注意の転換」4(2.5)→3(2.5),「思考回避」6(2.5)→3(2.5),「自己教示」10(3.5)→5(2.5),「無視」6(1.5)→3(2.5),「願望思考」8(4)→5(3.5),「破滅思考」4(2)→2(2),「痛み行動の活性化」5(2)→5(3),「他の行動の活性化」9(2)→4(2)となり,CSQの各下位項目のうち注意の転換,思考回避,自己教示,無視,願望思考,他の行動の活性化で術前後に有意な変化がみられた.歩行SEは14(3.5)→19.5(3.25）、疼痛SEは6(0.5)→8(1.5)となり,有意に改善した(p＜0.05).歩行SEおよび疼痛SE,JKOMを従属変数とし,各身体機能,VAS,CSQ下位項目の変化量を独立変数とした単回帰分析では有意差を認めなかった.<BR>【考察】術後3カ月ではVASや10m歩行時間,JKOMの改善とともに痛み対処方略の採用そのものが減少していた.TKAによる疼痛軽減、術後の疼痛コントロールがなされ,身体機能や日常生活動作の改善が示された.一方,膝伸展筋力やバランス評価では術前後で有意な変化はみられなかった.TKA後の経過は,身体機能の改善よりも疼痛の程度が生活の改善に関与していることが示唆された.更に,改善に影響を及ぼした因子を検討するため解析を行ったが,特徴的なものは示されなかった.CSQ下位項目は個人ごとに傾向が異なるため,さらに因子内でのグループ化など詳細な検討が必要である.<BR>【理学療法学研究としての意義】臨床の疼痛管理では,患者自身の疼痛に対する認知の把握やその活用はほぼ行われていない.早期退院が推奨される現状において,患者自身の自己管理は重要となり,術後の身体機能や痛み対処の変化,患者のself efficacyが退院後の機能回復にどのような影響を及ぼすのかということは,患者指導における有用な情報となると思われる.

【目的】<BR>外乱刺激により体幹が不意に不安定になる場合、多裂筋や脊柱起立筋は同時に活動させるが、予測される場合では、多裂筋と脊柱起立筋は異なった活動をするといわれている。しかし、物体挙上動作時に質量予測の有無が体幹筋全体に対してどのような影響を与えているかの報告は見当たらない。本研究では予測よりも重い重量物を挙上したときの体幹筋の筋活動にどのような影響を与えるのかを分析し比較検討した。<BR><BR>【方法】<BR>被検者は特記する既往および腰痛の訴えがなく、本研究への同意を示した成人男性11名を被検者とした。動作課題は、テーブル上に提示された物体を、光刺激を合図に右上肢で挙上するよう指示した。挙上動作は物体を10回挙上させ重さを認識させた場合の1.0kg（予測1.0kg）、4.0kg（予測4.0kg）、重さ1.0kgと認識させたあとに、分からないようにすり替え4.0kgを挙上させた場合（予測外4.0kg）の計3種類でおこなった。被検筋はワイヤ電極にて腹横筋、多裂筋、表面電極にて腹直筋、外腹斜筋、脊柱起立筋の左右5筋、計10筋とした。物体が床から離れた時点を0msecと定め、‐200から+200msecを解析区間とし，区間内を100msecごとに4相に分けた。記録されたデータはモーションアーチファクトを除去し整流化後にRoot Mean Squareにより平滑化し、各相の筋活動量の平均値を算出した。次に、その値を予測4.0kgにおける解析区間内の最大活動量の値で除すことで正規化し％筋活動量とした。％筋活動量を用い各相および各条件間での比較検討をおこなった。統計処理は一元配置の分散分析をおこない、有意差があったものに対してTukeyによる多重比較検定をおこなった。<BR><BR>【説明と同意】<BR>被検者には研究内容を理解してもらった上で同意を得、整形外科医立会いのもと実施した。なお、本研究は早稲田大学スポーツ科学学術院、人を対象とする研究等倫理委員会の承認を得て実施した。<BR><BR>【結果】<BR>・条件ごとの各相による筋比較<BR>予測1.0kgでは左右多裂筋が1相（-200～-100msec）より2相（-100～0msec）で有意に高くなっていた（p＜0.01）。3相（0～100msec）、4相（100～200msec）では2相に対し有意に低くなっていた（p＜0.01）。その他の筋には有意差が認められなかった。予測外4.0kgでは右多裂筋が1相より2相で有意に高くなっていた（p＜0.05）。また、左多裂筋が1相や3相に対し4相で有意に高くなっていた（p＜0.05）。その他の筋には有意差が認められなかった。予測4.0kgでは右脊柱起立筋、右多裂筋が1相より2相、3相、4相で有意に高くなっていた（p＜0.01）。また、左脊柱起立筋、左多裂筋が1相より2相、3相で有意に高くなっていた(p＜0.05）。その他の筋には有意差が認められなかった。<BR>・相ごとの条件による筋比較<BR>1相および2相ではすべての筋において有意差が認められなかった。3相では左右脊柱起立筋が予測1kg、予測外4kgに対し予測4kgで有意に高くなっていた（p＜0.05）。また、左右多裂筋も同様に予測4kgで有意に高くなっていた（p＜0.01）。その他の筋には有意差が認められなかった。4相では左右多裂筋が予測1kgに対し予測外4kgで有意に高くなっていた（p＜0.05）。その他の筋には有意差が認められなかった。<BR><BR>【考察】<BR>予測1kgの挙上動作において、左右多裂筋は挙上直前から筋活動を高めていた。挙上直後（0～100msec）には筋活動が低下し挙上前と有意差は認められなくなった。予測4kgでは左右脊柱起立筋は左右多裂筋と同時に挙上直前（-100～0msec）から筋活動を高め、挙上後（100～200msec）も高めた筋活動を維持していた。予測外4kgでは、右多裂筋が挙上直前から筋活動を高めていた。左多裂筋は挙上後に遅れて筋活動を高めていた。予測1kg、予測外4kgと予測4kgを比較すると、予測4kgでは脊柱起立筋と多裂筋が挙上直後に筋活動を有意に高めていた。挙上後では予測外4kgが予測1kgに対し、左右多裂筋の筋活動を有意に高めていた。今回の結果より、1kgの質量と誤認して4kgの質量を挙上する場合には、挙上（-200～100msec）まで1kgと同様の体幹筋の筋活動をおこない、挙上後（100～200msec）に両側多裂筋の筋活動が高くなっていた。つまり、予測よりも重い物体を挙上した場合には、挙上直前や直後に負荷に適応した体幹筋の筋活動がおこなえていないため、腰部・体幹の安定性に何らかの影響を与えている可能性が示唆された。<BR><BR>【理学療法学研究としての意義】<BR>物体を挙上する際、質量を誤認して発症する急性腰痛の一要因を解明し、不意の動作においても腰椎の安定性を高めておくことができる、腰痛予防のためのリハビリテーションへと応用していく。

目的 日本人成人を対象とし，健康増進のために推奨されている身体活動に関連する主観的評価による自宅近隣の環境要因を明らかにすることとした．方法 30-59歳の3,000名を対象にウェブ調査を実施した．身体活動と環境要因は日本語版国際標準化身体活動質問紙(IPAQ)及びIPAQ環境尺度により調査した．また，社会的要因（性，年齢，婚姻状況，就労状況，同居人数，教育歴，世帯収入）を自記式質問紙により調査した．男女別に，社会的要因を調整し，推奨される身体活動量を満たすことに関連する環境要因のオッズ比を算出した．従属変数は，(1)歩行，(2)歩行以外の中等度以上の身体活動，(3)中等度以上の身体活動((3)＝(1)＋(2))とし，それぞれ，週あたりの実施時間が150分未満と以上の2群に分類して分析した．結果 150分以上の歩行及び中等度以上の身体活動と有意な関連が認められた環境要因は，スーパーや商店へのアクセスが良いこと（男性：OR=1.44，女性：OR=1.73），バス停／駅へのアクセスが良いこと（OR=1.75，1.88），目的地が多いこと（OR=1.62，1.44）であった．また，景観が良いことは歩行以外の中等度以上の身体活動（OR=1.30，1.39）及び中等度以上の身体活動（OR=1.41，1.43）と関連していた．レクリエーション施設があることは，3つ全ての身体活動と関連していた．さらに，十字路／交差点があること（OR=1.32，1.44），自動車・オートバイを保有していること（OR=1.66，1.85）は歩行と，運動実施者を多く見かけること（OR=1.48，1.35）は歩行以外の中等度以上の身体活動と関連していた．結論 日本人成人において，運動実施に関する環境要因は，歩行以外の中等度以上の身体活動と関連し，生活活動における環境要因は，歩行及び中等度以上の身体活動と関連しており，自宅近隣の環境要因の種類は，異なった種類の身体活動と関連があることが明らかとなった．

