日足P&Fの状況：（07月07日）～（07月11日）

This study aimed to determine the relation between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) and maximum phonation time (MPT), and the MPT required to attain a threshold value for VE/VCO2 slope of ≤34 in chronic heart failure (CHF) patients. This cross-sectional study enrolled 115 CHF patients (mean age, 54.5 years men, 84.9%). VE/VCO2 slope was assessed during cardiopulmonary exercise testing (CPX). Thereafter, patients were divided into 2 groups according to exercise capacity: VE/VCO2 slope ≤34 (VE/VCO2 ≤34 group, n = 81) and VE/VCO2 slope >34 (VE/VCO2 >34 group, n = 34). For MPT measurements, all patients produced a sustained vowel/a:/ for as long as possible during respiratory effort from the seated position. All subjects showed significant negative correlation between VE/VCO2 slope and MPT (r = -0.51, P < 0.001). After adjustment for clinical characteristics, MPT was significantly higher in the VE/VCO2 ≤34 group vs VE/VCO2 >34 group (21.4 ± 6.4 vs 17.4 ± 4.3 s, F = 7.4, P = 0.007). The appropriate MPT cut-off value for identifying a VE/VCO2 slope ≤34 was 18.12 seconds. An MPT value of 18.12 seconds may be a useful target value for identifying CHF patients with a VE/VCO2 slope ≤34 and for risk management in these patients.

Background: There has been a growing interest in environmental initiatives to reduce sedentary behaviour. A few existing studies on this topic are mostly cross-sectional, focused on the general adult population, and examining neighbourhood walkability. This study examined associations of perceived environmental attributes with change in TV viewing time over seven years among older Australian adults in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.Methods: The AusDiab study is a population-based study on diabetes and its risk factors in adults. We used the data on 1072 older adults (60+ years at baseline) collected in 2004-05 (baseline) and in 2011-12 (follow-up; 45.4% men, mean age 67.5 years). Generalized linear modelling examined associations with 7 years change in TV viewing time of nine perceived neighbourhood-environment attributes relating to local shops, alternative routes, footpaths, parks, attractiveness, natural features, bicycle/walkway tracks, local traffic, and safety.Results: On average, participants increased their TV viewing time from 127 min/day to 137 min/day over the 7 years period. Adjusted for baseline TV viewing levels, TV viewing time at follow-up was 8% lower (95%CI: 0.85, 0.99) among those who did not perceive local traffic as a deterrent compared to those who perceived traffic as a deterrent. A trend for significant interaction between working status and the presence of a parks nearby indicated that, for those who were not working, those who reported having parks nearby had a marginal association with lower TV viewing time at follow-up than those who did not (p = 0.048).Conclusions: Overall TV viewing time increased on average by 10 minutes/day over 7 years among older Australian adults. Local traffic that makes walking difficult or unpleasant may increase older adults' leisure-time sedentary behaviours such as TV viewing, possibly by deterring outdoor activities.

