Publications by authors named "Chika Tanimura"

18 Publications

  • Page 1 of 1

Development of a Reflective Ability Scale for Clinical Nurses.

Yonago Acta Med 2021 Aug 24;64(3):303-314. Epub 2021 Aug 24.

School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan.

Background: Enhancement of reflective ability leads to improved nursing practice and individual growth. This study aimed to develop a reliable, validated scale that can effectively assess the reflective ability of clinical nurses.

Methods: Study participants were 1,872 nurses. We developed an anonymous self-administered questionnaire consisting of 33 original scale items and used it to conduct a survey. The scale was developed based on a construct validity study using item analysis, exploratory factor analysis, and confirmatory factor analysis. Reliability was estimated with Cronbach's α values. Criterion-related validity was assessed using Pearson's correlation analysis.

Results: There were 1,292 responses (response rate, 69.0%). Responses from 1,262 subjects with no missing data were analyzed (valid response rate, 97.7%). Based on the item analysis and exploratory factor analysis, we developed a trial scale model with 3 factors and 25 items. We named the first factor (Factor 1) "Recall Their Own Nursing Practice," the second factor (Factor 2) "Reflect on Their Own Nursing Practice" and the third factor (Factor 3) "Expand Their Own Nursing Practice". This model was modified based on modification indices from the confirmatory factor analysis. A model with 3 factors and 19 items was developed. It had acceptable fit indices (goodness of fit index = 0.914; adjusted goodness of fit index = 0.890; comparative fit index = 0.949; root mean square error of approximation = 0.070). Cronbach's α coefficients were 0.962 for all scale items, 0.922 for Factor 1, 0.918 for Factor 2, and 0.885 for Factor 3. The correlation coefficient between the model and the Professional Identity Scale of Nurses was 0.506 ( < 0.01).

Conclusion: We developed a reflective ability scale consisting of 3 factors and 19 items. We demonstrated its construct validity, reliability, and criterion-related validity. This scale can effectively assess the reflective ability of nurses.
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http://dx.doi.org/10.33160/yam.2021.08.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380555PMC
August 2021

Urinary pentosidine level is associated with grip strength and gait speed in community-dwelling adults: a cross-sectional study.

BMC Musculoskelet Disord 2021 Apr 26;22(1):392. Epub 2021 Apr 26.

School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan.

Background: Muscle and bone interactions might be associated with osteoporosis and sarcopenia. Urinary pentosidine and serum 25-hydroxyvitamin D (25(OH)D) might affect muscle and bone interactions. It is unclear whether these biomarkers are affected by age and sex or play a role in muscle and physical functions. We aimed to investigate the association between urinary pentosidine and serum 25(OH)D levels with muscle mass, muscle strength, and physical performance in community-dwelling adults.

Methods: Two-hundred and fifty-four middle-aged and elderly adults were enrolled. There was no significant difference in age between 97 men (75.0 ± 8.9 years) and 157 women (73.6 ± 8.1 years). The skeletal muscle mass index (SMI), grip strength, and gait speed were assessed. The urinary pentosidine level was measured. We evaluated the association of urinary pentosidine and serum 25(OH)D levels with age and sex (student's t-test) and correlations between biomarker and each variable (Pearson's correlation coefficients). Multiple regression analysis was performed with grip strength and gait speed as dependent variables and with age, height, weight, body mass index (BMI), speed of sound (SOS), SMI, glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), 25(OH)D, and pentosidine as independent variables using the stepwise method.

Results: The urinary pentosidine level was negatively correlated with grip strength, gait speed, eGFR, and insulin-like growth factor-1 (IGF-1) in men and with SOS, grip strength, and gait speed in women. The serum 25(OH)D level was positively correlated with IGF-1 in women and grip strength in men. Grip strength was associated with age, height, and pentosidine in men and height and pentosidine in women. Gait speed was associated with age, BMI, and pentosidine in men and age, height, and pentosidine in women.