Purpose : The purpose of the present study was to explore the perception of strength training among older adults who engaged in strength training.<BR>Methods : Semi-structured interviews were conducted with 15 participants aged 60-74 years who engaged in strength training in a sports facility. The questions of the interview included those regarding the mode of exercises they perceived as strength training, and perception about typical people engaged in strength training. Interviews were audio-taped and transcribed verbatim. The three interviewers reviewed the transcripts and categorized the perceptions.<BR>Results : Nine categories of current perceptions of strength training were identified: structured exercises (n=15) , exercises for particular people (n=9) , exercises which those with positive outlook participated in (n=7) , easy exercises (n=6) , lifestyle activities (n=5) , exercises in which healthy people participated (n=5) exercises done in particular place (n=3) , vigorous-intensity exercises (n=2) , and unconcerned exercise (n=2) . Thirteen of participants mentioned the previous perceptions to strength training: unconcerned exercise (n=9) , exercises for particular people (n=7) , structured exercises (n=4) , vigorous-intensity exercises (n=3) , exercises done in particular place (n=1) , and others (n=4) .<BR>Discussions : These results indicate that some older adults who engaged in strength training perceived strength training as an easy and lifestyle-based exercise, and that the perceptions might have been changed in the process of behavioral change for strength training.

Built environment is an important correlate of physical activity participation. Understanding the long-term effects of environment on health behavior is necessary for the promotion of population-based physical activity. However, most studies assessing the relationships between physical activity and environment have been conducted in the United States and Australia. The present study reviews Japanese researches on built environment and physical activity, and discusses the applicability of the built environment on promoting physical activity among Japanese adults. A review was conducted by searching the PubMed and Ichushi electronic database from inception to Sept 24, 2009. Eligible articles were identified as follows : 2 studies that developed the environment scale ; 10 studies that assessed the relationships with physical activity and built environment. There have been only a limited number of studies which were conducted with Japanese adults, thus more researches are needed to draw conclusions about the built environment associated with physical activity.

Purpose : The purpose of the present study was to explore the perception of strength training among older adults who engaged in strength training.<BR>Methods : Semi-structured interviews were conducted with 15 participants aged 60-74 years who engaged in strength training in a sports facility. The questions of the interview included those regarding the mode of exercises they perceived as strength training, and perception about typical people engaged in strength training. Interviews were audio-taped and transcribed verbatim. The three interviewers reviewed the transcripts and categorized the perceptions.<BR>Results : Nine categories of current perceptions of strength training were identified: structured exercises (n=15) , exercises for particular people (n=9) , exercises which those with positive outlook participated in (n=7) , easy exercises (n=6) , lifestyle activities (n=5) , exercises in which healthy people participated (n=5) exercises done in particular place (n=3) , vigorous-intensity exercises (n=2) , and unconcerned exercise (n=2) . Thirteen of participants mentioned the previous perceptions to strength training: unconcerned exercise (n=9) , exercises for particular people (n=7) , structured exercises (n=4) , vigorous-intensity exercises (n=3) , exercises done in particular place (n=1) , and others (n=4) .<BR>Discussions : These results indicate that some older adults who engaged in strength training perceived strength training as an easy and lifestyle-based exercise, and that the perceptions might have been changed in the process of behavioral change for strength training.

The purpose of this study was to explore patterns of lifestyle walking behavior among Japanese adults aged 30-49 and to identify their sociodemographic characteristics.A sample of 5,009 was collected from registrants of a social research company. The study was a cross-sectional survey using the Internet. Measured variables were walking behavior in five domains (commuting, working, shopping, exercising and other movement) and sociodemographic characteristics. Hierarchical cluster analysis was utilized to identify walking patterns.Four walking behavior clusters were identified: cluster 1 (N=1,089) walking while commuting, working and shopping; cluster 2 (N=381) walking while commuting; cluster 3 (N=1,257) walking for exercise; cluster 4 (N=1,161) walking while shopping. Cluster 1 had the highest proportion of walkers who met physical activity recommendations. Also it had a high proportion of women who were unmarried, employed, without children, or finished university or graduate school. Cluster 2 showed a high proportion of men who were married, with children, with high household income, or finished university or graduate school, and women who were married, employed, without children, with high household income, or finished university or graduate school. Cluster 3 had a high proportion of women aged 40-49. Cluster 4 showed a low proportion of men with high household income and a high proportion of women who were married, unemployed, or with children.This study indicated that walking behavior patterns in both genders was different depending on marital status, number of children, educational level and household income. In addition, the employment status of women had apparent effects on these patterns.

目的 日本人成人を対象とし，健康増進のために推奨されている身体活動に関連する主観的評価による自宅近隣の環境要因を明らかにすることとした．<br>方法 30-59歳の3,000名を対象にウェブ調査を実施した．身体活動と環境要因は日本語版国際標準化身体活動質問紙(IPAQ)及びIPAQ環境尺度により調査した．また，社会的要因（性，年齢，婚姻状況，就労状況，同居人数，教育歴，世帯収入）を自記式質問紙により調査した．男女別に，社会的要因を調整し，推奨される身体活動量を満たすことに関連する環境要因のオッズ比を算出した．従属変数は，(1)歩行，(2)歩行以外の中等度以上の身体活動，(3)中等度以上の身体活動((3)＝(1)＋(2))とし，それぞれ，週あたりの実施時間が150分未満と以上の2群に分類して分析した．<br>結果 150分以上の歩行及び中等度以上の身体活動と有意な関連が認められた環境要因は，スーパーや商店へのアクセスが良いこと（男性：OR=1.44，女性：OR=1.73），バス停／駅へのアクセスが良いこと（OR=1.75，1.88），目的地が多いこと（OR=1.62，1.44）であった．また，景観が良いことは歩行以外の中等度以上の身体活動（OR=1.30，1.39）及び中等度以上の身体活動（OR=1.41，1.43）と関連していた．レクリエーション施設があることは，3つ全ての身体活動と関連していた．さらに，十字路／交差点があること（OR=1.32，1.44），自動車・オートバイを保有していること（OR=1.66，1.85）は歩行と，運動実施者を多く見かけること（OR=1.48，1.35）は歩行以外の中等度以上の身体活動と関連していた．<br>結論 日本人成人において，運動実施に関する環境要因は，歩行以外の中等度以上の身体活動と関連し，生活活動における環境要因は，歩行及び中等度以上の身体活動と関連しており，自宅近隣の環境要因の種類は，異なった種類の身体活動と関連があることが明らかとなった．

Objective: To examine differences in physiologic and psychosocial outcomes between age groups after an exercise-based supervised-recovery phase 11 cardiac rehabilitation outpatient program.
Design: This is a longitudinal observational study. The study assessed 442 consecutive cardiac patients. Patients were divided into the middle-aged group (&lt;65 yrs, n = 242) and older-age group (&gt;= 65 yrs, n = 200). Peak oxygen uptake, handgrip and knee extensor muscle strength, upper- and lower-body self-efficacy for physical activity, and physical component summary and mental component summary scores as assessed by SF-36 were measured at 1 and 3 mos after the onset of acute myocardial infarction or cardiac surgery and were compared.
Results: All physiologic and psychosocial outcomes increased significantly between months 1 and 3 in both groups. However, increases were greater in the middle-aged vs. older-aged group in peak oxygen uptake (+13.1% vs. +8.7%, P &lt; 0.01), knee extensor muscle strength (+17.6% vs. +13.3%, P = 0.01), lower-body self-efficacy for physical activity (+17.3% vs. +12.7%, P = 0.02), and physical component summary score (+5.4% vs. +2.7%, P = 0.02).
Conclusions: Age-related differences in various physiologic and psychosocial measures indicated greater improvement from an exercise-based supervised recovery-phase II cardiac rehabilitation outpatient program in middle-aged vs. older-aged patients. Older adults may derive equal mental or emotional benefit from such a cardiac rehabilitation program but do not experience as much improvement in physiologic outcomes as middle-aged adults.

