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Summary Background & aims A limited number of studies have developed simple anthropometric equations that can be implemented for predicting muscle mass in the local community. Several studies have suggested calf circumference as a simple and accurate surrogate maker for muscle mass. We aimed to develop and cross-validate a simple anthropometric equation, which incorporates calf circumference, to predict appendicular skeletal muscle mass (ASM) using dual-energy X-ray absorptiometry (DXA). Furthermore, we conducted a comparative validity assessment of our equation with bioelectrical impedance analysis (BIA) and two previously reported equations using similar variables. Methods ASM measurements were recorded for 1262 participants (837 men, 425 women) aged 40 years or older. Participants were randomly divided into the development or validation group. Stepwise multiple linear regression was applied to develop the DXA-measured ASM prediction equation. Parameters including age, sex, height, weight, waist circumference, and calf circumference were incorporated as predictor variables. Total error was calculated as the square root of the sum of the square of the difference between DXA-measured and predicted ASMs divided by the total number of individuals. Results The most optimal ASM prediction equation developed was: ASM (kg) = 2.955 × sex (men = 1, women = 0) + 0.255 × weight (kg) − 0.130 × waist circumference (cm) + 0.308 × calf circumference (cm) + 0.081 × height (cm) − 11.897 (adjusted R2 = 0.94, standard error of the estimate = 1.2 kg). Our equation had smaller total error and higher intraclass correlation coefficient (ICC) values than those for BIA and two previously reported equations, for both men and women (men, total error = 1.2 kg, ICC = 0.91; women, total error = 1.1 kg, ICC = 0.80). The correlation between DXA-measured ASM and predicted ASM by the present equation was not significantly different from the correlation between DXA-measured ASM and BIA-measured ASM. Conclusions The equation developed in this study can predict ASM more accurately as compared to equations where calf circumference is used as the sole variable and previously reported equations; it holds potential as a reliable and an effective substitute for estimating ASM.

BACKGROUND: Some patients with end-stage osteoarthritis of the knee remain unsatisfied after total knee arthroplasty (TKA). We postulated that to increase satisfaction, self-efficacy (SE) for physical activity should receive more attention in rehabilitative intervention, alongside the management of patient expectations, pain, and function. OBJECTIVE: We examined the relative impact of Physical Activity SE on Health-Related Quality of Life (HRQOL) alongside other factors such as pain and physical function which are well-addressed by current interventions. METHODS: One hundred and six first-TKA recipients (15 Male/91 Female, age 73.6 ± 7.2) were evaluated at 3 and 6 months post-operatively using the Medical Outcomes Study 36-Item Health Survey (SF-36v2) for HRQOL, knee extension strength measurement, Timed Up and Go test (TUG), One Leg Standing time test (OLS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and function, and an instrument for measuring Physical Activity SE among the frail elderly in Japan. RESULTS: Significant improvement over pre-operative values was found at 3 and 6 months in TUG, OLS, WOMAC Pain and Function, and the 8 subscales of the SF-36v2. Factors found to significantly impact SF-36v2 subscale scores at 6 months post-operatively were found to be knee pain, knee function, and SE for physical activity. CONCLUSION: These results support our postulation that interventions to improve SE for physical activity could have comparable impact alongside interventions for knee pain and knee function, on the advancement of HRQOL among TKA recipients.

This study aimed to examine the cross-sectional associations of sedentary time and physical activity time with bone density in patients with chronic kidney disease (CKD). The isotemporal substitution (IS) modeling was used to estimate the beneficial effects of behavioral changes (e.g., replacing sedentary time with physical activity time) on bone density in these patients. A total of 92 patients with CKD (age: 65 ± 9 years; estimated glomerular filtration rate: 57 ± 22 mL/min/1.73 m2) were included in this cross-sectional study. The times spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using a triaxial accelerometer. Through quantitative ultrasound measurements, the stiffness index, as a measure of bone density, was calculated using the speed of sound and broadband ultrasound attenuation. In multivariate analyses, the stiffness index was beneficially associated with the MVPA time (β = 0.748), but was not significantly associated with the SB and LPA times. The IS models showed that replacing 10 min/day of SB with the equivalent LPA time was not significantly associated with the stiffness index; however, replacing 10 min/day of SB with the equivalent MVPA time was beneficially associated with the stiffness index (β = 0.804). These results suggest that a small increase in MVPA time (e.g., 10 min/day) may attenuate the decline in bone density in patients with CKD. Our findings may provide insight for the development of novel strategies for improving bone health in patients with CKD.

A key skill in archery is the ability to suppress postural tremor while aiming at a target. Providing feedback during daily archery practice is a potentially effective way of suppressing tremor. However, postural tremor is subtle and difficult to measure using vision-based techniques. This article proposes a feedback method that uses a bow equipped with a small, lightweight acceleration sensor. First, we automatically detect an archer's shooting execution cycle, including the aiming, release, and follow-through phases, by using binary classification, and then, we quantify postural tremor during aiming. Then, from the quantified postural tremor, we regress the expected total score that the archer would obtain in a series of shots during a real game. We performed an experiment with 11 members of a university archery club and achieved 1) a precision of 0.72 and recall of 0.80 in shooting detection and 2) an absolute correlation coefficient of 0.74 in score prediction with leave-one-subject-out cross-validation.