Conclusion: Urinary pentosidine levels are significantly associated with grip strength and gait speed and may serve as a biomarker of muscle and bone interactions.
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http://dx.doi.org/10.1186/s12891-021-04279-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077690PMC
April 2021

Relationship of Physical Activity to Self-Care Agency and Physical Condition Among Older Adults in a Rural Area.

Yonago Acta Med 2021 Feb 6;64(1):18-29. Epub 2021 Jan 6.

Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan.

Background: Maintaining physical activity is important for older adults. "Self-care agency" is the ability to perform self-care, which is defined as people following their own will, managing themselves, and maintaining activities. We investigated the relationship among physical activity and self-care agency, demographic factors and physical condition in older adults.

Methods: Self-care agency was assessed by using the Self-Care Agency Questionnaire developed for Japanese patients with chronic diseases. Among 175 older adults aged 65 years or older living in a rural area, responses from 83 who performed physical activities were analyzed. Correspondence analysis was conducted to characterize demographic factors and self-care agency.

Results: A higher proportion of women than men were engaged in physical activity. Irrespective of age and sex, many of the participants performed stretching exercises, walking, radio exercises, TV exercises, and participated in community circles. Participants who engaged in physical activities had significantly higher self-care agency scores than inactive participants. Among the active participants, the self-care agency score was significantly higher for women than men ( = .04) and was also significantly higher for participants aged ≥ 75 years compared to those aged < 75 years. Individuals with a high self-care agency tended to participate in local programs and perform brief physical activities at home.

Conclusion: Physically active older adults demonstrated high self-care agency. Their activities were easily carried out in their daily lives, with activities varying by age and sex. Support from community health experts is needed to promote suitable physical activity among older adults tailored for age and sex, especially among older adults who have low self-care agency.
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http://dx.doi.org/10.33160/yam.2021.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902176PMC
February 2021

Effects of a Self-efficacy Theory-Based Training Program for Peers of Patients with Type 2 Diabetes.

Yonago Acta Med 2020 Nov 19;63(4):282-293. Epub 2020 Sep 19.

Municipal Health Office, Municipality of Pateros, Metro Manila, Philippines.

Background: Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes.

Methods: A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a self-efficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, role-playing, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants' self-efficacy for management of their diabetes. Secondary outcomes were participants' knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life.

Results: At 12 and 18 months after the intervention, participants' knowledge of diabetes was significantly increased compared with baseline (both < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy ( = 0.594, = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation.

Conclusion: The training program significantly improved participants' knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes.
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http://dx.doi.org/10.33160/yam.2020.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683908PMC
November 2020

The Risk Factor of Worsening Low Back Pain in Older Adults Living in a Local Area of Japan: The GAINA Study.

Yonago Acta Med 2020 Nov 24;63(4):319-325. Epub 2020 Nov 24.

Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.

Background: Several factors, particularly osteoporosis, obesity, and a lack of exercise, contribute to low back pain (LBP). This observational longitudinal cohort study to identify the risk factors for worsening low back pain.

Methods: We sent a self-administered questionnaire and a consent form for this study to 1,450 subjects aged > 40 years in Hino, Japan. Baseline assessments of 273 individuals undergoing medical check-ups were conducted from 2014 to 2016. The subjects were divided into Group A (no change or improvement in LBP) and Group B (worsening LBP). LBP was assessed using a visual analog scale; body mass index (BMI), bone mineral density, skeletal muscle index (SMI), standing posture, and habitual exercise frequency were also evaluated. We defined, habitual exercise as nontherapeutic exercise (e.g. swimming, walking, physical exercise and work out).

Results: Overall, 81.2% subjects performed habitual exercise in Group A, a greater number of subjects than the 40.8% in Group B. BMI, SMI, and bone mineral density (BMD) were not significantly different between the two groups. Lack of exercise was a significant risk factor for worsening of LBP. On the other hand, the lack of osteoporosis treatment was significantly different between subjects with worsening LBP despite habitual exercise and those who did not perform habitual exercise.