Background: Dog ownership appears to have associated health benefits as a result of increased physical activity through dog walking. This study examined the association between dog ownership and health-related physical activity among Japanese adults. Methods: Male and female respondents to an Internet-based cross-sectional survey were divided into the following groups: dog owner (DOG), nondog pet owner (NDOG), and nonpet owner (NPOG). Moderate and vigorous physical activity amount (MVPA), walking amount (Walking), and sedentary behavior time (SB) were estimated from the International Physical Activity Questionnaire. Analyses of covariance and logistic regression analysis were used. Results: The differences in MVPA, Walking, and SB were statistically significant among the three groups. DOG had a significantly greater amount of MVPA than NDOG and NPOG. DOG also had a significantly greater amount of Walking and less SB time than NPOG, and DOG was 1.5 times more likely to meet the physical activity recommendation than NDOG and NPOG. Conclusions: The dog owners had higher physical activity levels than owners of other kinds of pets and those without any pets, suggesting that dogs may play a major role in promoting physical activity. However, only 30% of the dog owners met the recommended criteria for physical activity.

Background Whether upper-extremity and lower-extremity muscle strength can predict a prognosis of congestive heart failure (CHF) patients is unclear. This study evaluated the impact of muscle strength on long-term mortality in patients with CHF.
Design Prospective observational study of male Japanese CHF patients.
Methods Clinical characteristics (age, body mass index, left ventricular ejection fraction, heart failure etiology, and medications) were obtained from hospital records of 148 male outpatients with stable CHF. Brain natriuretic peptide was determined as an index of disease severity. Peak oxygen uptake (V) over dot(O2), handgrip, and knee extensor muscle strength were also determined.
Results After 1331.9 +/- 700.3 days of follow-up, 13 cardiovascular-related deaths occurred, and the patients were divided into two groups: survival (n = 135) and nonsurvival (n = 13). No significant differences were found between the groups in clinical characteristics, brain natriuretic peptide levels, and knee extensor muscle strength. Peak (V) over dot(O2) (P= 0.011) and handgrip strength (P=0.008) were significantly lower in the (V) over dot(O2) nonsurvival versus survival group. Left ventricular ejection fraction, peak , and handgrip strength were found by univariate Cox proportional hazards analysis to be significant prognostic indexes of survival. Multivariate analysis, however, revealed handgrip strength to be an independent predictor of prognosis. A handgrip strength cutoff value of 32.2 kgf was determined by the analysis of receiver-operating characteristics and was assessed. Kaplan-Meier survival curves after log-rank test showed significant prognostic difference between the two groups (P=0.008).
Conclusion Handgrip strength may be useful for forecasting prognosis in patients with CHF. Eur J Cardiovasc Prev Rehabil 16:21-27 (C) 2009 The European Society of Cardiology

Background: Although engaging in the recommended amount of physical activity provides disease-prevention benefits, few studies have examined the proportion and correlates of meeting the Japanese physical activity recommendation. This study investigated the prevalence and demographic correlates of attaining the recommended value on the Exercise and Physical Activity Reference for Health Promotion 2006. Methods: Data were analyzed for 5177 Japanese adults who took an Internet-based cross-sectional survey. The International Physical Activity Questionnaire and 6 possible demographic correlates were obtained. Respondents were divided into 3 groups recommended, insufficient, and inactive according to their estimated weekly physical activity level. A multivariate logistic regression analysis was used. Results: Overall, 26.6% of respondents were physically active according to the recommendation criterion. Gender, employment status, age, marital status, and educational level were statistically significant. In men, being employed and in women, being 30 to 39 years of age were negatively associated with the attainment of the recommendation. Being male, being a married woman, and having a college education or higher for women were positively correlated with the attainment of the recommendation. Conclusions: Different associations of demographic correlates with the physical activity recommendation for men and women were found, suggesting that gender-specific strategies for targeting the population or specific interventions might be more effective in promoting physical activity among Japanese adults.

The present study identified what kinds of activities Japanese adults perceived as activities for muscular fitness improvement and examined the relationship between age and the perception about such activities. The sample was 1,636 Japanese adults (40.2±12.2years) collected from the registrants of a Japanese social research company. The study design was cross-sectional study using an internet questionnaire. The respondents selected all activities which they perceived as activities for muscular fitness improvement from 14 activities: push-ups, sit-ups, cleaning room, swimming, playing with child, going up and down stairs and slope, yoga, machines exercise, dumbbells exercise, stretching exercise, squat, jogging, rubber bands and tubes exercise, and walking. A chi-square test was utilized for examining the association between the perception and age groups. More than half of respondents treated sit-ups (82.1%), push-ups (72.3%), dumbbells exercise (66.4%), machines exercise (62.1%), squat (58.2%), rubber bands and tubes exercise (55.7%), and swimming (55.6%) as activities for muscular fitness improvement. On the other hand, 30-49% of them also perceived going up and down stairs and slope (46.7%), walking (32.5%), stretching exercise (31.7%), and jogging (30.4%) asactivities for muscular fitness improvement. Compared with younger people, older people were more likely to perceive walking and going up and down stairs and slopes as activities for muscular fitness improvement (p<0.05). It was concluded that the perception of activities for muscular fitness improvement in Japanese adults would be different from the activities for muscular fitness improvement recommended by current guidelines of the American College of Sports Medicine and the Japanese Ministry of Health, Labour and Welfare.

Objective: To examine gender differences in clinical characteristics and physiological and psychosocial outcomes at entry into phase II cardiac rehabilitation.
Design: Cross-sectional study.
Subjects: The study comprised 442 consecutive patients with cardiac diseases assessed at entry into a phase II cardiac rehabilitation programme.
Methods: Clinical characteristics of the patients, such as age, education, marital status, employment and body mass index, were obtained from hospital records. Oxygen uptake, handgrip and knee extensor muscle strength were measured to assess physiological outcomes. Self-efficacy for physical activity, hospital anxiety depression scale and health-related quality of life assessed by Short Form-36 were evaluated to assess psychosocial outcomes.
Results: The number of married women and their levels of education, employment and body mass index were significantly lower, and their ages higher, than those of the men. Measures of physiological outcome in women were significantly lower than those in men. Measures of self-efficacy for physical activity and Short Form-36 physical and emotional subscale scores were lower and anxiety levels higher in women than in men.
Conclusion: Cardiac rehabilitation programmes exclusively for women focusing on physiological outcomes, group counselling, and training to enhance physical and emotional domains may encourage increased participation by women in cardiac rehabilitation.