【はじめに、目的】 健康関連QOL(HRQOL)を向上させる因子の一つとして、身体活動セルフ・エフィカシー(SE)が注目されている。SEとはBanduraによると「ある結果を生み出すために必要な行動をどの程度うまく行うことができるかという個人の確信」と定義されている。特に運動や身体活動に関するSEは、身体活動や行動変容や運動の継続、更にはHRQOLに関係するとされている。しかしながら人工膝関節全置換術(TKA)患者に対して、身体活動SEが身体機能およびHRQOLに及ぼす影響について明らかにされていない。本研究の目的はTKA後のリハ介入における身体機能、HRQOLおよび身体活動SEの回復過程とその関連性について明らかにすることである。【方法】 対象は2010年10月から2011年7月までに当院でTKAを施行した変形性膝関節症患者44例48膝とした。手術時年齢は73.2±7.7歳、BMI26.1±3.5 kg/m2，術後在院日数25.2±5.3日、術後リハは当院プロトコールに準じて術後3ヶ月間外来リハを実施した。身体機能評価としてTimed Up and Go test(TUG)、開眼片脚起立時間、膝伸展筋力を測定した。HRQOLの評価指標としてSF-36の下位8尺度である身体機能(PF)、日常役割機能－身体(RP)、体の痛み(BP)、全体的健康感(GH)、活力(VT)、社会生活機能(SF)、日常役割機能－精神(RE)、心の健康(MH)と身体的サマリースコア(PCS)と精神的サマリースコア(MCS)を用いた。身体活動SEは虚弱高齢者の身体活動SE尺度（歩行、階段、重量物）とその総合得点を用いた。評価は術前、術後1ヶ月(退院時)と3ヶ月(外来通院時)とした。統計解析は回復過程を一元配置分散分析とBonferroni多重比較、身体機能およびHRQOLと身体活動SEとの関連性に関しては各変化量をpearsonの相関係数を用い、有意水準は5%未満とした。【倫理的配慮、説明と同意】 本研究は当院生命倫理委員会の承認(0826)を受け、対象者に研究内容の説明文書を用いて口頭による説明を行い、研究参加への同意を得て実施した。【結果】 各項目は術前(T1)→術後1ヶ月(T2)→術後3ヶ月(T3)の順に平均値±標準偏差で示した。TUGは11.8±3.8→11.7±3.8→10.5±3.3秒となりT1とT3，T2とT3で有意に改善した。開眼片脚起立時間は13.3±19.3→20.8±26.1→23.2±31.8秒となりT1とT3で有意に向上した。膝伸展筋力は0.5±0.2→0.5±0.1→0.6±0.1N・m／kgとなりT2とT3で有意に向上を認めた。SF-36の下位尺度のうち、PFは37.7±20.8→40.6±25.6→52.5±20.3点、BPは35.1±15.3→36.2±19.2→49.8±21.2点、SFは53.9±27.1→56.8±25.3→69.8±23.5点となりT1とT3，T2とT3で有意に改善を認めた。GHは48.8±13.6→53.5±14.5→54.1±16.5点となりT1とT3で有意に改善を示した。PCSは16.5±12.5→15.3±14.6→23.1±16.1点となりT1とT3，T2とT3で有意に改善した。身体活動SEのうち、歩行SEは12.4±5.0→14.9±6.4→15.9±5.3点、階段SEは8.9±5.2→10.4±5.2→12.5±5.1点、重量物SEは14.1±5.9→15.7±5.3→17.3±6.1点となりT1とT3で有意に向上した。身体活動SEの総合得点では35.4±12.5→41.1±13.1→45.6±12.8点となりT1とT2，T1とT3で有意に向上を認めた。身体活動SEの総合得点とHRQOLとの関連性はPF、RP、BP、RP、GH、REおよびPCSと有意な正の相関を示した(r＝0.307～0.508，p＜0.05)。身体活動SEの総合得点と身体機能の各項目とは有意な相関が見られなかった。【考察】 身体機能、HRQOLおよび身体活動SEは時間経過とともに有意に改善を示した。退院時では十分な改善が得られず、退院後もリハの継続が必要になると考える。身体機能と身体活動SEはHRQOLと関連性があり、身体機能とは関連性がないことが示唆された。HRQOLを向上させるためには、身体機能に加え、身体活動SEを高めるような方策を積極的にリハに組み入れていく必要があると考える。【理学療法学研究としての意義】 TKA後のリハは身体活動SEを高めるアプローチを加えることで、TKA患者のHRQOLを向上させることが可能になると考える。

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<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively). 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.

Background: Inconsistent associations of neighbourhood walkability with adults' body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices - conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods: Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003-2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires in 2007-2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results: The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p < 0.01). No significant associations were found between the overall neighbourhood walkability indices and weight change. Among walkability components, there was a marginally significant negative association between space syntax measure of street integration and weight change: one standard deviation increment in street integration was associated with 0.31 kg less weight gain (p = 0.09). Conclusions: Using a prospective study design and a novel space-syntax based measure of walkability, we were not able to identify relationships between neighbourhood walkability with weight gain. This is consistent with other inconclusive findings on the built environment and obesity. Research on the built environment and adults' weight gain may need to consider not just local environments but also a larger scale environment within a city or workplace environment in order to capture multiple behaviours relevant to weight gain.

BackgroundThere 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 ResultsNational 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.ConclusionsCVD 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.