Conclusion: Although habitual exercise is useful to prevent LBP, it may not necessarily be useful for those with a lack of osteoporosis treatment. Although exercise is typically posited to prevent LBP, it may not be effective in preventing LBP associated with osteoporosis.
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http://dx.doi.org/10.33160/yam.2020.11.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683895PMC
November 2020

Effectiveness of ultrasonographic skeletal muscle assessment in patients after total knee arthroplasty.

Osteoporos Sarcopenia 2019 Sep 25;5(3):94-101. Epub 2019 Sep 25.

Division of Rehabilitation, Tottori University Hospital, Yonago, Japan.

Objectives: This study aimed to characterize the skeletal muscles of patients who underwent total knee arthroplasty (TKA) using ultrasonography in order to investigate the effectiveness of ultrasonographic skeletal muscle assessment after TKA.

Methods: This study included 50 TKA patients (TKA group) and 41 residents with osteoarthritis who have not received TKA (non-TKA group). Ultrasonography was used to assess the characteristics of several different muscles. Various postoperative outcomes were evaluated. Muscle thickness (MT) and echo intensity (EI) results were compared among operated knees in the TKA group, nonoperated knees in the TKA group, and more severely affected knees in the non-TKA group. For the TKA group, multiple regression was conducted to examine the association between skeletal muscle characteristics of operated knees and postoperative outcomes.

Results: The MTs of the vastus medialis, vastus intermedius, and rectus femoris (RF) were significantly smaller and the RF-EI was significantly greater for both operated and nonoperated knees in the TKA group compared with the non-TKA group (P < 0.017). Several parameters of physical function were significantly poorer in the TKA group than in the non-TKA group (P < 0.05). Multiple regression demonstrated that RF-MT was associated with knee range of motion, knee strength, and physical functional performance in the TKA group (P < 0.05).

Conclusions: The quantity and quality of skeletal muscles were lower in the TKA group than in the non-TKA group. Ultrasonography may be useful for assessing skeletal muscles in TKA patients because MT assessed with ultrasonography was associated with various parameters of physical function.
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http://dx.doi.org/10.1016/j.afos.2019.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838742PMC
September 2019

Association between dental caries indicators and serum glycated hemoglobin-levels among patients with type 2 diabetes mellitus.

J Oral Sci 2019 ;61(2):335-342

Division of Health Administration and Promotion, Faculty of Medicine, Tottori University.

Diabetes mellitus (DM) with poor glycemic control is often linked to oral manifestations. This study aimed to investigate the association between dental caries (DC) and glycated hemoglobin (HbA1c) among patients with type 2 DM (T2DM). A health center-based cross-sectional study was conducted comprising 91 eligible patients with T2DM (21 males and 70 females) with a mean age (± standard deviation) of 61.49 ± 9.71 years. A structured interview, screening for DM-related factors, and oral examination were performed. Serum HbA1c levels were used as an index for glycemic control. A comparison between patients with controlled T2DM, i.e., HbA1c ≤7.0% (n = 46), and uncontrolled T2DM, i.e., HbA1c >7.0% (n = 45), showed significant differences in mean values of decayed teeth (DT) (P = 0.045); missing teeth (P = 0.002); and decayed, missing, and filled teeth (DMFT) index (P < 0.001). Results of multiple linear regression analysis revealed that the number of DT was significantly correlated with serum HbA1c levels (95% confidence interval [CI] 0.173 to 0.972, P = 0.005). Furthermore, DMFT index values and serum HbA1c levels (95% CI 0.532 to 1.658, P < 0.001) showed a significant association. This study provides substantial evidence on the association between DC indicators and serum HbA1c levels.
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http://dx.doi.org/10.2334/josnusd.18-0156DOI Listing
November 2019

Association of serum bone- and muscle-derived factors with age, sex, body composition, and physical function in community-dwelling middle-aged and elderly adults: a cross-sectional study.