Supplemental digital content is available in the text., Purpose We aimed to investigate the hypothesis that type I collagen plays a role in increasing bone mineral density (BMD) and muscle stiffness, leading to low and high risks of fatigue fracture and muscle injury, respectively, in athletes. As a potential mechanism, we focused on the effect of the type I collagen alpha 1 chain gene (COL1A1) variant associated with transcriptional activity on bone and skeletal muscle properties. Methods The association between COL1A1 rs1107946 and fatigue fracture/muscle injury was evaluated in Japanese athletes. Effects of the polymorphism on tissue properties (BMD and muscle stiffness) and type I collagen α1/α2 chain ratios in muscles were examined in Japanese nonathletes. Results The C-allele carrier frequency was greater in female athletes with fatigue fracture than in those without (odds ratio = 2.44, 95% confidence interval [CI] = 1.17–5.77) and lower in female athletes with muscle injury than in those without (odds ratio = 0.46, 95% CI = 0.24–0.91). Prospective validation analysis confirmed that in female athletes, muscle injury was less frequent in C-allele carriers than in AA genotype carriers (multivariable-adjusted hazard ratio = 0.27, 95% CI = 0.08–0.96). Among female nonathletes, the C-allele of rs1107946 was associated with lower BMD and lower muscle stiffness. Muscle biopsy revealed that C-allele carriers tended to have a larger type I collagen α1/α2 chain ratio than AA genotype carriers (2.24 vs 2.05, P = 0.056), suggesting a higher proportion of type I collagen α1 homotrimers. Conclusion The COL1A1 rs1107946 polymorphism exerts antagonistic effects on fatigue fracture and muscle injury among female athletes by altering the properties of these tissues, potentially owing to increased levels of type I collagen α1 chain homotrimers.

Yasuhiro Nagasawa,1,2 Ai Shibata,3 Hanako Fukamachi,4,5 Kaori Ishii,5 Rikard K Wicksell,6 Koichiro Oka5 1Department of Rehabilitation, Hasegawa Hospital, Yachimata, Chiba, Japan; 2Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; 3Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 4Sport Sciences Laboratory, Japan Sport Association, Tokyo, Japan; 5Faculty of Sport Sciences, Waseda University, Saitama, Japan; 6Department of Clinical Neuroscience, Karolinska Institute, Stockholm, SwedenCorrespondence: Yasuhiro NagasawaDepartment of Rehabilitation, Hasegawa Hospital, 85 Yachimatani, Yachimata, Chiba, 289-1103, JapanTel +81 3 444 0137Fax +81 3 444 0807Email nagasawaid@toki.waseda.jpPurpose: The aim of this study was to translate the Psychological Inflexibility in Pain Scale Japanese version (PIPS-J) and inspect its validity and reliability in older patients with chronic low back pain and knee pain.Materials and Methods: The PIPS was translated into Japanese by a bilingual linguistic expert and three researchers and administered to 120 outpatients with low back pain and knee pain (61.7% women, age 73.8± 7.8 years). Construct validity and criterion validity were evaluated using confirmatory factor analysis and the correlations with the Acceptance and Action Questionnaire-II Japanese version (AAQ-II-J) and the Cognitive Fusion Questionnaire Japanese version (CFQ-J), respectively. Internal consistency using Cronbach’s alpha and test–retest reliability (n=43) were also examined.Results: Of all, 78.3% had low back pain, 55.6% had knee pain, and 44.2% both. The confirmatory factor analysis reproduced the original PIPS structure with two factors and indicated good model fit (GFI = 0.915, CFI = 0.970, RMSEA = 0.060). All items’ standardized regression weights ranged from 0.35 to 0.80. Criterion validity was shown by correlations of r = 0.58 for PIPS-J pain avoidance with the AAQ-II-J, and r = 0.45 between PIPS-J cognitive fusion and the CFQ-J. Cronbach’s alpha for the PIPS-J total score was α=0.85 (pain avoidance: 0.87; cognitive fusion: 0.68). The test–retest correlation for all 12 items was r = 0.54 (pain avoidance: 0.48; cognitive fusion: 0.54).Conclusion: Although a less relevant item was found on each of subscales, the PIPS-J appear to be fairly valid and reliable to evaluate psychological inflexibility in chronic pain among Japanese older adults.Keywords: pain avoidance, cognitive fusion, older patients, chronic low back pain, chronic knee pain

Aim To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. Methods In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. Results Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2 . The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. Conclusions Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943-950.

Background Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another. Methods In 174 older Japanese adults (age, 50–83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels. Results In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (rs = − 0.229), LPA (rs = 0.265), and MVPA (rs = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (β = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (β = 5.49, p Conclusions These cross-sectional findings suggest that sedentary behaviour (detrimentally) and physical activity (beneficially) may affect renal function and that replacing sedentary behaviour with MVPA may benefit renal health in older adults.

Awareness of the effect of the neighbourhood built environment on cardiovascular diseases is growing. In this Comment, we identify major conceptual, methodological and policy-relevant issues in research related to the built environment and describe potential future directions to improve the scientific rigour of research in this field.

Aim Watching sports at stadiums can have a favorable impact on health-related outcomes in older adults. We examined the effect of watching professional baseball at a ballpark on older adults' health-related outcomes. Methods A total fo 58 participants aged 65-85 years were randomized into a spectator group (n = 29) and waiting-list group (n = 29). During the 2-month intervention, there were 21 games. The spectator group watched games at the ballpark, and the waiting-list group maintained their daily routines. The health-related outcomes were executive and cognitive functions, health-related quality of life, depression symptoms, subjective happiness and physical activity. Results The median days watching baseball games in the spectator group was 6 days (interquartile range 4-10 days). Executive function using the reverse Stroop interference rate showed a non-significant trend of improvement in the spectator group compared with the waiting-list group (P = 0.063). The spectator group showed a significant reduction in depressive symptoms compared with the waiting-list group (P = 0.016). Conclusions Regularly watching professional baseball at a ballpark reduced older adults' depression symptoms. Geriatr Gerontol Int 2019; 19: 717-722.