Background: In addition to insufficient moderate-to-vigorous physical activity (MVPA), prolonged sitting time is also a health risk for older adults. An understanding of population subgroups who have prolonged television viewing (TV) time, a predominant sedentary behavior, can aid in the development of relevant health promotion initiatives; however, few such studies have focused on older adults, the most sedentary segment of the population as a whole. The aim of this study is to examine the socio-demographic attributes associated with TV time among community-dwelling Japanese older men and women.Methods: A population-based, cross-sectional mail survey was used to collect data on TV time, MVPA, and socio-demographic characteristics. The survey was conducted from February through March 2010. Participants were 2700 community-dwelling older adults (aged 65-74 years, 50% men) who were randomly selected from the registry of residential addresses of three cities in Japan. Data from 1665 participants (mean age: 69.5 years, 52% men) who completed all variables for the present study were analyzed. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of prolonged TV time (2 hours/day) for each socio-demographic attribute, stratified by gender.Results: Of the 1665 participants, 810 (48.6%) watched TV for more than 2 hours/day. The median television viewing time (25th, 75th percentile) was 2.00 (1.07, 3.50) hours/day. Prolonged TV time was associated with not in full-time employment, lower educational attainment, weight status, living in regional areas and low MVPA for the whole sample. For men, prolonged TV time was associated with lower educational attainment; (OR = 1.53, 95% CI: 1.12 2.07), underweight (OR = 1.63, 95% CI: 1.02-2.60), overweight (OR = 1.57, 95% CI: 1.11-2.21), and low MVPA (OR = 1.43, 95% CI: 1.02-2.02). For women, living in regional areas (OR = 2.02, 95% CI: 1.33-3.08), living alone (OR = 1.61, 95% CI: 1.03-2.49), not driving (OR = 1.79, 95% CI 1.21-2.65), overweight (OR = 1.50, 95% CI: 1.00-2.24), and low MVPA (OR = 1.51. 95% CI: 1.05-2.17) were associated with prolonged TV time.Conclusions: These findings identify particular socio-demographic and behavioral characteristics related to TV time among Japanese older adults. It should be noted that correlates of prolonged TV time differed by gender. Women in living situations with limited transportation options tended to spend prolonged time watching TV. Health promotion initiatives for older adults, particularly for older women, may be more effective if they take these attributes into account.

目的健康日本21の中間報告書では、身体活動•運動分野の重点課題の 1 つとして「エクササイズガイド2006の普及」が挙げられている。一方、肥後•中村（2008）によれば、エクササイズガイド2006の認知者の割合は、他の健康づくり施策よりも低いものの、エクササイズガイド2006認知者の方が歩行習慣者の割合が多いことが報告されている。本研究の目的は、エクササイズガイド2006の認知度の経時変化を検討することと、エクササイズガイド2006の認知と身体活動量との関連性を縦断的に検討することであった。
方法対象は、社会調査モニター1100人（39.8±SD10.1歳）であった。2007年11月（T1）、2008年12月（T2）の計 2 回、インターネットを用いた質問調査を縦断的に実施した。エクササイズガイド2006の認知度は、「内容を知っている」、「聞いたことはあるが内容は知らない」、「聞いたことがない•今回の調査で始めて知った」の 3 段階で評価した。週当たりの身体活動量（METs•時/週）は、IPAQ–SV（Craig et al., 2003；村瀬他、2002）を用いて推定した。Mann–Whitnney 検定を用いて、期間中にエクササイズガイド2006を認知した者と、認知しなかった者の身体活動量の変化量を比較した。
結果エクササイズガイド2006の内容を知っていた者の割合は、T1 で1.4%、T2 で2.2%であり、認知度の有意な経時変化は認められなかった。調査期間中にエクササイズガイド2006を知った者の方が、両時点とも知らなかった者と比較して、身体活動量が低下傾向にあった（P=0.013）。
結論1 年間で認知度は向上しておらず、我が国においてエクササイズガイド2006の普及は進んでいないことが示唆された。エクササイズガイド2006の戦略的な普及方策の検討が求められる。ただし、先行研究とは異なり、エクササイズガイド2006を認知することが、身体活動の促進に対して肯定的な影響を与える可能性は示されなかった。普及が進み、認知度が向上した段階で検討を行うことで、両者の関係がより明確となるだろう。

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.