BMC Musculoskelet Disord 2019 Jun 5;20(1):276. Epub 2019 Jun 5.

School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan.

Background: Understanding interactions between bone and muscle based on endocrine factors may help elucidate the relationship between osteoporosis and sarcopenia. However, whether the abundance or activity of these endocrine factors is affected by age and sex or whether these factors play a causal role in bone and muscle formation and function is unclear. We aimed to evaluate the association of serum bone- and muscle-derived factors with age, sex, body composition, and physical function in community-dwelling middle-aged and elderly adults.

Methods: In all, 254 residents (97 men, 157 women) participated in this cross-sectional study conducted in Japan. The calcaneal speed of sound (SOS) was evaluated by quantitative ultrasound examination. Skeletal muscle mass index (SMI) was calculated by bioelectrical impedance analysis. Grip strength was measured using a dynamometer. Gait speed was measured by optical-sensitive gait analysis. Serum sclerostin, osteocalcin (OC), insulin-like growth factor-1 (IGF-1), myostatin, and tartrate-resistant acid phosphatase-5b (TRACP-5b) concentrations were measured simultaneously. The difference by sex was determined using t test. Correlations between serum bone- and muscle-derived factors and age, BMI, SOS, SMI, grip strength, gait speed, and TRACP-5b in men and women were determined based on Pearson's correlation coefficients. Multiple regression analysis was performed using the stepwise method.

Results: There was no significant difference with regard to age between men (75.0 ± 8.9 years) and women (73.6 ± 8.1 years). Sclerostin was significantly higher in men than in women and tended to increase with age in men; it was significantly associated with SOS and TRACP-5b levels. OC was significantly higher in women than in men and was significantly associated with TRACP-5b levels and age. IGF-1 tended to decrease with age in both sexes and was significantly associated with SOS and body mass index. Myostatin did not correlate with any assessed variables.

Conclusions: Sclerostin was significantly associated with sex, age, and bone metabolism, although there was no discernable relationship between serum sclerostin levels and muscle function. There was no obvious relationship between OC and muscle parameters. This study suggests that IGF-1 is an important modulator of muscle mass and function and bone metabolism in community-dwelling middle-aged and elderly adults.
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http://dx.doi.org/10.1186/s12891-019-2650-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549364PMC
June 2019

A Path Model Analysis of the Causal Relationship between Self-care Agency and Healthy Behavior in Community-dwelling Older People from the GAINA Study.

Yonago Acta Med 2019 Mar 28;62(1):137-145. Epub 2019 Mar 28.

School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.

Background: Self-care agency is an important determinant of self-care behavior. The purpose of this study was to identify the causal relationship between self-care agency and healthy behavior, and to construct a conceptual model of healthy behavior among older people living in a rural community.

Methods: This study was conducted as a cross-sectional survey at the Hino, a town in western Tottori Prefecture, Japan. Participants who were enrolled in the Good Ageing and Intervention against Nursing Care and Activity Decline (GAINA) study from 2014 to 2018 (467 new participants) were initially investigated. Of 398 participants aged ≥ 65 years, 5 were excluded due to missing data, and thus 393 were analyzed. Nurse researchers conducted face-to-face interviews with participants to check the accuracy of data obtained from a self-administered questionnaire, which included demographic information, physical condition (comorbidities, knee pain, low back pain, and locomotive syndrome), healthy behavior, and self-care agency. Correlations among variables were investigated by Pearson's correlation coefficient analysis, and path analysis was performed to assess causal relationships.

Results: A total of 393 persons (160 men and 233 women) were investigated, ranging in age from 65 to 92 years, with a mean age of 75.1 years (SD: 6.9 years). Path analysis revealed poor fit of a model in which pain and locomotive syndrome were factors inhibiting healthy behavior. When the model included only self-care agency, the indices of model fit were almost satisfactory (Goodness-of-fit index = 0.967, Adjusted goodness-of-fit index = 0.900, Comparative fit index = 0.951, and Root mean square error of approximation = 0.088), and the coefficient of determination (R) was 0.38. The self-care agency items with the greatest influence on healthy behavior were the ability to "grasp the techniques/tips needed to maintain health," and the ability to "persist with healthy behavior."

