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• Study suggests exercise may help prevent traffic injuries. • Elderly people who do not exercise have a gap between their awareness and behavior when crossing the street. • A high percentage of elderly people are able to react in some way when they are about to have an injury. Introduction: In recent years, the percentage of elderly fatalities in traffic crashes in Japan has been increasing and has exceeded 50% since 2010. The fatality rate is high for the elderly due to the deterioration of physical functions. Method: The purpose of this study was to reduce the high fatality rate of elderly people at the time of the crash and to find out the effective exercise elements for maintaining physical functions, and to deter traffic crashes and reduce the fatality rate of the elderly people. Results: The effect of exercise on improving and maintaining physical fitness was remarkable, and even when encountering a near miss injuries or crashes, the percentage of the group that was able to respond in some way to a near miss or crashes was higher in the group that regularly exercised. The elderly who do not exercise tend to take longer to start crossing and tend to check both sides of the road less often while crossing. In addition, when they were about to encounter a car, they tended to continue walking, which tended to lead to dangerous crossing. Conclusion: As a result of the questionnaire survey, the possibility of preventing traffic crashes by participating in sports was confirmed. As a result of running experiments using a crossing simulator, it was found that elderly people who do not exercise have a gap between their usual awareness of crossing and their actual behavior. Practical implications: Through the discovering elements of exercise that are useful in reducing injuries will make it possible to provide accurate guidance and training to elderly people with reduced physical functions, and it is expected that pedestrians will be able to avoid traffic injuries with their own abilities. [ABSTRACT FROM AUTHOR]

Background: With a rapidly aging population in Japan, locomotive syndrome is becoming an increasingly serious social problem. Exercise therapy using the lumbar type HAL, which is a wearable robot suit that can assist voluntary hip joint motion, would be expected to cause some beneficial effects for people with locomotive syndrome. The purpose of this study was to assess whether the deterioration of low back pain and any other adverse events would occur following HAL exercise therapy. Moreover, the changes of motor ability variables were evaluated.Methods: We enrolled 33 participants (16 men, 17 women) with locomotive syndrome in this study. They received exercise training (sit-to-stand, lumbar flexion-extension, and gait training) with HAL (in total 12 sessions). We assessed the change of low back pain (lumbar VAS). More than 50% and 25 mm increase compared to baseline was defined as adverse events. One-leg standing time (OLST), 10-m walking test (10MWT), Timed Up and Go test (TUG), 1-min sit-to-stand test (1MSTS), FIM mobility scores and EQ-5D were measured.Results: Of the 33 participants, 32 (16 men, 16 women) (97.0%) completed all 12 exercise training sessions using the lumbar type HAL. One woman aged 82 years withdrew because of right upper limb pain after the second session regardless of the use of HAL. There was no participant who had deterioration of low back pain. Any other adverse events including external injuries and/or falling, skin disorders, uncontrollable cardiovascular or respiratory disorders, and other health disorders directly related to this exercise therapy did not occur. Several outcome measures of motion ability including OLST, TUG and 1MSTS, EQ VAS and lumbar pain improved significantly after this HAL training.Conclusions: Almost all patients with locomotive syndrome completed this exercise training protocol without any adverse events related to HAL. Furthermore, balance function variables including OLST, TUG and 1MSTS improved after this HAL exercise therapy even though mobility function variables including 10MWT and FIM mobility scores did not show any significant change. These findings suggest that the exercise therapy using the lumbar type HAL would be one of the options for the intervention in locomotive syndrome. [ABSTRACT FROM AUTHOR]