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Background. Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective. The aim of this study was to investigate the association between varus thrust and 2 subcategories--'pain and stiffness' and 'activities of daily living (ADI.)'--of the Japanese Knee Osteoarthritis Measure (JKOM). Design. This was a cross-sectional study. Methods. In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age [greater than or equal to]50 years, medial knee OA and Kellgren-Lawrence (K/L) grade [greater than or equal to] 1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for vims alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results. Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment ([beta] = 17, P =.005). However, the association between varus thrust and ADL was not significant ([beta]=.11, P =.058). Based on sensitivity analyses, including participants of K/I. grade 1 had little influence on this analysis. Limitations. Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the crosssectional design of this study. Conclusions. Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance., Knee osteoarthritis (OA) is the most common joint disease and an important cause of pain and disability among older adults. (1,2) In a 2009 study by Yoshimura et al, (3) [...]

Chronic low back pain (LBP) is known to cause various disorders compared with acute LBP. However, there was no study evaluating presenteeism due to LBP divided into subcategories by the duration of LBP. Therefore, this study aims to investigate the relationship between acute or chronic LBP and presenteeism in hospital nursing staff. Overall, 1100 nurses filled in a questionnaire on basic attributes, LBP symptoms, depression symptoms, and work productivity. The subjects were divided into three groups based on the period of LBP and the compared work productivity. Work Limitation Questionnaire Japanese version (WLQ‐J) was used for the assessment of work productivity. The effects of acute and chronic LBP on presenteeism were evaluated through multiple regression analysis models. In total, 765 subjects, without missing values, were included. The overall prevalence of LBP was 64.6% (acute LBP 47.5%, chronic LBP 17.1%). On multiple regression analysis, acute pain and presenteeism were not associated. Conversely, chronic LBP was associated with time management (adjusted β = −2.3, 95% CI: −4.5 to −1.1), mental‐interpersonal relationship (adjusted β = −2.8, 95% CI: −5.1 to −0.6), and output (adjusted β = −2.7, 95% CI: −5.4 to 0.0) after adjustment for sex and career years. When depression was included in the adjustment factors, chronic LBP and WLQ subscales were not associated. It became obvious that Chronic LBP in nurses was significantly related to time management, mental‐interpersonal relationship, and output. The importance of preventing a decline in work productivity by taking precautions to prevent chronic LBP and depression was suggested.

The association between subjective cognitive decline and falls has not been clearly determined. Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline. We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without. A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17–3.12; p= 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01–0.85, p= 0.04). The result suggests that the objective–subjective disparity may affect falls in community-dwelling older adults. The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.

To evaluate the clinical impact in knee osteoarthritis (OA) of coexisting patellofemoral (PF) joint OA (PFOA) in Japanese patients with medial tibiofemoral (TF) joint OA (TFOA). Patients with medial knee OA (n = 143) were enrolled. The radiographic severity of the TF and PF joints, anatomic axis angle of the TF joint, patellar alignment, trochlear morphology, patellar height, and passive range of motion (ROM) of the painful knee were evaluated. Additionally, the Japanese Knee Osteoarthritis Measure (JKOM) was used to investigate the association between the presence of PFOA and clinical symptoms. PFOA was present in 98 of 143 patients (68.5%) with medial knee OA. Quantile regression analysis revealed that coexisting PFOA was associated with the pain‐related subcategory of the JKOM. Furthermore, multiple logistic regression analysis showed that coexisting PFOA was associated with higher odds of reporting knee pain on using stairs while ascending (odds ratio [OR] 4.81 [95% confidence interval (95% CI) 1.73, 14.3]) and descending (OR 3.86 [95% CI 1.44, 10.8]). A more varus knee alignment and lower knee flexion ROM, which are features of patients with coexisting PFOA, were associated with knee pain while ascending/descending stairs. However, patellar alignment, trochlear morphology, and patellar height were not significantly associated with knee pain. PFOA coexisting with medial knee OA was associated with worse clinical symptoms, particularly while ascending/descending stairs, although patellar alignment did not contribute to reporting knee pain. Further studies that include evaluation of the PF joint are warranted to develop a basis for an optimal intervention based on compartmental involvement.

The shuttle walking test (SWT) is a simple, widely used method for assessing endurance performance in the elderly. Despite widespread community use, its associated factors are unclear. We aim to identify previously undefined SWT association factors in community-dwelling elderly people. Herein, 149 healthy elderly Japanese subjects performed the SWT, and were assessed for height, weight, smoking history, 10-m walk time, Timed Up and Go (TUG) scores, handgrip strength, skeletal mass index (SMI), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), cardio-ankle vascular index, and ankle brachial index. We divided men and women into higher and lower SWT score groups, compared between-group parameters, and performed stepwise multivariate logistic regression analysis to identify factors independently associated with SWT scores. Age, BMI, 10-m walk time, TUG score, SMI, FVC (L; %-predicted), and FEV1(L; %-predicted) were significantly different between SWT score groups for men, while in women, significant differences were observed in age, TUG score, handgrip strength, FVC (L; %-predicted), and FEV1(L; %-predicted) (p< 0.05). In the multivariate logistic regression model, 10-m walk time, and FEV1showed significant associations with SWT results in men; among women, age was the only significantly associated factor (p< 0.05). Results indicate that better lung function and shorter walk time independently associate with SWT results in community-dwelling men; in women, age is the only association. Our findings may offer insight when considering the focus of community exercise programs among the elderly.

Context:Chest wall mobility is strongly related to respiratory function; however, the effect of aging on chest wall mobility—and the level at which this mobility is most affected—remains unclear.

The aim of this study was to investigate the physiological characteristics of community-dwelling elderly subjects, aged ≥65 years, with airflow limitation in the Japanese community. Subjects were recruited through local press advertisement, and 180 individuals were enrolled. Data on age, body mass index (BMI), gender, smoking history, and past medical history were obtained, as were pulmonary function parameters, skeletal muscle mass index, and physical activity. The final study population comprised 161 participants from whom we obtained valid spirometry results. The mean age of this population was 73.4 ± 4.4 years, and 78 participants (48.4 %) were men. The prevalence of airflow limitation was 29.2 % (n= 47). Subjects with airflow limitation were significantly older (P= 0.01) and had poorer pulmonary function (P< 0.01), lower BMI (P< 0.01), and lower skeletal muscle mass index (P= 0.03) than healthy elderly subjects. Furthermore, skeletal muscle mass index was significantly correlated with the percentage of predicted forced vital capacity (r= 0.45, P< 0.05) and forced expiratory volume in 1 s (r= 0.50, P< 0.05) only in men with airflow limitation. We found that the skeletal muscle mass index was significantly reduced in community-dwelling elderly with airflow limitation, and the skeletal muscle mass index was correlated with pulmonary function only in men with airflow limitation.