本研究では、身体活動・運動実施の規定要因としての行動的スキルの利用を評価するために、運動に関する行動的スキル（EBS）尺度を作成した。そして運動行動の変容ステージとの関連を検討した。EBS尺度の項目は、運動の行動的プロセスや身体活動・運動介入で用いられている行動変容技法を参考にして準備した。対象地区に居住する20歳以上の1,078名に対して質問紙調査を実施し、有効回答者647名を分析の対象とした。探索的因子分析の結果、 5項目からなる1因子構造の尺度が作成された。計量心理学的分析の結果、EBS尺度が高い信頼性と妥当性を有することが示された。次にEBS得点と運動行動の変容ステージとの関連を検討した。分散分析の結果、EBS得点と変容ステージの間には有意な関連が認められた。前熟考期に属する者は他の全てのステージに属する者と比較して得点が低く、実行期、維持期に属する者は、熟考期、準備期に属する者よりも得点が高かった。結果は、運動に関する行動的スキルの利用が個人の変容ステージに影響されることを示している。以上のことから、運動に関する行動的スキルは身体活動・運動習慣の定着を目的とした介入において有益な情報をもたらすと考えられる。

Background: Physical activity levels in childhood have decreased, making the promotion of children's physical activity an important issue. The present study examined gender and grade differences in objectively measured sedentary behavior, physical activity, and physical activity guideline attainment among Japanese children and adolescents.Methods: In total, 329 boys and 362 girls age 3-15 years completed the survey. School grade, gender, height, and weight were collected by questionnaires and physical activity objectively measured using an accelerometer (Lifecorder Suzuken Co.). Physical activity level (in MET) was classified as sedentary (1.5), light (= 1.5 to 3), moderate (= 3 to 6), or vigorous (= 6). Continuous zero accelerometer counts for = 20 min were censored and a valid accelerometry study required at least 3 days (2 weekdays and 1 weekend day) with 600 min/day total wear time. Two-way analysis of covariance and logistic regression analyses, adjusted for weight status and accelerometer wear time, were used to examine gender and grade differences in physical activity variables and the likelihood of physical activity guideline attainment by gender and grade level.Results: Participants were sedentary 441.4 (SD, 140.1) min/day or 53.7 % of the average daily accelerometer wear time of 811.2 (118.7) min, engaged in light physical activity 307.1 (70.0) min or 38.4 % of wear time, moderate physical activity 34.6 (14.8) min (4.3 %), vigorous physical activity 28.3 (19.1) min (3.6 %), and took 12462.6 (4452.5) steps/day. Boys were more physically active and took more steps/day than girls. Students in higher grades were less active than those in lower grades. Boys were significantly more likely to meet physical activity guidelines than girls (OR: 2.07, 95 % CI: 1.45-2.96). Preschoolers (6.66, 4.01-11.06), lower-grade elementary school students (17.11, 8.80-33.27), and higher-grade elementary school students (7.49, 4.71-11.92) were more likely to meet guidelines than junior high school students.Conclusions: Boys and lower-grade students engaged in more physical activity and were more likely to attain guidelines than girls and higher-grade students. These findings highlight the need for effective and sustainable strategies to promote physical activity in Japanese school children.

目的：身体活動・運動実施による大腸がん予防効果への認知とそれに関連する要因を検討した。方法：インターネットによる横断調査を実施し、登録モニター1,964名（平均年齢44.7歳）を分析対象とした。調査項目は、身体活動・運動実施による大腸がん予防効果の認知、大腸がんに関する知識レベルの高低、身体活動・運動実施とがんに関する情報取得、および身体活動・運動実施状況、社会人口統計学的変数であった。解析は、認知を従属変数、その他すべての変数を独立変数として、ロジスティック回帰分析を行った。結果：分析対象者の47.5％が身体活動・運動実施による大腸がん予防効果を認知していた．60歳代（調整オッズ比、95％信頼区間：0.59，0.45-0.79）、教育歴が大学・大学院の者（1.32，1.05-1.66）、身体活動・運動実施とがんに関する情報取得者（2.07，1.71-2.51）、および身体活動・運動実施状況が推奨群の者（1.43，1.12-1.84）に、認知と有意な関連がみられた。結論：身体活動・運動実施による大腸がん予防効果の認知は約半数であり、十分でないことが示された。今後は全体の認知向上を図ると同時に、年齢層や教育歴に配慮した方策を検討していくことが必要である。