An increasing number of studies have examined neighbourhood built environment attributes associated with cycling. Some of them suggest non-linear relationships between built environment attributes and cycling. This study examined the strength and shape of associations of cycling for transport with objectively measured built environment attributes. Data were from 9146 Australian adults who took part in the 2009 South-East Queensland Travel Survey. Participants (aged 18–64 years) completed a 24-hour travel survey, in which they reported modes of travel. Residential density, Walk Score and a Space Syntax measure of street integration were calculated at a neighbourhood level using geographic information systems. Multilevel logistic regression analyses examined associations of bicycle use with each built environment attribute, which was modelled continuously and categorically. All continuous measures of the built environment attributes were associated with bicycle use. Each one-decile increment in residential density, Walk Score, and street integration was associated with 13%, 16%, and 10% higher odds of bicycle use, respectively. However, the associations appeared to be non-linear, with significant odds ratios observed only for the higher categories of each built environment attribute relative to the middle category. This study found that adults living in high-density neighbourhoods with more destinations nearby and well-connected streets were more likely to cycle for transport. However, medium-level density, access to destinations and street connectivity may not be enough to facilitate bicycle use. Further studies are needed to investigate urban design threshold values above which cycling can be promoted.

Aims This study aims to examine the effect of differences in nutritional status on activities of daily living (ADL) and mobility recovery of hospitalized elderly patients with heart failure (HF). Methods and results From among 377 consecutive HF patients who underwent rehabilitation at one acute‐care hospital from January 2013 to August 2015, those who were aged ≥ 65 years could walk with assistance before hospitalization and who were hospitalized for the first time were included in this retrospective cohort study. Exclusion criteria were pacemaker surgery during hospitalization, change to other departments, death during hospitalization, and unmeasured ADL. We investigated patient characteristics, basic attributes, Geriatric Nutritional Risk Index (GNRI), ADL [motor Functional Independence Measure (motor FIM)], and Rivermead Mobility Index (RMI). Of these 377 patients, 96 met the inclusion criteria and were divided into the low GNRI group (n = 38, 83.5 ± 8.3 years, 44.7% male) and high GNRI group (n = 58, 81.0 ± 6.6 years, 55.2%). Patient characteristics and the difference between motor ADL and motility recovery and nutrition data were analysed with unpaired t‐test, χ 2 test, and two‐way analysis of covariance. In comparing the two groups, the following parameters were significantly lower in the low GNRI group than in the high GNRI group: body mass index (18.7 ± 2.2 vs. 23.2 ± 2.7 kg/m2, P

Objective The aim of this study was to investigate the associations between dietary patterns and abdominal obesity among middle-aged and elderly Japanese people, using both waist circumference (WC) and visceral fat (VF) as indices. Methods A cross-sectional study was conducted with 829 adults (534 men and 295 women), 40 to 79 y of age, who participated in the Waseda Alumni's Sports, Exercise, Daily Activity, Sedentariness and Health Study (WASEDA'S Health Study). Dietary patterns were derived from principal component analysis. VF was measured using magnetic resonance imaging. To examine the associations of each dietary pattern with WC and VF, we calculated multivariate-adjusted means and 95% confidence intervals (CIs) of WC and VF for the tertile of each dietary pattern score. Results Two main dietary patterns were identified: “healthy Japanese” and “seafood and alcohol.” The healthy Japanese dietary pattern score was inversely associated with WC and VF in men only. WC measurements were 84.9 cm (95% CI, 83.7–86.1), 83.9 cm (95% CI, 82.7–85.1), and 82.4 cm (95% CI, 81.2–83.6); P trend = 0.006, and VF measurements were 94.0 cm 2 (95% CI, 85.6–102.4), 89.4 cm 2 (95% CI, 81.1–97.7), and 80.4 cm 2 (95% CI, 72.5–88.4); P trend = 0.027 for the lowest through the highest tertile of healthy Japanese dietary pattern scores in men. The seafood and alcohol dietary pattern was not associated with WC and VF. Conclusion The healthy Japanese dietary pattern was negatively associated with WC and VF in middle-aged and elderly Japanese men.

Excessive sedentary behavior may contribute to the pathogenesis of chronic kidney disease (CKD). The nephron index is a novel methodology for non-invasively estimating the number of functional nephrons, under the assumption that serum fibroblast growth factor 23 (FGF23) concentrations should correlate with phosphate excretion per nephron. The purpose of this study was to investigate the cross-sectional associations between daily sedentary time and the nephron index in middle-aged and older adults with or without CKD.The daily time spent in sedentary behavior was assessed using a tri-axial accelerometer in 294 participants (182 non-CKD adults and 112 CKD patients). The nephron index value was calculated by measuring blood and spot urine phosphate and creatinine, together with serum FGF23 concentrations and estimated glomerular filtration rate.We observed that advancing age and CKD were associated with a progressive decrease in the nephron index value. Additionally, CKD patients with more sedentary time also had a greater nephron index decrease compared to those with less sedentary time (P 0.05). Multiple linear regression analysis confirmed the independent association between sedentary time and the nephron index after adjusting for age, sex, presence of CKD, overweight/obesity, medication use, and total wear time (β = -0.13, P = 0.035).These cross-sectional findings suggest that age- or CKD-related decreases in the estimated nephron number (that is, the nephron index) may be accelerated by increased sedentary behavior.