本研究では、身体活動・運動実施の規定要因としての行動的スキルの利用を評価するために、運動に関する行動的スキル（EBS）尺度を作成した。そして運動行動の変容ステージとの関連を検討した。EBS尺度の項目は、運動の行動的プロセスや身体活動・運動介入で用いられている行動変容技法を参考にして準備した。対象地区に居住する20歳以上の1,078名に対して質問紙調査を実施し、有効回答者647名を分析の対象とした。探索的因子分析の結果、 5項目からなる1因子構造の尺度が作成された。計量心理学的分析の結果、EBS尺度が高い信頼性と妥当性を有することが示された。次にEBS得点と運動行動の変容ステージとの関連を検討した。分散分析の結果、EBS得点と変容ステージの間には有意な関連が認められた。前熟考期に属する者は他の全てのステージに属する者と比較して得点が低く、実行期、維持期に属する者は、熟考期、準備期に属する者よりも得点が高かった。結果は、運動に関する行動的スキルの利用が個人の変容ステージに影響されることを示している。以上のことから、運動に関する行動的スキルは身体活動・運動習慣の定着を目的とした介入において有益な情報をもたらすと考えられる。

The present study investigated the relative contributions of psychological, social, and environmental factors to meeting physical activity recommendation by walking among Japanese adults. Self-reported measures of total weekly physical activity, vigorous and moderately intense activity, walking, self-efficacy, pros, cons, social support, health-professional advice, home exercise equipment, access to facilities, neighbourhood safety, enjoyable scenery, frequently observing others exercising, and residential area were obtained from 1932 Japanese male and female adults using an Internet-based cross-sectional survey on February, 2008. Based on the recommendation criteria of the Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006), respondents were divided into 3 groups: recommended, insufficient, and inactive. A force entry multivariate logistic regression model was utilized. Overall, 69.0% of responders walked in daily life, for transportation or for exercise. However, only 12.1% walked according to the recommended criterion of the EPAR2006. When adjusting for all other variables, there was no association between psychological, social, and environmental factors and recommended group in males. However, self-efficacy, pros, enjoyable scenery were positively whereas social support and living in both suburban and rural areas were negatively associated with only insufficient group in males. For females, selfefficacy, home exercise equipment, and enjoyable scenery were positively associated, whereas living in rural area was negatively associated with both recommended and sufficient groups. Living in suburban area was negatively associated with only insufficient group. Different psychological, social, and environmental correlates were found in walking behaviours with the recommended and insufficient level as well as for males and females. This suggests that a design of intervention that accounts for the specific correlates with each walking activity level and gender found in the current study may more effectively promote walking due to well-matching the needs and characteristics of the target population among Japanese adults.

PURPOSE: The purpose of the present study was to identify the determinants of the participation in walking program with the E-mail function of cellular phone.<br>METHODS: The sample was collected from the registrants of Japanese social research company. The company sent their registrants (30-49 years old) the requests for answering the questionnaire. The recruitment of the program was in the end of the questionnaire. In about 13,000 registrants receiving the requests, 4935 who answered all questions were identified as the subjects in the present investigation. The intervention program with e-mail newsletter was offered to all applicants. Signal detection analysis was used for selecting predictor of applicant from potential variables (gender, age, marital status, number of family, educational background, occupation, family income, hour per day spent in television watching, and hour per day spent in internet using, stage of change for walking behavior, and self-efficacy for regular walking).<br>RESULTS: 1,268 of the subjects (25.7%) applied for the program. Signal detection analysis revealed that the predictors of applicant were stage of change, self-efficacy, and hour in internet using. As these variables, people were classified 6 groups.<br>CONCLUSION: The present study indicates that those who engage in walking, have higher self-efficacy for regular walking, or use internet more frequently tends to participate in the walking program using information technology.

The stages of change (Precontemplation, Contemplation, Preparation, Action, and Maintenance) are a key concept of the transtheoretical model. The present study, designed as a cross-sectional study using an Internet questionnaire, was intended to identify characteristics of stages of change for strength training behavior and to examine the relationship between them and self-efficacy for strength training behavior. Measured variables included stages of change for strength training behavior, moderate-vigorous physical activity, type of strength training, self-efficacy for strength training behavior, and socio-demographic variables. Subjects (5,177 Japanese adults; 40.1±12.0 years; recruited from registrants of a social research company) were in the following stages: 39.5% in Precontemplation; 25.1% in Contemplation; 21.0% in Preparation; 5.6% in Action; and 8.8% in Maintenance. The most common types of strength training activities were done at home (74.3%), used the subject's own body weight (60.4%), and were done in the subject's own way (85.1%). ANCOVA results showed a significant association between stages of change and moderate-vigorous physical activity. Subjects who were women, older, unemployed, with lower education levels, or with lower income significantly tended to be classified into the two earlier stages with the χ² and Kruskal-Wallis tests. In multiple logistic regression analysis, self-efficacy predicted stages of change. Approaches to promote strength training such as enhancement of self-efficacy targeting those who were in earlier stages (e.g. older women) would be needed.

The purpose of the present study was to examine the prevalence of strength training among Japanese adults, and to identify the characteristics of individuals who engage in strength training regularly. The current data was collected from 3000 randomly selected Japanese adults in the SSF National Sports-Life Survey 2006 (Sasakawa Sports Foundation, 2006). The response rate was 62.2%. As a result, the prevalence of regular strength training (more than 2 times per week) was 3.9%. In particular, the rates of regular strength training were low in older individuals (60-69 years were 2.5%, over 70 years were 0.6%). Logistic regression analysis revealed that age, gender, smoking habit, and self-rated physical fitness were significantly correlated with regular strength training. These findings indicate that the majority of Japanese do not participate strength training, especially among the elderly, women, smokers, and those with a lower degree of physical fitness.

Objective: Indices of exercise capacity such as peak oxygen uptake (VO2peak) and muscle strength are important In association with reduced mortality. The present study compared differences in V02peak and muscle strength indices (grip strength and knee extensor and flexor muscle strength) with disease severity and investigated the relation of these variables in congestive heart failure (CHF) patients.
Design: The study comprised 102 patients with stable CHIF (93 men, age 61.4 +/- 10.2 yrs) with left ventricular ejection fraction (LVEF) &lt;40% by echocardiography. We used New York Heart Association (NYHA) functional class to index disease severity. VO2peak, grip strength, knee extensor, and flexor muscle strength were determined. Patients were divided into three groups by NYHA class: class I (n = 39), class 11 (n 49), and class III (n = 14).
Results: Age, sex, and LVEF did not differ according to NYHA class. VO2peak and all muscle strength indices decreased with increases in NYHA class (P &lt; 0.05). VO2peak correlated positively with all muscle strengths (P &lt; 0.05). Stepwise linear regression analysis revealed that grip and knee extensor strength were important in predicting VO2peak center dot
Conclusions: Exercise capacity and disease severity in CHIF patients may be influenced not only by lower-limb but also upper-limb muscle strength.

ある状況における行動に対して形成されたセルフ・エフィカシーは、その状況を超えて、他のセルフ・エフィカシーにも般化すると言われている。しかし、セルフ・エフィカシーの般化を実証的に検討した研究はほとんど報告されていない。そこで本研究では、大学生の睡眠習慣に対する介入による、起床に関するセルフ・エフィカシーの向上が、他の健康行動に関するセルフ・エフィカシーを高めるかどうかを検討した。大学生20名を介入群と対照群に無作為に割り付け、睡眠日誌への記入による睡眠習慣の測定、ライフコーダーEXの装着による身体活動量の測定、および質問紙による心理変数の測定を3週間行った。3週のうち、初めの1週間をベースライン期間、残りの2週間を介入期間とした。介入内容は、セルフ・エフィカシーを高める情報源に基づき、平日の平均起床時間よりも1時間早く起きること、目標の明記、成功1回につき200円の報酬、積極的評価、および気分状態の確認であった。repeated ANOVAを行った結果、起床に関する自己調整セルフ・エフィカシーに関して、時間の主効果が認められた（F (2,36)=19.15, p<.01）。しかし、他の健康行動に関するセルフ・エフィカシーについては、時間の主効果、および群×時間の交互作用は認められなかった。以上より、起床に関するセルフ・エフィカシーが両群とも高められたものの、他の健康行動に関するセルフ・エフィカシーは高められなかったことから、セルフ・エフィカシーの般化は明らかとはなかった。