PURPOSE:Although a foot care program for long-term care prevention has been launched in Japan, few studies have examined its effectiveness. The purpose of the present investigation was to examine the association of foot problems with fall experience and fear of falling among Japanese community-dwelling elderly people.;METHODS:The participants were 10,581 community-dwelling elderly people (75.2 +/- 5.6 years) and the study design was cross-sectional using a questionnaire. Self-reported tinea pedis, skin problems (inflammation, swelling, or discoloration), nail problems (thickening or deformities), impairment (in function or blood flow), regular foot care, and wearing of appropriate shoes were selected as parameters of foot problems and their care. Logistic regression analysis was conducted to examine whether these were related to fall experience (in the past 1 year) and fear of falling adjusted for age, the Tokyo Metropolitan institute of gerontology index of competence, medical conditions, and lower limb functions.;RESULTS:Forty-six percents of males and 39.0% of females reported at least one foot problem. After adjusting for covariates, tinea pedis (male: adjusted odds ratio = 1.37[95% confidence interval= 1.15-1.63], female: 1.29[1.08-1.53]), skin problems (male: 1.66[1.32-2.101, female: 1.37[1.13-1.66]), nail problems (male: 1.72[1.45-2.051, female: 1.48[1.26-1.74]), and functional impairment (male: 2.42[1.91-3.05], female: 1.66[1.36-2.04]) were significantly associated with fall experience. Also, each problem was negatively associated with fear of falling (tinea pedis[male: 1.37 [1.15-1.62], female: 1.25[1.07-1.47]], skin problems[male: 1.42[1.13-1.801, female: 1.62[1.34-2.00]], nail problems[male: 1.41[1.19-1.68], female: 1.46[1.25-1.70]], functional impairment [male: 2.05[1.61-2.60], female: 2.10[1.69-2.60]]). In addition, regular foot care (0.81[0.71-0.921) was a significant correlate of fear of falling in females.;CONCLUSIONS:These results imply that focusing on foot problems (i.e., tinea pedis, skin problems, nail problems, functional impairment) would be one of means for fall preventions. Well-designed prospective studies evaluating foot problems objectively are now needed to confirm the relationships indicated by this study.

This study aimed to determine the relation between the regression slope relating minute ventilation to carbon dioxide output ((V) over dotE/(V) over dotCO2 slope) and maximum phonation time (MPT), and the MPT required to attain a threshold value for (V) over dotE/(V) over dotCO2 slope of = 34 in chronic heart failure (CHF) patients.This cross-sectional study enrolled 115 CHF patients (mean age, 54.5 years; men, 84.9%). (V) over dotE/(V) over dotCO2 slope was assessed during cardiopulmonary exercise testing (CPX). Thereafter, patients were divided into 2 groups according to exercise capacity: (V) over dotE/(V) over dotCO2 slope = 34 ((V) over dotE/(V) over dotCO2 = 34 group, n = 81) and (V) over dotE/(V) over dotCO2 slope 34 ((V) over dotE/(V) over dotCO2 34 group, n = 34). For MPT measurements, all patients produced a sustained vowel/a:/for as long as possible during respiratory effort from the seated position.All subjects showed significant negative correlation between (V) over dotE/(V) over dotCO2 slope and MPT (r = -0.51, P 0.001). After adjustment for clinical characteristics, MPT was significantly higher in the (V) over dotE/(V) over dotCO2 = 34 group vs (V) over dotE/(V) over dotCO2 34 group (21.4 +/- 6.4 vs 17.4 +/- 4.3 s, F = 7.4, P = 0.007). The appropriate MPT cut-off value for identifying a (V) over dotE/(V) over dotCO2 slope = 34 was 18.12 seconds.An MPT value of 18.12 seconds may be a useful target value for identifying CHF patients with a (V) over dotE/(V) over dotCO2 slope = 34 and for risk management in these patients.

Background: Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults. Methods: A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses. Results: Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8-1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0-1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours. Conclusions: The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed. © 2013 Kaori Ishii et al.