Conclusion: Self-care agency can promote healthy behavior among community-dwelling older people. Regardless of physical problems such as pain and locomotive syndrome, older people have the potential to adopt positive healthy behavior if they acquire self-care agency.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437415PMC
March 2019

Impact of Hands-on Experience of a Cadaver Dissection on the Professional Identity Formation of Health Sciences Students.

Yonago Acta Med 2019 Mar 28;62(1):131-136. Epub 2019 Mar 28.

§Department of Anatomy, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.

Background: In Japan, some nursing and health science universities that train nurses and/or clinical laboratory technicians have a curriculum in which students observe medical students performing a cadaver dissection. Observing a cadaver dissection is believed to affect the formation of a student's professional identity. This study aimed to investigate the effects of observing a cadaver dissection on the professional identity of nursing and clinical laboratory science students to find an effective educational support system for developing professional identity.

Methods: Sophomores majoring in nursing science or clinical laboratory science were asked to complete a questionnaire with a professional identity scale before and after hands-on experience of a cadaver dissection performed by medical students. After their hands-on session was complete, they responded to a free-answer question about acquiring a professional identity.

Results: The professional identity score of nursing students significantly decreased after the hands-on experience of the cadaver dissection. No significant change in professional identity score was observed in the clinical laboratory science students. However, the effect size () was moderate.

Conclusion: Although professional identity formation fluctuates immediately after the experience of the hands-on experience of a cadaver dissection, the findings do suggest that these hands-on sessions will be effective for developing their professional identity if educational support is provided to help them utilize what they learned through reflection.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437412PMC
March 2019

A Conceptual Model for Quality of Life Among People with Type 2 Diabetes in the Philippines.

Yonago Acta Med 2019 Mar 28;62(1):53-61. Epub 2019 Mar 28.

School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.

Background: The increased prevalence of chronic diseases is a social issue in developing countries.

Methods: To create a conceptual model representing the quality of life of low-income people with type 2 diabetes in the Philippines, 117 low-income adult participants in a public support group were studied, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores on quality of life (QOL) were analyzed in terms of their relationships with the following factors: basic attributes, physical factors (glycated hemoglobin level, complications, comorbidities, and symptoms), social factors (support, education, and financial status), and cognitive factors (knowledge, attitude, self-efficacy, and self-management behavior).

Results: Based on correlation coefficients among variables and goodness-of-fit test results through a path analysis, 2 models representing causal relationships were created, both of which showed sufficient goodness-of-fit.

Conclusion: Glycated hemoglobin levels, knowledge of blood glucose levels, self-efficacy, and self-management behavior (exercise) influenced PCS scores, while age, glycated hemoglobin levels, neuropathy, knowledge of insulin, self-efficacy, and self-management behavior (exercise) influenced MCS scores. The influence of self-efficacy was prominent in both cases, providing an important insight for healthcare professionals to develop effective support methods.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437403PMC
March 2019

Association between speed of sound of calcaneal bone assessed by quantitative ultrasound and sarcopenia in a general older adult population: A cross-sectional study.

J Orthop Sci 2019 Sep 5;24(5):906-911. Epub 2019 Feb 5.

School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan. Electronic address:

Background: Lower calcaneal speed of sound may be related to sarcopenia because sarcopenia and osteopenia/osteoporosis show a linked relationship in older adults. The purpose of this study is to clarify whether the speed of sound of calcaneal bone assessed by quantitative ultrasound is associated with sarcopenia in a community-dwelling older adult population.