介護予防事業などに参加が想定される身体機能の低下した虚弱高齢者向けの身体活動セルフ・エフィカシー(SE)測定尺度を作成し、信頼性と妥当性について検討を行った。また、この尺度を用いて地域在住の虚弱高齢者の身体活動SEを評価し、年齢、性別、活動能力との関連を調査した。対象は男76例、女111例、平均年齢74.3±5.6歳の地域在住高齢者とした。検討の結果、信頼性は高く、内定整合性は概ね得られており、基準関連妥当性、厚生概念妥当性は得られていた。65〜74歳の前期高齢者と75歳以上の後期高齢者の年齢層別、性別による身体活動SEを比較するためWilcoxon検定を行なった。その結果、歩行、階段昇り、重量物挙上の3つのうち、重量物挙上のみ前期高齢者群が有意に高い得点を示し、性別では全ての項目で男性が女性より有意に得点が高かった。身体活動SEと老件式活動能力(下位尺度)との関係をみるため、短相関係数と年齢を制御変数とした偏相間係数を求めた。歩行は手段的自立(LADL)、知的能動性、社会的役割と有意に相関し、階段昇りはLADLと知的能動性と有意に相関した。重量物挙上はどの下位尺度とも相関しなかった。

Exercise maintenance after supervised cardiac rehabilitation is important in maintaining both physical activity and physiological factors, such as peak VO₂ and muscle strength (MS), associated with reduced mortality. However, there is no evidence of the effects of unsupervised exercise training and MS training on physical activity and physiological factors after supervised cardiac rehabilitation of Japanese cardiac patients. We conducted a randomized, controlled trial to evaluate the effect of unsupervised exercise training on physical activity and selected physiological factors after supervised cardiac rehabilitation. Eighteen myocardial infarction (MI) patients (16 men, 2 women; mean age 66.3 years) were recruited following completion of a supervised recovery-phase cardiac rehabilitation program. Patients were randomly assigned to a MS training (n=10) or control group (n=8). Baseline measurements of physical activity, peak VO₂, and MS were performed at the end of supervised recovery-phase cardiac rehabilitation (6 months after the onset of MI: T1). Six months later, after going through an unsupervised exercise program (12 months after the onset of MI: T2) exercise maintenance, peak VO₂, MS, and physical activity were remeasured. The MS training group performed low-intensity MS training and walking over the second 6-month period; the control group performed walking exercise only. All patients maintained their exercise training. At T2, there were no significant differences in peak VO₂ values between the MS training and control groups. There was also no significant difference in physical activity (mean number of steps per week) between the MS training and control groups. However, MS was significantly higher in the MS training group than in the control group. We concluded that unsupervised exercise training and low-level MS training performed after supervised cardiac rehabilitation may effectively maintain not only physical activity and peak VO₂ but increase MS.

Objective: To evaluate the effect of the self-monitoring approach (SMA) on self-efficacy for physical activity (SEPA), exercise maintenance, and objective physical activity level over a 6-mo period after a supervised 6-mo cardiac rehabilitation (CR) program.
Objective: To evaluate the effect of the self-monitoring approach (SMA) on self-efficacy for physical activity (SEPA), exercise maintenance, and objective physical activity level over a 6-mo period after a supervised 6-mo cardiac rehabilitation (CR) program.
Design: We conducted a randomized, controlled trial with 45 myocardial infarction patients (38 men, seven women; mean age, 64.2 yrs) recruited after completion of an acute-phase, exercise-based CR program. Patients were randomly assigned to an SMA group (n = 24) or control group (n = 2 1). Along with CR, the subjects in the SMA group self-monitored their weight and physical activity for 6 mos. The SMA used in this study was based on Bandura's self-efficacy theory and was designed to enhance confidence for exercise maintenance. The control group participated in CR only. All patients were evaluated with the SEPA assessment tool. Exercise maintenance, SEPA scores, and objective physical activity (average steps per week) as a caloric expenditure were assessed at baseline and during a 6-mo period after the supervised CR program.
Results: Mean period from myocardial infarction onset did not differ significantly between the SMA and control groups (12.1 +/- 1.3 vs. 12.2 +/- 1.2 mos, P = 0.692). All patients maintained their exercise routine in the SMA group. Mean SEPA score (90.5 vs. 72.7 points, P &lt; 0.001) and mean objective physical activity (10,458.7 vs. 6922.5 steps/wk, P &lt; 0.001) at 12 mos after myocardial infarction onset were significantly higher in the SMA than control group. SEPA showed significant positive correlation with objective physical activity (r = 0.642, P &lt; 0.001).
Conclusions: SMA during supervised CR may effectively increase exercise maintenance, SEPA, and objective physical activity at 12 mos after myocardial infarction onset.

急性心筋梗塞患者を対象とし,短期間の運動療法を主体とした心臓リハビリテーション(心リハ)が身体活動セルフ・エフィカシーに及ぼす影響について検討した.急性期心リハを終了し,かつ心肺運動負荷試験を施行した115例を対象とした.心肺運動負荷試験終了後,運動療法を主体とした回復期心リハ参加群(n=77)と非参加群(n=38)の二群に選別した.心リハ参加群は,非参加群に比し,歩行に関する身体活動セルフ・エフィカシーはT1からT2にかけて有意に向上した.階段昇降に関する身体活動セルフ・エフィカシーは,T1からT2にかけて向上する傾向にあった.8週間の回復期心リハは,身体活動に対するセルフ・エフィカシーのうち,特に歩行の向上に影響する可能性が示唆された

本研究では, 食事・栄養情報をゲートウェイとしたウォーキングプログラムの開発およびその実施を目的とした.わが国において保健行動として広く採択・実施されている食事・栄養や食生活に関する健康情報をゲートウェイに, 運動, とりわけウォーキングの健康に及ぼす恩恵を認知させ, その行動を実施, 定着させることが本プログラムの目的である.食事・栄養や食生活に関する情報を媒介とすることで, 運動や身体活動を保健行動として実施していない対象者に介入プログラムを提供することが可能となった (運動非習慣者の教室参加率: 56.3%) .また教室型のプログラムでは, 行動科学に基づく理論や技法を取り入れることにより, 学習型の介入プログラムの開発および実践を試みた.実際には, 目標設定とセルフモニタリングを重視し, 教室開催日のみならず日々の生活環境の中で, これらスキルを活用できるよう介入を行い運動習慣の定着を図った.その結果, 教室期間中の参加率は94.1%と高く維持され, 教室実施前後のウォーキング実施頻度は介入前の1.31日から介入後には3.31日と有意に増加し, その後の4ヶ月にわたるフォローアップ後も2.83日と高く維持された.これらの結果は, ウォーキングプログラムの開発に食事・栄養や食生活に関する情報がゲートウェイとして有用であることに加え, プログラム中に行動変容技法を導入することが保健行動の維持, 定着に重要であることが示唆された.今後, 地域, 職域などの保健事業としてこのような介入プログラムが活用されることが望まれる.