Background - Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coronavirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers&rsquo, domain-specific sedentary and active behaviours. Methods - We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p &lt, 0.001 and p &lt, 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p &lt, 0.001 and b = 0.23, 95% CI 0.11, 0.36, p &lt, 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = &minus, 0.04, 95% CI &minus, 0.06, -0.01, p &lt, 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b=&minus, 0.06, 95% CI &minus, 0.10, &minus, 0.02, p &lt, 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers&rsquo, sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers&rsquo, sedentary behaviours and physical activity.

usc Background: Daily step count is the simplest measure of physical activity. However, little is known about how daily step count related to time spent in different intensities of physical activity (PA) and sedentary behavior (SB). Methods: These cross-sectional data were derived from 450 older Japanese adults (56.7% men; mean age, 74.3 years) who were randomly selected from three communities and responded a survey. Daily step count and time spent in moderate-to-vigorous PA (MVPA), light-intensity PA (LPA), and SB were measured using a validated wearable technology (HJA-350IT). Associations of daily step count with time spent in measured behaviors were examined using linear regression models with isometric log-ratio transformations of time-use composition, adjusting for gender, age, and residential area. Results: Participants averaged 5,412 (standard deviation, 2,878) steps/d and accumulated MVPA, LPA, and SB corresponding to 4.0%, 34.8%, and 61.2% of daily waking time, respectively. Daily step count significantly increased with increase in time spent in MVPA relative to other behaviors (ie, LPA and SB) and in the ratio of LPA to SB after allowing for MVPA. After stratification, daily step count was significantly related to the ratio of LPA to SB in those taking

Previous studies have not investigated the determinants of resting oxidative stress, including physical fitness, as it relates to redox regulation. The present study therefore was aimed at identifying lifestyle and biological factors that determine resting oxidative stress, including objectively measured physical fitness. In 873 middle-aged and elderly men and women, age and anthropometric parameters, lifestyle-related parameters, medication and supplementation status, physical fitness, biochemical parameters, and nutritional intake status, as well as three plasma oxidative stress markers: protein carbonyl (PC), F2-isoprostane (F2-IsoP), and thiobarbituric acid reactive substances (TBARS), were surveyed and measured. The determinants of PC, F2-IsoP, and TBARS in all participants were investigated using stepwise multiple regression analysis. In PC, age ( β = − 0.11 , P = 0.002 ), leg extension power ( β = − 0.12 , P = 0.008 ), BMI ( β = 0.12 , P = 0.004 ), and HDL-C ( β = 0.08 , P = 0.040 ) were included in the regression model (adjusted R 2 = 0.018 ). In the F2-IsoP, smoking status ( β = 0.07 , P = 0.060 ), BMI ( β = 0.07 , P = 0.054 ), and HbA1c ( β = − 0.06 , P = 0.089 ) were included in the regression model (adjusted R 2 = 0.006 ). In TBARS, glucose ( β = 0.18 , P < 0.001 ), CRF ( β = 0.16 , P < 0.001 ), age ( β = 0.15 , P < 0.001 ), TG ( β = 0.11 , P = 0.001 ), antioxidant supplementation ( β = 0.10 , P = 0.002 ), and HbA1c ( β = − 0.13 , P = 0.004 ) were included in the regression model (adjusted R 2 = 0.071 ). In conclusion, the present study showed that age, anthropometric index, lifestyle-related parameters, medication and supplementation status, objectively measured physical fitness, biochemical parameters, and nutritional intake status explain less than 10% of oxidative stress at rest.

Background There are spatial disparities in cardiovascular disease ( CVD ) mortality related to area‐level socioeconomic status ( SES ) disadvantage, but little is known about the spatial distribution of CVD mortality according to built environment factors. We examined joint associations of neighborhood walkability attributes and SES with CVD mortality rates through linkage of Japanese national data sets. Methods and Results National data were used from the 1824 municipalities (of the 1880 potentially eligible municipalities) across Japan. The outcome was mortality from CVD for a 5‐year period (2008–2012) for each municipality. A national index of neighborhood deprivation was used as an indicator of municipality‐level SES . A national walkability index (based on population density, road density, and access to commercial areas) was calculated. Compared with higher SES municipalities, relative rates for CVD mortality were significantly higher in medium SES municipalities (relative rate, 1.05; 95% CI, 1.02–1.07) and in lower SES municipalities (relative rate, 1.09; 95% CI, 1.07–1.12). There were walkability‐related gradients in CVD mortality within the high and medium SES areas, in which lower walkability was associated with higher rates of mortality; however, walkability‐related CVD mortality gradients were not apparent in lower SES municipalities. Conclusions CVD mortality rates varied not only by area‐level SES but also by walkability. Those living in areas of lower walkability were at higher risk of CVD mortality, even if the areas have a higher SES . Our findings provide a novel element of the evidence base needed to inform better allocation of services and resources for CVD prevention.

Objective Insufficient physical activity and excessive sedentary behavior can contribute to decreased skeletal muscle strength, which is strongly associated with increased mortality in patients with chronic kidney disease (CKD). However, the potential impact of replacing sedentary behavior with physical activity on skeletal muscle strength remains unclear in these individuals. The purpose of this study was to examine the associations of physical activity, sedentary behavior, and skeletal muscle strength in patients with CKD using an isotemporal substitution model to estimate the associations on replacing time from one behavior to another while keeping the total time and other behaviors fixed. Methods A total of 108 patients with CKD (mean age = 65 [SD = 9] y; mean estimated glomerular filtration rate = 57 [SD = 22] mL/min/1.73 m2) participated in this cross-sectional analysis study. The time spent in sedentary behavior, light-intensity physical activity, and moderate- to vigorous-intensity physical activity (MVPA) was assessed using a triaxial accelerometer. Handgrip strength, isometric knee extension strength, and 30-second chair stand test were used to measure skeletal muscle strength. Results In multivariate analyses (single-factor and partition models), the time spent in MVPA was beneficially associated with both isometric knee extension strength and 30-second chair stand test. Furthermore, the isotemporal substitution model found that replacing 10 min/d of sedentary behavior or light-intensity physical activity with equivalent MVPA time was beneficially associated with both isometric knee extension strength and 30-second chair standtest. Conclusion These cross-sectional findings indicate that MVPA time is beneficially associated with lower extremity muscle strength and that a slight increase in the MVPA time may contribute to maintaining skeletal muscle strength in patients with CKD. Impact Increasing the time spent in MVPA (10 min/d) may be a feasible strategy in patients with CKD who have a high prevalence of impaired physical function.