Methods: This was a cross-sectional observational study. The participants in the study were recruited from a group of individuals who had registered for an annual town-sponsored medical check-up. The inclusion criteria for participation in the study were (1) aged older than 40 years, (2) living independently, and (3) able to walk without assistance. Those who had nursing care insurance were excluded. Four hundred sixty-seven residents (182 men, 285 women) were registered in the study. Demographic information, fall history, muscle mass index, grip strength, and gait speed were assessed. The speed of sound through the calcaneal bone was evaluated using a CM-200 sonometer. The assessment for sarcopenia is based on the recommendations of the Asian Working Group for Sarcopenia.

Results: Speed of sound was positively correlated with muscle mass index and gait speed in men, and was positively correlated with grip strength and gait speed in women, when adjusted for age and body mass index. In a multivariate logistic regression analysis adjusted for age and sex and other confounders, speed of sound was independently related with lower gait speed and sarcopenia in women. Speed of sound under 1470.5 m/sec had discriminated for sarcopenia in females.

Conclusion: We propose that the speed of sound of calcaneal bone may be used to screen for sarcopenia in women. Sarcopenia should be considered if the speed of sound value is less than 1470.5 m/s in older women.
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http://dx.doi.org/10.1016/j.jos.2019.01.003DOI Listing
September 2019

Association between sarcopenia and low back pain in local residents prospective cohort study from the GAINA study.

BMC Musculoskelet Disord 2017 Nov 15;18(1):452. Epub 2017 Nov 15.

Department of Orthopedic Surgery,Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.

Background: Low back pain (LBP) is one of the most common ailments that people experience in their lifetime. On the other hands, Sarcopenia also leads to several physical symptoms and contributes to reducing the quality of life of elderly people.The purpose of this study is to investigate the association between sarcopenia and low back pain among the general population.

Methods: The subjects included 216 adults (79 men and 137 women; mean age, 73.5 years) undergoing a general medical examination in Hino, Japan. Skeletal muscle index (SMI), The percentage of young adults' mean (%YAM) of the calcaneal bone mass using with quantitative ultrasound (QUS) method and walking speed were measured, and subjects who met the criteria of the Asian Working Group for Sarcopenia were assigned to the sarcopenia group. Subjects with decreased muscle mass only were assigned to the pre-sarcopenia group, and all other subjects were assigned to the normal group. Then, we compared the correlations with low back pain physical finding. The Oswestry Disability Index (ODI) and the low back pain visual analogue scale (VAS) were used as indices of low back pain. Statistical analysis was performed among three groups with respect their characteristic, demographics, data of sarcopenia determining factor, VAS and ODI. We also analysed prevalence of LBP and sarcopenia. We investigated the correlations between ODI and the sarcopenia-determining factors of walking speed, muscle mass and grip strength.

Results: Sarcopenia was noted in 12 subjects (5.5%). The pre-sarcopenia group included 38 subjects (17.6%), and the normal group included 166 subjects (76.9%). The mean ODI score was significantly higher in the sarcopenia group (25.2% ± 12.3%; P < 0.05) than in the pre-sarcopenia group (11.2% ± 10.0%) and the normal group (11.9% ± 12.3%). %YAM and BMI were significantly lower in the sarcopenia group than in other groups (P < 0.05). A negative correlation existed between walking speed and ODI (r = -0.32, P < 0.001).

Conclusions: The results of this study suggested that decreased physical ability due to quality of life in residents with LBP may be related to sarcopenia.
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http://dx.doi.org/10.1186/s12891-017-1807-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688752PMC
November 2017

Self-care agency, lifestyle, and physical condition predict future frailty in community-dwelling older people.

Nurs Health Sci 2018 Mar 8;20(1):31-38. Epub 2017 Nov 8.

School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan.