本研究の目的は、中等度の強度の有酸素運動に伴う疲労感の変化を検討することであった。さらに、疲労感の変化と一過性運動に対するセルフ･エフィカシーの変化との関係を検討した。16名の大学生または大学院生が、本研究の被験者として招集された。運動セッションに伴って、1）疲労感を測定する日本語版 Iceberg Profile、2）中等度の強度の運動を継続できるというセルフ・エフィカシーという2つの測定尺度が用いられた。被験者は、自転車エルゴメータで、中等度の強度のサイクリングを20分間行った。さらに、コントロール条件として、被験者は20分間の読書を行った。運動が疲労感に与える影響を検討するために、繰り返しのある分散分析を行った。しかし、分散分析の結果、条件の主効果、時間の主効果、および条件×時間の交互作用は認められなかった。この結果は、中等度の強度の運動が疲労感を増強しないことを示している。相関係数の算出によって、運動に伴う疲労感の変化量とセルフ・エフィカシーの変化量との関係を検討した。疲労感の変化量はセルフ・エフィカシーの変化量と関連していなかった。本研究の結果は、運動に伴う疲労感とセルフ・エフィカシーが、独立して生じる可能性を示唆している。

The purpose of the present study was to compare differences in physiological outcomes and health-related quality of life (HRQOL) in relation to degree of illness in patients with chronic heart failure (CHF) and to compare HRQOL in CHF patients with that of a normal Japanese population. One hundred and twenty-five patients with stable CHF (93 men, 32 women, mean age 63.3 ± 12.4 years) with left ventricular ejection fraction (LVEF) of less than 40% were enrolled in the present study. We used New York Heart Association (NYHA) functional class as an index of degree of illness. In 64 of the 125 patients, physiological outcome measures included peak oxygen uptake (peak V̇O 2) and V̇E/V̇CO2 slope. HRQOL was assessed with the medical outcome study short form-36 (SF-36) Japanese version. In addition, SF-36 scores of CHF patients were compared against Japanese standard values. Age and LVEF did not differ according to NYHA functional class. The eight SF-36 subscale scores and peak V̇O2 decreased with increases in the NYHA functional classes, whereas V̇E/ V̇CO2 slope increased with increases in NYHA functional class (p&lt
0.05). Of the 8 SF-36 subscales measured in CHF patients, only the bodily pain score attained that of the normal Japanese population. These findings suggest that HRQOL decreases as NYHA functional class increases and other physiological measures worsen. In addition, HRQOL values of CHF patients were low in comparison with standard values of a normal Japanese population.

We investigated the changes of an 8-week cardiac rehabilitation (CR) program on physiological outcomes and health-related quality of life (HRQL) in Japanese cardiac surgery patients. Subjects were 47 consecutive outpatients (32 men, 15 women
mean age 59.4 ± 12.6 years) recovering from cardiac surgery. Patients performed both aerobic exercise on a treadmill at anaerobic threshold intensity and moderate resistance training 2 days per week, 60 min per session, from 1 to 3 months after cardiac surgery. Differences in the eight SF-36 subscale scores and physiological outcomes within the patient group at 1 month and at 3 months after cardiac surgery were analyzed. Peak oxygen uptake, handgrip strength, and knee extension strength were used as physiological outcome measures. HRQL was assessed with the Japanese version Medical Outcome Study Short Form 36 (SF-36). Significant change in overall physiological outcome from 1 month to 3 months was observed. There was also significant change in seven of the eight SF-36 health status subscale scores (physical functioning, role-physical, bodily pain, general health, vitality, role-emotional, and mental health). However, with the exception of physical functioning and mental health scores, values did not reach those of the average healthy Japanese. In conclusion, we found that CR exercise training for Japanese cardiac surgery patients during the recovery phase changes not only physiological outcomes but also HRQL as assessed by the SF-36.

Objective: The purpose of this study was to determine exercise maintenance rate, leisure-time objective physical activity level, and health-related quality of life in relation to exercise maintenance over the 6-mo period after a supervised 5-mo recovery-phase cardiac rehabilitation program in acute myocardial infarction patients. The study also investigated whether exercise maintenance resulted in reproducible health-related quality-of-life outcomes comparable with those of the Japanese normal population.
Design: This observational study comprised 109 acute myocardial infarction patients (89 men, 20 women; mean age, 63.5 +/- 10.1 yrs). Physiologic outcomes (peak oxygen uptake, handgrip, and knee-extension strength) measured at 1 and 6 mos after acute myocardial infarction onset were compared. Completed exercise maintenance and health-related quality-of-life questionnaires and results of electronic pedometer recordings to evaluate leisure-time objective physical activity level were assessed 6 mos after cardiac rehabilitation.
Results: The mean period from acute myocardial infarction to evaluation of outcomes was 18.8 +/- 3.4 mos. Ninety of 109 patients (82.6%) continued exercise for &gt;6 mos after cardiac rehabilitation (exercise group); 19 patients (17.4%) quit exercise after cardiac rehabilitation (nonexercise group). Improvement in physiologic outcomes was noted at 6 mos vs. those at 1 mo, but outcomes were not significantly different between groups. The exercise group performed significantly better than the nonexercise group for leisure-time objective physical activity level and scored significantly higher than the nonexercise group for seven of eight health-related quality of life measures, attaining scores similar to those of the Japanese normal population.
Conclusions: At &gt;18 mos after acute myocardial infarction, the exercise maintenance rate in our patients remains high, and exercise maintenance may be one of the factors contributing to improvement of health-related quality of life and leisure-time objective physical activity level.

Background The present study examined the impact of an 8-week cardiac rehabilitation (CR) program on physiological outcomes and health-related quality of life (HRQOL) of patients with acute myocardial infarction (AMI).
Methods and Results A total of 124 consecutive AMI patients were divided into a supervised outpatient CR group (n=82) and a non-CR group as a control (n=42). Peak oxygen uptake, handgrip strength, and knee extension muscular strength were used as physiological outcome measures. HRQOL outcomes were assessed by the Medical Outcome Study Short Form 36 (SF-36). CR group patients performed both aerobic exercise and moderate resistance training from 1 month (T1) to 3 months (T2) after AMI onset. Age, sex, body mass index, medications, and ejection fraction were similar in both groups. Significantly greater increases in overall physiological outcomes from T1 to T2 were measured in the CR group compared with those of the non-CR group. There were also significantly greater improvements in 4 of the 8 SF-36 health status subscales (physical functioning, role-physical, general health, and vitality) in the CR group compared with the non-CR group.
Conclusions Eight weeks of exercise training have specific effects on improvement in HRQOL and physiological outcomes in Japanese patients.

認知的方略は、運動に関する文献において、興味深い方略とされてきた。われわれは、2つの主要な認知的方略である、連合的方略と分離的方略に注目した。連合的方略は、課題 (運動) への集中を指し、分離的方略は、課題から注意をそむけることを意味する (Stevinson & Biddle, 1998)。競技スポーツに関する多くの文献があるにも関わらず、非競技場面で認知的方略を用いた運動を行う際の心理学的状態については、ほとんど明らかにされていない。本研究は、非競技場面において、認知的方略を用いた一過性運動の心理学的状態にもたらす効果を検討した。16名の被験者が集められ、カウンタ・バランスされた2つの条件、連合的方略条件と分離的方略条件に参加した。両方の運動条件において、被験者は中等度の強度による10分間のサイクリング運動を行った。運動前、ウォームアップ時、運動終了直後、および運動終了5分後において、被験者は、Waseda Affect Scale of Exercise and Durable Activity (WASEDA; 荒井他、2003b) とFeeling Scale (FS; Rejeski, 1985) という2つの運動固有尺度の評価を行った。分散分析は、両方の条件が高揚感、落ち着き感、および快感情を増加させることを示した。そして、分離的方略を用いた運動は、連合的方略を用いた運動と比較して、10分間の運動終了直前における快感情を増加させることを明らかにした。

急性心筋梗塞(AMI)86例を対象とし,AMI発症後1,6ヵ月時点およびAMI発症12ヵ月以上経過後に健康関連QOL調査を施行した.また,重症度別に健康関連QOLを層別した.健康関連QOLには,SF-36日本語版を用いた.SF-36の8つの下位尺度(身体機能,体の痛み,全体的健康観,活力,心の健康,役割機能-身体,社会生活機能,役割機能精神)は,AMI発症後19ヵ月までには,日本人の国民標準値に到達した.重症度別に層別したところ,中等度群は53例,軽度群は33例,高度群は0例であった.AMI発症後1,6,19ヵ月におけるSF-36の8つの下位尺度を従属変数,群間を独立変数とする二元配置分散分析で,1,6,19ヵ月におけるSF-36のすべての8つの下位尺度は,中等度群と軽度群において交互作用は認められなかった