Evidence suggests a positive effect of dog ownership on physical activity. However, most previous studies used self-reported physical activity measures. Additionally, it is unknown whether owning a dog is associated with adults’ sedentary behaviour, an emerging health risk factor. In this study, physical activity and sedentary behaviour were objectively collected between 2013 and 2015 from 693 residents (aged 40–64 years) living in Japan using accelerometer devices. Multivariable linear regression models were used, adjusted for several covariates. The means of total sedentary time and the number of long (≥ 30 min) sedentary bouts were 26.29 min/day (95% CI − 47.85, − 4.72) and 0.41 times/day (95% CI − 0.72, − 0.10) lower for those who owned a dog compared to those not owning a dog, respectively. Compared with non-owners, dog-owners had significantly higher means of the number of sedentary breaks (95% CI 0.14, 1.22), and light-intensity physical activity (95% CI 1.31, 37.51). No significant differences in duration of long (≥ 30 min) sedentary bouts, moderate, vigorous, and moderate-to-vigorous-intensity physical activity were observed between dog-owners and non-owners. A novel finding of this study is that owning a dog was associated with several types of adults’ sedentary behaviours but not medium-to-high-intensity physical activities. These findings provide new insights for dog-based behavioural health interventions on the benefits of dog ownership for reducing sedentary behaviour.

[Purpose] The purpose of this study was to identify the factors influencing change in life-space mobility after total knee arthroplasty (TKA) in patients with severe knee osteoarthritis (knee OA). [Participants and Methods] Overall, 58 primary unilateral TKA recipients (9 males and 49 females; age ± SD 74.6 ± 6.5 years) were enrolled. We evaluated Life-Space Assessment (LSA) scores, knee extensor strength, Timed Up and Go test (TUG), one-leg standing time (OLS), Western Ontario and McMaster Universities osteoarthritis Index, and physical activity self-efficacy (SE) before surgery and at 3 months post-operation. [Results] Life space mobility significantly expanded 3 months after surgery compared with preoperative baseline. Preoperatively, walking SE and knee extensor muscle strength on the operative side were found to have strong correlation with LSA scores, while stairs SE and knee extensor muscle strength of the operative side were correlated at 3 months post-operation. [Conclusion] These findings suggest that to expand the life-space mobility of TKA recipients, it is important to enhance self-efficacy for general physical activity in addition to strengthening the quadriceps muscles.

[Purpose] The purpose of this study was to identify which physical attribute could influence each outcome in the Stand-up test and the Two-step test and the degree of their involvement. [Participants and Methods] The participants were 2,476 people (1,674 males and 802 females), who underwent a two-day health checkup and were requested to take the Locomotive Syndrome Risk Test (Locomo Test). Participants were divided into groups under the Locomo level based on the result of Locomo Test by gender. Furthermore, the relationship between each physical attributes (quartile) based on the result of Locomo Test and the Locomo level was evaluated. [Results] According to the relationship between each physical attributes and Locomo level 1 in the Stand-up test, height showed a positive relationship and the multivariable adjusted odds ratio significantly increased with taller height in both genders. Body weight and BMI showed a negative relationship, although rather weak positive relationship, it was identified in waist circumference. On the other hand, there was no clear correlation between each physical attribute and Locomo level 1 in the Two-step test. [Conclusion] The findings indicate The Stand-up test would overestimate the decline of locomotor function in taller people and would underestimate it in shorter individuals.

Background: The purpose of the present study was to clarify the differences in social demographic factors and sedentary behavior by gender in Japanese living overseas in Malaysia. Methods: First, 130 subjects were surveyed by self-entry questionnaire for statistical factors related to social demographics and sedentary behavior. These factors were age (years), gender (man/woman), body mass index (BMI, kg/m2), educational history (>13 years, %), employment (full-time or part-time, yes, %), alcohol intake (a certain amount, yes, %), smoking behavior (yes, %), and marital status (yes, %). BMI, as obtained from the participants’ weight and height, was collected from the self-reported questionnaire and assessed. Sitting behavior time as an index of sedentary behavior on workdays, non-workdays, and total time was identified by questionnaire. Data were analyzed using the chi square-test and t-test, respectively. The criterion for a statistically significant difference was p < 0.05. Results: Finally, 107 subjects (68 men, 39 women) were analyzed. The ratios of social demographic factors of the men versus women group were age (58.5 ± 14.7 vs. 61.0 ± 12.1 years, p = 0.36), BMI (23.1 ± 2.6 vs. 21.8 ± 2.6 kg/m2, p = 0.01), educational history (86.7% vs. 56.4%, p < 0.001), employment (51.5% vs. 10.3%, p Conclusion: These findings indicated that social demographic factors and sitting behavior time differed by gender. However, there are some limitations. This was a cross-sectional study conducted in only one city with a small number of participants who completed a self-entry questionnaire. In conclusion, assessment of the differences in social demographic factors and postponement of sedentary behavior for both genders may reduce sitting behavior time in overseas Japanese residents and may help in developing public health strategies.