The purpose of this 2 year longitudinal study was to identify the relationship between self-care agency, lifestyle, physical condition, and frailty among community-dwelling older people in a rural area of Japan. The participants were 133 older individuals aged 65 years or above. Data collection was conducted via face-to-face interviews using self-administered questionnaires. Background information, such as age, sex, current employment status, family structure, medication use, comorbidities, and knee and lower back pain, were assessed. The definition of frailty was based on the Frailty Checklist. Self-care agency, lifestyle habits, and locomotive syndrome were assessed using specific assessment scores. Logistic regression analysis showed that locomotive syndrome, knee and lower back pain, and stroke are risk factors for frailty. Among the factors associated with frailty, current employment, regular exercise, and self-care agency were recognized as preventive factors of depression, decreased cognitive function, and being housebound. Our findings suggest that enhancing self-care agency, regular exercise, and self-management skills for chronic illness and disability may decrease the progression of frailty among older people.
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http://dx.doi.org/10.1111/nhs.12376DOI Listing
March 2018

Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2-year prospective cohort study of the GAINA study.

Geriatr Gerontol Int 2017 Nov 18;17(11):2124-2130. Epub 2017 May 18.

Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan.

Aim: The purpose of the present study was to investigate whether sarcopenia was associated with future falls in the general Japanese older population.

Methods: This study was a 2-year prospective observational study. Participants were recruited from individuals who had an annual town-sponsored medical check-up and had not received nursing care. The inclusion criteria for participants in our study were: (i) agreement to participate; (ii) living independently; and (iii) the ability to walk to where the survey was carried out and to provide self-reported data. A total of 223 residents (82 men, 141 women) participated in the baseline assessment in the study. Demographic information, previous fall history, locomotive syndrome, body function and structural measurements and pain at the knee and/or lumber spine were assessed. The Asian Working Group for Sarcopenia algorithm was used to classify the presence of sarcopenia, and assess the history of falling when the participant received their annual medical check-up.

Results: A total of 162 participants had an annual follow-up assessment, 50 of whom (30.8%) fell at least once during the 2-year observational period after baseline assessment. Previous falling history, prevalence of locomotive syndrome, sarcopenia and pain were significantly higher in participants who had fallen compared with participants who had not. Multiple logistic regression analysis showed the prevalence of sarcopenia was a significant predictor of falling.

Conclusion: The key finding of the present study suggests that sarcopenia is a risk factor for falling in older adults who are living independently even after adjustment for previous falls and confounding factors. Geriatr Gerontol Int 2017; 17: 2124-2130.
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http://dx.doi.org/10.1111/ggi.13047DOI Listing
November 2017

Gait variability analysed using an accelerometer is associated with locomotive syndrome among the general elderly population: The GAINA study.

J Orthop Sci 2016 May 25;21(3):354-60. Epub 2016 Mar 25.

Rehabilitation Division, Misasaonsen Hospital, Yamada Misasa onsencho 690, Tohakugun, Tottori 682-0197, Japan. Electronic address:

Background: Gait variability analysed using an accelerometer provides a unique measurement of locomotive dysfunction in patients with musculoskeletal disease or in frail elderly subjects. Therefore, assessing gait variability may become a clinical screening method for the locomotive syndrome. The purpose of this study was to investigate whether gait variability analysed using an accelerometer was associated with locomotive syndrome in the general elderly population.

Methods: A total of 273 residents were screened after a yearly medical check-up, and of these, 223 subjects (mean age, 73.6 ± 8.3 years) met the eligibility criteria. Demographic information, body function and structure measurements (bone mass, grip strength, muscle mass, and postural alignment), and gait parameters were assessed. Gait variability analysis was based on acceleration using a wireless tri-axial accelerometer attached to the 3rd lumbar vertebra process by a trunk belt. Autocorrelation coefficients were used to represent gait variability in three directions: vertical, mediolateral, and anteroposterior. The subjects were classified as either having or not having the locomotive syndrome based on the 5-question Geriatric Locomotive Function Scale.