本研究の目的は、身体障害をもつ男子車いす競技選手を対象として、精神的スキルとスポーツ経験年数、スポーツ実施理由、受傷時期の関係を検討することであった。27名の男子車いす競技選手が、精神的スキルとしての心理的競技能力を測定するために、DIPCA(徳永・橋本,1994)に回答した。その結果、(1)競技志向の者のほうが健康志向の者より、「競技意欲」「自信」「作戦能力」および「協調性」において高く、(2)総合得点および「予測力」において、経験年数が5年以上の場合、健康志向の者と比較して競技志向の者が高かった。また、(3)受傷経過年数が長い者ほど、「精神の安定・集中」が高くなった。以上のことから、スポーツ経験年数、スポーツ実施理由、および受傷時期が、車いす競技選手の心理的競技能力の関連要因であることが示唆された。

We examined the effects of physical activity on social skill and cognitive appraisal of stressors in school-aged children. Participants (873 pupils in Grades 4 through 6; 434 boys and 439 girls) completed the Assessment Scale of Physical Activity for Children (Uechi et al., 2000), the Social Skills Scale for Children (Shimada, 1998) and the Cognitive Appraisal Scale for Children (Shimada, 1998). Multiple regression analyses indicated that social skill improved due to physical activity with friends and family. Physical activity had a positive effect on cognitive appraisal of stressors in both boys and girls. It is concluded that engaging in physical activities with friends and family may moderate negative effects of stress by improving social skill of children.

The purpose of this study was to develop the Waseda Affect Scale of Exercise and Durable Activity (WASEDA), a measure of psychological states to the stimulus properties of acute exercise. The WASEDA consists of 12 items that capture 3 distinct affects: Negative affect, Positive engagement and Tranquility showed by factor analysis. The subscales have good internal consistency, content and factorial validity. The second purpose of present study was to examine psychological responses in acute exercise using WASEDA. According to employing WASEDA, it was suggested that participants reported desirable affects after moderate-intensity stationary cycling. Also, the subject's exercise of self-paced walking improved their psychological states. Moreover, discriminant validity for the WASEDA subscales was demonstrated by examining psychological responses shown in acute exercise. Finally, several directions for shown WASEDA were proposed.

わが国でも行動変容のトランスセオレティカル・モデルは、身体活動増進に関する研究に応用されつつある。本研究は、運動することの恩恵と負担を測定するための運動に関する意思決定のバランス尺度を開発した。加えて、運動行動の変容段階の分布を調べ、運動に関する意思決定のバランスとの関係について検討した。608名の中年者が、運動することの恩恵 (pros) と負担 (cons) に関する内容で構成される30項目の調査票に回答した。ステップワイズ因子分析の結果、次のような2因子が抽出された: 1つは、10項目の運動に対するポジティブな知覚で構成される恩恵に関する内容、もう一つは、運動することを避けるような負担に関する内容で構成されている。計量心理学的特性について分析を行った結果、運動に関する意思決定のバランス尺度は、高い信頼性と妥当性を有することが示された。運動行動の変容段階に対する調査対象の回答から、203名 (33.4%) が無関心期、123名 (20.2%) が関心期、114名 (18.8%) が準備期、48名 (7.9%) が実行期、120名 (19.7%) が維持期に属していた。運動行動の変容の5段階別にみた、恩恵、負担および意思決定のバランス (恩恵から負担を引いた) 平均得点において有意差が認められた。定期的に運動をしている人と比べて運動を始めていない人は、運動することについて感じる恩恵とほぼ同じくらい負担を感じていた。わが国における身体不活動に関連する制御可能な要因を理解するためのさらなる継続的な研究と介入効果を示す実証研究が、身体活動および運動を効果的に増進させるための重要な情報をもたらすであろう。

行動変容のトランスセオレティカル・モデル（TTM）は，人がどのように健康行動を変容するかを理解するために用いられてきた。元々は，不健康な習慣的行動（たとえば，喫煙）の変容を説明あるいは予測するために開発されたものであった。最近では，身体活動・運動行動の研究分野においても TTM を利用することが支持されている。本研究は，日本人中年者を対象に，運動行動における TTM の構成要素について検討した。特に，運動行動の変容段階と運動セルフ・エフィカシーとの関係を調べた。<br/> 初めに，本研究では運動セルフ・エフィカシーを査定するための尺度を開発した。467人の中年者が，調査票に回答した。ステップワイズ変数選択による探索的因子分析の結果，5 項目 1 因子からなる尺度が開発された。計量心理学的分析の結果，この尺度が高い信頼性と妥当性を有することが示唆された。<br/> 次に，変容段階とセルフ・エフィカシーの関係を検討するため，中年者808人を対象に横断的調査が行われた。運動行動の変容段階と運動セルフ・エフィカシーを査定する調査票を実施した。運動行動の変容段階分類と運動セルフ・エフィカシーとの間に有意な関連が認められた。特に，本研究の対象者におけるセルフ・エフィカシー得点は，無関心期に属する人が他の段階の人と比較して最も低く，維持期の人が最も高かった。一般的に，段階を通じて直線的なパターンで変化した。<br/> 本研究では横断的調査デザインおよび非無作為サンプル抽出法を用いているために結果の解釈が制限されるが，本研究と先行研究の結果の類似性は，運動行動の変容段階と運動セルフ・エフィカシーの関係が，年齢や文化の違いに関わらず支持されることを示している。これらの関係を正しく理解することによって，健康増進に関わる専門家は身体活動・運動の増進に対する働きかけを改善させることができる。

A study was conducted to clarify the effects of exercise habits on cardiovascular reactivity to a psychological stressor in healthy Type A individuals. Ninety male and 88 female undergraduate students were initially recruited to complete the student version of the Jenkins Activity Survey as a measure of their Type A behavior pattern (TABP). Subjects were identified as Type A or Type B based on their TABP scores. They were then assigned to an exercise (E) or non-exercise (NE) group according to their exercise habits. Six females and six males each made up the 4 condition groups (Type A-E, Type A-NE, Type B-E and Type B-NE). Cardiovascular reactivity (heart rate:HR and skin temperature:ST) was assessed during the time periods of baseline, mirror drawing test (MDT) and recovery for all subjects. Results revealed that Type A individuals had greater and more rapid HR reactivity than Type B individuals and that male Type A subjects showed significantly greater ST reactivity relative to female Type A and Type B subjects. Only males showed a significant main effect of exercise habits on HR reactivity during the MDT. The E group demonstrated more rapid HR recovery following the task than the NE group. During the MDT, Type A individuals showed significantly greater ST reactivity than Type B subjects in the NE group, while there was no difference of TABP type in ST reactivity in the E group. Also, no significant main effect and interaction was shown in the MDT performance. These results suggest that exercise habits contribute to the lowering of cardiovascular reactivity to a psychological stressor and indirectly to the prevention of cardiovascular diseases for Type A individuals.

In the present study, we investigated the effects of a lO-week strength training program on stress reactivity. Thirty five college women were assigned randomly to one of three groups : high intensity strength training (n=12), moderateintdnsity strength training (n=12),or control condition (n=11). All subjects underwent psychological, physical fitness and cardiovascular stress reactivity assessments before and after the 10-week training period. Tests of physical fitness included muscle strength and endurance (muscular fitness), body composition, and cardiovascular fitness, including maximal oxygen uptake (VO_2max) and minutes to reach 85% of age-predicted heart rate maximum. Measures of physical self-efficacy assessed perceived confidence for various muscular tasks. Heart rate (HR),systolic blood pressure (SBP), and diastolic blood pressure (DBP) responses were measured during psychosocial stress. The results demonstrated that training at both strength intensities significantly improved muscular fitness and body composition, whereas neither high nor moderate intensity training altered aerobic fitness. It was also found that strength training significantly reduced cardiovascular reactivity upon exposure to various psychosocial stressors in college women. There was a negative association between cardiovascular reactivity and physical self-efficacy. While it is clear that the reductions in physiological responses to stress were independent of the aerobic components, cognitive-behavioral factors may play some important roles in the modification of psychophysiological responses to stress.

