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This study examined whether the number of steps taken by frail older adults increased after two types of interventions (custom-made daily routine [CDR] vs. exercise) were conducted over 12 weeks. The participants were 36 frail older adults aged 84.5 ± 6.0 years who attended a day-care center. They were assigned to one of three groups: CDR (n = 13), home-based exercise (HE,n = 10), or control (CON,n = 13). A wrist-worn accelerometer was used to measure their step count in 24 hr for 6 days. The CDR group demonstrated a daily step count change of approximately 25%, which was significantly higher than that of the CON group (effect size [r] = .51,p = .040). There were no significant changes in the HE group. Thus, a CDR might be useful for increasing the number of steps in frail older adults.

[Purpose] Reportedly, males take fewer steps than females among frail older adults. The step count of frail older adults may be influenced by domestic roles in the instrumental activities of daily living. In this study, we aimed to investigate the association between instrumental activities of daily living and the number of steps in frail older females. [Participants and Methods] In this cross-sectional study, we included 27 frail older females aged 84.4 ± 6.5 years who attended a day-care center. We used the Fillenbaum’s instrumental activities of daily living screener and measured the number of steps using an accelerometer, functional independence measure, grip strength, and short physical performance battery. We investigated the association between instrumental activities of daily living and daily steps. Furthermore, we compared the outcomes of the differences in the independence using a subscale of instrumental activities of daily living. [Results] Instrumental activities of daily living and step counts showed a significant correlation. Participants dependent on meal preparation and housework took significantly fewer steps per day. The dependence of their activities also caused low functional independence measure and weak grip strength. [Conclusion] In frail older females, decreased ability for instrumental activities of daily living were associated with fewer steps. Domestic roles may increase the daily steps in frail older adults.

Reducing sitting time, independent of physical activity, is important for health. However, few reports have been published regarding physical activity of housewives compared to that of employed women. We examined strategies to shorten housewives' sitting time using a single-blind randomized controlled trial. Forty-eight housewives (38.0 ± 4.5 years old) were randomly assigned to one of three groups: pamphlet, self-feedback, and tailored feedback groups. All participants received a pamphlet describing the risks of prolonged sitting. The self-feedback and tailored feedback groups were also given feedback on sitting time by a smartphone application. The tailored feedback group received individual suggestions regarding lifestyle to shorten sitting time. We measured physical activity using an accelerometer and health-related quality of life using the Short-Form 8. The longest prolonged sitting time significantly decreased over time, a significant reduction was observed after the intervention only in the tailored feedback group. Vitality, mental health, and role emotional components of health-related quality of life showed a significant improvement with time but no significant differences were observed among the study groups. We suggested an easy approach to shortening prolonged sitting time in housewives using a pamphlet and feedback by smartphone. However, tailored consulting was necessary to yield a more effective result.

Objective To investigate the effect of a tailored education program using home floor plans on falls prevention in discharged older patients. Design A single-center, parallel, pragmatic, pilot randomized controlled trial with equal allocation to the intervention and control groups. Setting Discharged hospital patients were followed-up in their home settings. Participants All discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n = 60). Interventions Both groups received standard care (exercises) and the intervention group also received a tailored education program for falls prevention using home floor plans. Measurements Falls and near-falls at the participants’ homes using a 1-month fall calendar during the 1-month period after discharge. The evaluators were blinded at the baseline assessment. Results Nine participants were withdrawn from the study, leaving 51 of 60 (85%) participants for the final analyses. No falls occurred in the intervention group (n = 25) during follow-up. However, 2 participants (7.7%) fell in the control group (n = 26). Near-falls were reported by 7 participants (28.0%) in the intervention group and 13 participants (50.0%) in the control group. The intervention group had 75% less near-falls compared with the control group, as assessed using a Cox proportional hazards model (hazard ratio, 0.25; 95% confidence interval, 0.09–0.75). Conclusions The tailored education program using home floor plans at the hospital was effective for reducing falls and near-falls among discharged orthopedic patients. Registration of clinical trials: This study was registered with the Research Ethics Committee of University Hospital Medical Information Network (UMIN) Center (000018201).