Results: Of the 223 subjects, 41 (18.3%) had the locomotive syndrome. Autocorrelation coefficients in three directions were lower in the subjects with locomotive syndrome. Using multivariate logistic regression analysis with adjustment factors, of the autocorrelation coefficients only gait variability in the vertical axis remained a significant independent associated with the locomotive syndrome.

Conclusion: This finding suggested that gait variability based on evaluation of autocorrelation coefficients in the vertical axis measured using an accelerometer has the potential to become a screening method for the locomotive syndrome in the general elderly population.
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http://dx.doi.org/10.1016/j.jos.2016.02.003DOI Listing
May 2016

Phantom experiment and clinical utility of quantitative shear wave elastography for differentiating thyroid nodules.

Endocr J 2014 8;61(6):615-21. Epub 2014 Apr 8.

Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.

Shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) is a novel ultrasonography technique. The aim of this study was to investigate the clinical usefulness of quantitative SWE for differentiating thyroid nodules. For phantom study, we measured the shear wave velocities (SWVs) of the four spheres of 2- and 1-cm diameters with varying hardness. For clinical study, the SWVs of normal thyroid glands and thyroid nodules, that were classified as benign or malignant according to either cytological or pathological findings, were measured. The SWVs of each thyroid patient were compared with that of a normal thyroid and each other. In phantom study, the SWVs for the 2-cm spheres correlated with the hardness of the targets, whereas the values for the 1-cm spheres did not. In clinical study, 112 nodules identified in 167 patients and 94 normal thyroid glands were analyzed according to the criteria for the study. The nodules included 84 benign nodules, and 28 papillary carcinoma. The mean SWVs of each group were 1.64 ± 0.47 m/s for normal thyroid, 1.88 ± 0.62 m/s for benign nodules and 2.67 ± 0.76 m/s for papillary carcinoma. The SWVs of papillary carcinoma were significantly higher than those of benign nodules (P < 0.001). The area under the ROC curve was 0.809 with a cut-off value of 2.01 m/s. The sensitivity and specificity were 85.7% and 62.0% respectively. Results showed that SWE provides new information on tumor characteristics, such as hardness and larger nodules tended to provide stable measurements.
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http://dx.doi.org/10.1507/endocrj.ej14-0061DOI Listing
April 2015

Difficulties in the daily life of patients with osteoarthritis of the knee: scale development and descriptive study.

J Clin Nurs 2011 Mar;20(5-6):743-53

Department of Adult & Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan.

Aim: The aim of this study was to develop an instrument to assess difficulties in daily life experienced by patients with osteoarthritis of the knee and to investigate factors influencing difficulties in daily life.

Background: Osteoarthritis of the knee is commonly associated with clinical symptoms and disabilities. No scale has been available to assess the comprehensive and subjective difficulties felt in daily life by patients affected in social and cultural lifestyle. Therefore, little is known about difficulties in osteoarthritis of the knee patients and supportive care necessary for them.

Design: A scale development and descriptive study.

Methods: The participants consisted of 362 patients with osteoarthritis of the knee. The scale development involved several phases including item development, reliability testing, criterion-related validity testing and construct validity testing.

Results: The exploratory factor analysis included three domains: 'suffering in social life', 'hardship in activities in daily life' and 'apprehension about the future life'. A confirmatory factor analysis confirmed validity of the construct, with a demonstrated good fit between the factor structure of the new scale and the observed data. Difficulties in daily life scores were significantly influenced by pain, loss of balance, muscle weakness, stiffness and swelling.

Conclusion: We developed a reliable and valid scale for the measurement of difficulties in daily life experienced by patients with osteoarthritis of the knee. It is important for healthcare professionals to understand these difficulties in daily life experienced by patients with osteoarthritis of the knee and to educate patients with practical information and self-management strategies.

Relevance To Clinical Practice: This new scale could provide useful information to guide clinical practice in assessing and managing difficulties in daily life experienced by patients with osteoarthritis of the knee.
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http://dx.doi.org/10.1111/j.1365-2702.2010.03536.xDOI Listing
March 2011
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