The first purpose of this study was to develop a Japanese version of the Physical Self-Efficacy Scale (PSE) which was developed by Ryckman et al. (1982). In Study 1,751 subjects were asked to answer questionnaires. As result of factor analysis. two factors — "Perceived Physical Ability (PPA)" and "Perceived Self-Presentation (PSP)" — were identified. The reliability of this scale was established using the Cronbach α test, and test-retest correlation. In Study II, the validity of the scale was established by observing a correlation between the Japanese version of PSE and physical fitness (hand grip, knee extension/flexion strength). The result of these analyses showed that physical fitness were correlated significantly with the PPA factor, thus establishing construct validity. Next, in Study III, the relationship between physical self-efficacy and habitual exercise behavior for older adults was investigated. Analysis of the correlation revealed that habitual exercise behavior had a low but significant correlation with PPA, but not with PSP. These results suggest thal self-perception about objective physical ability was an important factor in the exercise behavior of older adults.

A study was conducted to clarify the relationship between the characteristics of sport, eating behavior, and menstrual symptoms in female athletes. In Study 1, two groups of female athletes, identified by sport characteristics of body image and weight restriction (forced athletes : FA; and unforced athletes : UFA), and a non-exerciser group (control : C), were first classified into three menstrual states (amenorrhoeic : AS; oligomenorrhoeic; OS; and normal : NS) on the basis of self-reports. They then completed measurements of physique (height, weight, and BMI) and phydicdl composition (% fat) , and the Garner's Eating Disorder Inventory (EDI) . It was found that the FA group had a significantly larger frequency of AS and OS than the UFA and C groups. Analysis of variance revealed that the FA group had significantly lower %fat than the UFA and C groups. The FA group showed larger scores for some factors of the EDI relative to the other groups. Furthermore, AS and OS individuals also had low %fat dnd, large scores for some EDI factors. In Study 2, 5 high- and 5 low-score subjects were selected from each group of Study 1 according to the EDI to examine their menstrual symptoms. All subjects performdd the Spielberger's State-Trait Anxiety Inventory (STAI) and Menstrual Symptom Questionnaire (MSQ) each day for about one month. The data for the 7 days prior to, and the 7 days after the onset of menstruation were adopted to analyze the STAI and MSQ for comparison among the groups (FA, UFA and C) and eating behavior status (high and low EDI). It was found that the STAI and MSQ scores clearly increased around the day of menstruation onset in all groups, and that the UFA group had significantly smaller responses from day to day than the FS and C groups. While only the UFA group was superior to the other groups for psychological indices in relation to menstruation, both the athlete groups showed higher scores for physical symptoms than the C group. This suggests that while regular exercise may improve pychological responses to menstruation, it worsens physical symptoms such as pain. Especially, the drive for thinness and weight restriction may enhance the physical and psychological responses accompanying menstruation.

This study was designed to examine the psychological benefits of anaerobic exercise for older adults. Specifically, strength training was employed to examine the effects on mood and anxiety in a group of healthy but sedentary older women. 36 women (mean age=68.5 yr.) were randomly assigned to groups given high intensity or moderate intensity strength training or to a control group. Strength training was conducted three days a meek for 12 weeks. After the training period, both high and moderate strength-training programs produced marked improvements in muscle strength and body composition compared to the control subjects. The average improvements in the high and moderate intensity strength-training groups for muscle strength were 40.5 and 35.5%, respectively, and for percent body fat 1.52 and 2.50%, respectively. As for psychological changes, both training groups significantly improved positive mood (vigor), and the moderate intensity group significantly reduced trait anxiety compared to means of the control group. Also, both training groups showed some decrease in tension and state anxiety after the training period. These findings provide evidence for the effectiveness of anaerobic training to enhance perception of psychological well-being in older women. ii moderate intensity rather than high intensity of training regimen map be more beneficial for sedentary older women to improve psychological health.

The purpose of this study was to clarify the effects of aerobic exercise training on the cardiovascular-autonomic function and self-report evaluation in healthy Type A individuals. Seventy eight participants were first recruited by the local newspaper, and 14 male and 14 female individuals of them were chosen as subjects in this study by the Type A behabior pattern (TABP) questionnaire. Then, the subjects were randomly assigned to the 9-week aerobic exercise training (AE) and waiting-list control (WC) groups. The cardiovascular-autonomic function was assessed during the mental task by the spectral component analysis of electrocardiographic R-R interval variability for both subject groups prior to and following the training period. In addition, weight and ventilatory threshold (VT) as a physical fitness index were also compared between the pre- and post-training. Results revealed that while the AE group improved their VTs and decreased their weights following the training, the WC group didn't. The AE group showed a significantly greater power of high frequency obtained by the spectral component analysis after the 9 weeks compared to that prior to the training period, which indicated enhanced cardiovascular- parasympathetic (CP) function by the training. However, the AE group didn't show the improvement on the subscores of TABP. Some of the measures of perceived change had significantly greater scores for the AE group, relative to the WC group, after the training period. These results suggest that aerobic exercise training contributes to the enhancement of CP function and indirectly to the prevention of cardiovascular disease for Type A individuals, although it may not influence TABP itself.

A study was conducted to develop a scale for stressors experienced frequently by university athletes in daily and competitive life, and to examine the relationship between evaluation of the stressors and metnal health(stress response). In Study I, after selecting 66 items which university athletes identified as stressors in daily and competitive life, factor analysis showed that the main stressors were as follows:F1)human relationships in daily and competitive life, F2)competitive record, F3)expectation and pressure from others, F4)internal and social change in each individual, F5)content of club activity, and F6)economic condition and academic record. As a result, a daily and competitive stressor scale for university athletes, comprising 35 items, was developed. Psychometric analyses showed that the daily and competitive stressor scale for unviersity athletes had high reliability and validity. The results of ANOVA(independent variables:status in club, sex;dependent variables:6 subscales of the stressor scale)revealed that there were significant main effects and interactions in some subscales. In Study II, multiple regression analyses showed that a certain specific stressor tended to be strongly connected with a certain specific stress response. Furthermore, cluster anayses indicated that the evaluation pattern of stressors in university athletes could be classified into five main types:CL1)high score group on each factor, CL2)high score group on F2 and F4, CL3)high score group on F5 and F6, CL4)high score group on F3, and CL5)low score group on each factor. The results of MANOVA(independent variables:5 clusters;dependent variables:7 subscales of stress response scale)revealed that the expression pattern of stress response in university athletes also differed according to the stressor evaluation pattern. Finally, future research needs and implications for daily and competitive stressors and health-related problems in university athletes are discussed.

Increased participation in sports has been shown to have a positive linear relationship with athletic injuries. Recent studies conducted by health and sport psychologists have suggested that injured athletes may experience mood disturbances and lowered self-esteem. The purpose of this paper is to survey the existing literature which has examined the psychological effects of athletic injury, to explore recent trends, and to discuss where this type of research is heading in the future. Firstly, athletic injury is discussed as a stress factor which may bring about changes in psychological responses.This topic is discussed by comparing two studies which respectivery employ cross-sectional and longitudinal research designs. In the next section, stage and cognitive-appraisal models of psychological response and change due to athletic injury are presented, and studies employing these models are reviewed. It is been shown that cognitive-appraisal models may be more suitable for explaining the psychological change in injured athletes than stage models. Finally, methodological issues surrounding research of this nature are discussed, and ideas for future psychological studies of athletic injury, such as psychological intervention for injured athletes,are examined.