Walk Score® is a free publicly-available tool that evaluates how a particular location is supportive of residents' walking, based on the distance to various local destinations. Several studies have shown associations of Walk Score with walking behaviors. However, these studies have been conducted only in Western countries, such as the U.S.A., Australia, Canada, and France. In addition, the role of Walk Score in sedentary behaviors has not yet been explored. The current study examined associations of Walk Score with physically-active and sedentary behaviors in Japan. This study used cross-sectional survey data from the Healthy Built Environment in Japan (HEBEJ) project. In 2011, adults living in urban and rural areas in Japan (n = 1072) reported their walking and sedentary behaviors. Participants reported their walking in the past week for three specific purposes: for commuting; for errands; and for exercise. They also reported two sedentary behaviors in the past week: TV viewing and car driving. Walk Score was obtained manually for each participant's residential address. Logistic regression models (adjusted for covariates) were used to examine the associations of Walk Score with specific walking and sedentary behaviors. There were significant positive associations of Walk Score with two types of walking and car driving. Each 10-point increment in Walk Score (range: 0–97) was associated with a 34% (95%CI: 1.25, 1.42) higher odds of any walking for commuting; a 6% (95%CI: 1.01, 1.11) higher odds of any walking for errands; a 36% (95%CI: 1.23, 1.50) higher odds of sufficient walking for commuting; and, a 10% (95%CI: 0.83, 0.97) lower odds of driving a car for more than one hour per day. This study found for the first time that Walk Score was related to travel behaviors in a non-Western country. Walk Score can be useful to transport and urban designers in identifying local areas that support (or do not support) residents' active travel, and can help to inform broader environmental and urban design policy initiatives to promote active living.

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. 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 objectivelymeasured sedentary timeusing 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. 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). 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

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan. Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017). Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density (r = 0.82) and with the number of local destinations (r = 0.77). Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data., Highlights • Walk Score was positively associated with access to local destinations. • It was also associated with other walkable attributes such as intersection density. • Walk Score appears to be a valid measure of walkability in Japan.

Background and aims Physical activity (PA) levels are related to mortality and morbidity in patients with chronic heart failure (CHF). Health utility (HU), a very important cost-effectiveness analysis for health care and health status, is measured by several preference-based utility measures. This study aimed to evaluate the relation between PA and HU and the effect of disease severity on PA and HU in patients with CHF. Methods We enrolled 226 consecutive outpatients with CHF (mean age, 57.5years; males, 79.6%) in this retrospective cross-sectional study. Patients were divided into three groups by NYHA class for classification of disease severity. Patient characteristics, average step count in steps/day, PA energy expenditure (PAEE) in kcal/day for 7days as assessed by accelerometer, and HU assessed by Short Form-6D were compared between the groups. Results Average step count (r=0.37, P

Background Neighborhood environmental attributes can promote walking behavior among older adults. Nevertheless, these walkability attributes may affect walking behavior differently depending on the time of the day. This study examined the association between neighborhood environmental attributes and average step counts at different times of the day. Methods We included 122 older adults (aged ≥ 60 years, mean age: 70.0 years) from Taiwan in this study. Neighborhood environmental attributes were estimated using a geographic information system. An accelerometer was used to calculate their daily step counts during three time periods: morning (6:00 to 12:00), afternoon (12:01 to 18:00), and night (18:01 to 24:00). In this cross-sectional study, we performed multiple linear regression after adjustment for potential covariates to examine the correlation of five walkability attributes, namely residential density, street connectivity, sidewalk availability, destination accessibility, and public transportation accessibility, with total step counts during different time periods. Results Sidewalk availability, destination accessibility, and public transportation accessibility demonstrated a positive association with older adults' step counts during morning. No association was found between any neighborhood environment attribute and older adults’ total step count during afternoon and night. Conclusions Neighborhoods with high sidewalk availability, access to destinations, and public transportation accessibility may encourage older adults' walking behavior during morning. Future research applying longitudinal methods is required to understand how the time of the day affects environment's role in supporting walking behavior.

Highlights • Japanese adults spent on average 5.3 h each day sedentary. • Compared to other countries, more adults were found to be highly sedentary in Japan. • High sedentary time was associated with several sociodemographic characteristics., Sedentary behaviour is associated with risks of detrimental health outcomes. It is crucial to understand how much time people spend in sedentary behaviour and what factors affect too much sedentary time for effective intervention. However, few studies examined the prevalence and the correlates of sedentary behaviour in Japan. Therefore, we assessed total sedentary time and its sociodemographic correlates using a nationally representative sample of adults in Japan. Cross-sectional data from Sports-Life Survey in 2016 and 2018 conducted by Sasagawa Sports Foundation was used. Participants’ sociodemographic factors and total sedentary time were collected by questionnaires. We classified those with

Backgrounds The purpose of this study was to examine, in a sample of Japanese older adults, the associations of objectively-assessed sedentary behavior (SB) and physical activity (PA) with performance-based physical function. The isotemporal substitution (IS) approach was used to model simultaneously the effects of the specific activity being performed and the activity being displaced, in an equal time-exchange manner. Methods Among 287 older adults (65–84 years), we used accelerometers to identify the daily average time spent on SB (≤1.5 METs); light-intensity PA (LIPA) (>1.5 to

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. 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.

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

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.

Promoting active travel is a key strategy for enhancing population health. This commentary argues that new urban mobility, which involves shared and integrated modes of transport, can work as a catalyst to transform the built environments by enticing people to live in urban areas where such services are available and convenient.