[Purpose] The purpose of this study was to demonstrate the effects of expiration on abdominal muscle activity during maximum trunk flexion. [Subjects] Twenty-one healthy university students (10 men, 11 women) participated in this study. [Methods] Electromyography (EMG) was used to quantify the activity of the right rectus abdominis, external oblique, and internal oblique muscles. The paired t-test was used to examine the significance of differences in the abdominal muscles between maximum trunk flexion with breath holding and slow expiration. [Results] There was a significantly lower EMG activity in the external oblique muscle during maximum trunk flexion with slow expiration. [Conclusion] The results of this study indicate that slow expiration reduces external oblique muscle activity during maximum trunk flexion performed by healthy young subjects.

The purpose of this study was to clarify the correlation between neck slope angle and deep cervical flexor muscle thickness in healthy subjects. Forty-two healthy male (20.7 ± 2.6 years old) participated in this study. Neck slope angle was measured in a relaxed sitting posture. The deep cervical flexor muscle thickness was measured in a relaxed supine posture. The correlations between neck slope angle and normalized muscle thickness relative to body mass index were determined using Pearson's correlation coefficient. There was a moderate positive correlation between neck slope angle and normalized muscle thickness (r = 0.414, P = 0.006). The result demonstrated that participants with lower neck slope angles had smaller muscle thicknesses of the deep cervical flexor muscles. It appears that the deep cervical flexor muscle thickness might be associated with neck slope angle in a relaxed sitting posture.

Background: It has been previously shown that the intake of natural vitamin D compounds helps prevent falls among facility residents, whereas a multifactorial intervention does not necessarily prevent falls. Furthermore, exercise alone reportedly increases falls among the institutionalized frail elderly. Purpose: This study aimed to compare the reduction in falls among institutionalized frail elderly between interventions using exercise reduction, vitamin D supplementation, or a combination of both. Methods: The participants were residents in a longterm care health facility in Osaka, Japan. A randomized, non-blinded, controlled clinical trial was conducted from September 2013 to June 2014. The participants (n= 91) were divided into four groups based on the intervention. The participants were randomized to the four groups: control group, reduced exercise group, nutrition group, andmultifactorial group. The control group (n= 23) was provided usual care. Usual care included advice on environmental adaptations, falls prevention education, care conference, select walking aids, two sessions of individualized exercise for 20minutes per week, and resistance exercise for 30minutes per week. The reduced exercise group (n= 22) did not perform resistance exercise. The nutrition group (n= 23) was administered oral vitamin D (900 IU/day). The multifactorial group (n= 23) performed reduced levels of exercise and received vitamin D supplementation. The intervention period lasted three months, and falls were recorded for a 6-month follow-up period. The baseline data included age, sex, BMI, FIM, 25 hydroxyvitamin D, skeletal muscle mass index, grip strength, history of falls, and cognitive function. Falls were defined using the International Classification of Diseases. The primary endpoint was the incidence of falls, which was analyzed using Cox proportional-hazards regression analysis. The falls data were compared between the four groups. A two-way analysis of variance was used to compare preand post-test measurements and determine if there was an intervention effect. Results: Sixteen of the participants did not complete the study (retention rate, 82.4%). During the follow-up period, falls occurred in nine participants (52.9%) in the control group, seven participants (31.8%) in the reduced exercise group, six participants (35.3%) in the nutrition group, and four participants (21.1%) in the multifactorial group. In the two-way analysis of variance, group-time interactions indicated clear improvements in 25 (OH) D. However, the other outcome measures were not significantly different among the 4 groups. The Cox proportional-hazard regression analysis, adjusted for sex and age, resulted in the following hazard ratios, compared with the control group: reduced exercise group, hazard ratio 0.48, 95% confidence interval (CI) 0.17–1.30; nutrition group, hazard ratio 0.58, 95% CI 0.20–1.68; and multifactorial group, hazard ratio 0.28, 95% CI0.08–0.92. The valueswere significantly different between the control and multifactorial groups. Conclusion(s): The results suggest that the multifactorial intervention of reduced exercise and vitamin D supplementation is effective for falls reduction in institutionalized frail elderly. Implications: To prevent falls in facility residents, both physical abilities and nutritional status should be considered.