Background: Both physical inactivity and sedentary behavior (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavior change (e.g., replacing sedentary behavior with physical activity) on renal function are not fully understood. We used isotemporal substitution to model potential impacts on renal function of replacing time from one behavior to another in middle-aged and older adults. Methods: For 174 Japanese adults (aged 50 – 83 years; 76 % women), the time spent in sedentary behavior, light-intensity physical activity (LPA), and moderate to vigorous-intensity physical activity (MVPA) were assessed using uniaxial accelerometers. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels. Results: In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behavior ( r s = – 0.229), LPA ( r s = 0.265) and with MVPA ( r s = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behavior with equivalent LPA time was not significantly associated with eGFR ( β = 2.25, p = 0.111); however, replacement with the same amount of MVPA was beneficially associated with eGFR ( β = 5.51, p < 0.05). Conclusions: These cross-sectional findings suggest that both sedentary behavior (detrimentally) and physical activity (beneficially) may be contributors to maintaining renal function and that replacing sedentary behavior with MVPA may benefit renal health in middle-aged and older adults.

This study examined the relationship between a healthy Japanese dietary pattern and micronutrient intake adequacy based on the Dietary Reference Intakes for Japanese 2015 (DRIs-J 2015) in men and women. A cross-sectional study was conducted in 1418 men and 795 women aged 40&ndash, 87 years, who participated in the Waseda Alumni&rsquo, s Sports, Exercise, Daily Activity, Sedentariness, and Health Study. Dietary patterns were derived from principal component analysis of the consumption of 52 food and beverage items, which were assessed by a validated brief-type self-administered diet history questionnaire. Micronutrient intakes were quantified using the dietary reference intakes score (DRIs-score) for 21 micronutrients (based on DRIs-J 2015). The healthy dietary pattern score was significantly and positively correlated with the intakes of all 21 micronutrients used for constructing the DRIs-score in men and in women (each, p &lt, 0.001). In both sexes, the healthy dietary pattern scores were strongly and positively associated with DRIs-scores (in men: &rho, = 0.806, p &lt, 0.001, in women: &rho, = 0.868, p &lt, 0.001), and the DRIs-scores reached a plateau around the highest tertile of the healthy dietary pattern score. These results indicate that a healthy Japanese dietary pattern is associated with adequate micronutrient intakes based on the DRIs-J 2015 in both men and women.

Background Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers. Methods Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors. Results A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, “typically seeing work colleagues take sedentary breaks” was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = −7.08 [−13.75 to −0.40]). “I am motivated to take sedentary breaks” had an unfavorable association with less sedentary breaks (B [95% CI] = −1.36 [−2.61 to −0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, “Too stressed to take sedentary breaks” was significantly associated with less sedentary breaks (B [95% CI] = −5.6 [−9.17 to −2.02]). Conclusions Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

Different models of accelerometer have the potential to provide a different estimate of the same physical activity or sedentary behavior. Our study compared the outputs of the Active Style Pro (ASP) and ActiGraph (AG) devices in assessing predicted metabolic equivalents (METs) for specific activities under laboratory conditions. Thirty healthy young adults wore two hip accelerometers (ASP and AG), simultaneously while performing twenty-two activities (eight sedentary, eight household, and six ambulatory activities) in a controlled laboratory setting. For the AG, predicted METs for each activity was calculated using four equations based on vertical-axis and vector magnitude data. Separate paired t-tests and Bland&ndash, Altman analysis examined the difference and agreement in METs between AG using four commonly used equations and ASP measurements for each activity. AG devices using different equations calculated significantly different outcomes for most activities compared with ASP devices. The smallest differences in predicted METs estimates between ASP and AG were observed for ambulatory activities. Ambulatory activities demonstrated the best agreement between ASP and AG regardless of which AG equation was used. Our findings can be used to assist researchers in their selection of accelerometer and output estimation equations for measuring physical activity and sedentary behavior in adults.

Background. Comparability of accelerometers in epidemiological studies is important for public health researchers. This study aimed to compare physical activity (light, LPA, moderate, MPA, and moderate-to-vigorous, MVPA) and sedentary behavior (SB) data collected using two Omron triaxial accelerometer generations (Active style Pro, ASP) among a sample of Japanese workers in a free-living environment. Methods. Thirty active and sedentary workers (24&ndash, 62 years) wore two types of ASP accelerometers, the HJA-350IT (350IT) and the HJA-750C (750C), simultaneously for seven consecutive days to represent a typical week. The accelerometers estimated daily average step counts and time spent per day in LPA, MPA, and MVPA. If a participant had data for &ge, 4 days (&gt, 10 h/day) it was considered valid. The difference and agreement between the two ASPs were analyzed using a paired t-test, intra-class correlation coefficients (ICC), and a Bland&ndash, Altman analysis in total and for each type of worker. Results. Among all workers, the 750C measured significantly (p &lt, 0.05) less SB, MPA, MVPA, and more LPA compared with the 350IT. The agreements in ICC were high (ICC &ge, 0.94). Conclusions. Compared with the 350IT, the newer generation 750C ASP accelerometer may not provide equivalent estimates of activity time, regardless of the type of physical activity.

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes&mdash, dwelling density, street connectivity, and neighbourhood destination accessibility&mdash, using seven different neighbourhood definitions (three administrative unit boundaries, and 500, 800, 1000- and 1500-m road network buffers). The associations between the three built environment measures and five measures of physical activity (mean accelerometer counts per hour, percentage time in moderate&ndash, vigorous physical activity, self-reported walking for transport, self-reported walking for recreation and self-reported walking for all purposes) were modelled for each neighbourhood definition. The combination of the choice of neighbourhood definition, built environment measure, and physical activity measure determined whether evidence of an association was detected or not. Results demonstrated that, while there was no single ideal neighbourhood definition, the built environment was most consistently associated with a range of physical activity measures when the 800-m and 1000-m road network buffers were used. For the street connectivity and destination accessibility measures, associations with physical activity were less likely to be detected at smaller scales (less than 800 m). In line with some previous research, this study demonstrated that the choice of neighbourhood definition can influence whether or not an association between the built environment and adults&rsquo, physical activity is detected or not. This study additionally highlighted the importance of the choice of built environment attribute and physical activity measures. While we identified the 800-m and 1000-m road network buffers as the neighbourhood definitions most consistently associated with a range of physical activity measures, it is important that researchers carefully consider the most appropriate type of neighbourhood definition and scale for the particular aim and participants, especially at smaller scales.

Deterioration of daily activities increases frailty risk. Most of the previous research has examined the association between frailty and specific activities; nevertheless, the diversity of daily activities is also important. Although the type, frequency, and evenness of daily activities have been proposed as indicators of activity diversity, the association between these indicators and frailty remains unclear. In this study, we examined the association between activity diversity and frailty in community-dwelling older adults.This cross-sectional study comprised 658 community-dwelling older adults aged ≥ 65 years who participated in comprehensive health check-ups in 2018. Frailty was defined using the Japanese version of the Cardiovascular Health Study criteria. Three indicators, type, frequency, and evenness of daily activities, were used to assess activity diversity across one week. Multiple logistic regression analyses were performed, with frailty as the dependent variable and the three activity diversity indicators as independent variables. Socio-demographic, physical, and mental functioning factors were adjusted as covariates.Of the 658 participants (median age: 72 years; age range: 65-91 years; 60.5% women), 27 (4.1%) met the criteria for frailty. The frail group had significantly lower scores for type, frequency, and evenness of daily activities, as well as Mini-Mental State Examination scores (all at p0.01). We found significant independent associations in all activity diversity indicators with frailty, in multiple logistic models.Activity diversity is independently associated with frailty in community-dwelling older adults.

Background Sedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue. Objective This study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue. Methods Data from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue. Results Increases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P Conclusions Our findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers’ fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

Aim The present study examined the effects of individual pain coping-skills training (PCST) on knee pain, pain coping strategies, physical functions, and daily physical activity among older outpatients with osteoarthritis. Methods Twenty-five older adults who suffered from knee pain and had been diagnosed to have knee osteoarthritis (men: n=4; 75.4±6.3 years) were assigned to either a PCST group (n=13) or a general health education group (n=12) according to their wishes. Both groups attended 20-minutes sessions once a week for 8 weeks. At the baseline, the basic attributes (e.g. gender, age, duration of knee pain, and medical history), BMI, and the severity of knee osteoarthritis were obtained. Additionally, knee pain and limitations in mobility, pain coping strategies, pain self-efficacy, exercise self-efficacy, lower muscle strength, mobility, accelerometer -based time spent in physical activity and sedentary behavior were assessed before and after the 8-week intervention period. Analyses were performed using an intention-to-treat principle. Differences in each variable between the groups were examined using an analysis of covariance. Each participant's baseline value was used as the covariate. Results Even after controlling for the baseline attributes and values, only the PCST group exhibited a significant improvement in pain self-efficacy (p=0.005), exercise self-efficacy (p=0.042), lower muscle strength (p=0.004) and mobility (p=0.027). Furthermore, the PCST showed a significant increase in moderate-to vigorous-intensity physical activity (p=0.052) and a decrease in medical behaviors as one of pain coping strategies (p=0.073). Conclusion The present study showed that PCST therefore appears to be a feasible and effective therapeutic strategy which improves self-efficacy for controlling knee pain, which may also result in increasing the self-efficacy for exercise, physical functions, and daily physical activities.

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 ≥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±16.18kcal, 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 3551.80steps/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 85.17kcal/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.

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.

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 prior to 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), 2004–05 (Wave 2), and 2011–12 (Wave 3). The study sample consisted of adults aged 25 to 74 years at baseline who also attended site measurement at three time points (n=3261). Multilevel linear regression analysis examined associations of initial five-year changes in MVPA and TV viewing time (from baseline to Wave 2) with 12-year 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< 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 to those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2cm 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. Refereed/Peer-reviewed

As people age, they spend more time in and around their domestic environments, within which opportunities for health-enhancing physical activity (PA) may be limited. We examined the associations of frequency of excursions from home with accelerometer-determined PA and the total and prolonged sedentary behavior (SB, sitting for ≥30 min) among community-dwelling older adults.Overall, 434 older adults (men, 57.1 %; age, 70-79 years) wore an accelerometer (HJA-350IT, Omron Healthcare) for 7 days. Time spent in SB, light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and prolonged SB bout (≥30 min) were calculated. Frequencies of excursions from home were categorized as 0-3, 4-5, and 6-7 days/week. Associations of excursions with PA and SB were tested by analysis of covariance adjusted for sociodemographic characteristics.Frequencies were 14.3 %, 31.1 %, and 54.6 % for excursions 0-3, 4-5, and 6-7 days/week, respectively. For men, less frequent excursions from home were significantly associated with less MVPA and more total and prolonged SB times (estimated means [minutes/day]: MVPA, 32, 42, and 48; total SB, 589, 549, and 539; prolonged SB, 344, 288, and 265; respectively; p0.05). LPA was not statistically significant (p = 0.09). For women, less frequent excursions were significantly associated with all PA outcomes (SB: 536, 497, and 467; prolonged SB: 260, 213, and 204; LPA: 328, 363, and 379; MVPA: 36, 39, and 54, respectively).Among community-dwelling Japanese older adults, more frequent excursions from home were associated with more PA, less SB, and more-favorable SB patterns, suggesting a potential strategy for preventive-health initiatives.