Published papers

Objective　This study clarified the current status of awareness, knowledge, beliefs, and behavioral intentions regarding the Japanese physical activity guidelines (Active Guide) and their relationship with physical activity, sedentary behavior, and the participants’ characteristics.Methods　A cross-sectional study was conducted with 7,000 participants aged 20-69 years registered with an online survey company. Awareness, knowledge, beliefs, and behavioral intentions regarding the Active Guide were examined. Awareness was assessed by unprompted and prompted recall. Knowledge was assessed by numerical responses to “the recommended daily activity time (18-64 years/65 years and older)” and “physical activity time to be increased (plus-ten),” respectively. To survey the beliefs and behavioral intentions, we created a 5-point scale for the Active Guide. For physical activity, the amount of moderate-to-vigorous intensity physical activity was calculated from the Japan Public Health Center-based prospective Study (JPHC study) questionnaire. Physical activity level was calculated from the standard specific medical checkup and health guidance questionnaire. For sedentary behavior, the Japanese version of the International Physical Activity Questionnaire (IPAQ) was used. The dependent variables were awareness, knowledge, beliefs, and behavioral intentions. The independent variables were physical activity, sedentary behavior, and the participants’ characteristics (gender, age, body mass index, marital status, educational background, work status, and household income). After descriptive statistics were measured, a logistic regression analysis was performed to examine the associations.Results　Unprompted and prompted recall of the Active Guide were 1.7% and 5.3-13.4%, respectively. Those with knowledge of it scored 37.2%, 7.0%, 24.8%, and 2.6% for recommended daily activity time (18-64 years), daily physical activity time (65 years and older), plus-ten, and all three items answered correctly, respectively. The median (interquartile range) score of the beliefs was 21 (16-25) points (32-point scale). Those with behavioral intentions scored 51.4% for “recommended daily activity” and 66.9% for “plus-ten.” Logistic regression analysis showed that awareness, knowledge, beliefs, and behavioral intentions were positively associated with moderate-to-vigorous intensity physical activity and level. The results were inconsistent for sedentary behavior. Although personal characteristics differed based on assessment item, they were mainly associated with age, education level, employment, and household income.Conclusions　This study revealed that the number of people who had awareness and knowledge of the Active Guide remained low. Those with awareness, knowledge, beliefs, and behavioral intentions were more physically active. However, the results for sedentary behavior were not consistent. Hence, further research is required to understand this tendency. A future longitudinal study is also required.

社会情勢の変化により、児童の学力育成が重要視されている近年、児童が過ごす教室の温熱・空気環境が、児童の学習効率に影響することに加えて、身体活動が学習効率に与える影響について様々な報告がなされており、身体活動促進が児童・生徒の学力向上に寄与する可能性が示されている。そこで本研究では、教室の温熱・空気環境に加えて、児童の日常的な身体活動量が総合的に児童の学習効率に及ぼす影響を、計算作業成績を用いて客観的に評価することを目的とした。

本研究の目的は、アスリートの内側型距骨骨軟骨損傷に対して関節鏡視下経内果的骨軟骨移植術を行った症例を調査し本手術法の有用性と問題点を検討することである。術前に日常的にスポーツを行っていた4例4足を対象とした。性別は男3例、女1例で、年齢は中央値35歳であった。手術方法は、前外側ポータルから足関節鏡視を行い、脛骨内果にリーマーを用いて骨孔を開け、これを利用して膝蓋大腿関節面から採取した骨軟骨柱を移植した。術後経過観察期間は中央値3年1ヵ月であった。疼痛は著しく改善され、元のレベルへのスポーツ復帰は平均4.0ヵ月であった。アスリートの距骨滑車内側型骨軟骨障害に対して関節鏡視下経内果的骨軟骨移植術、3年1ヵ月の経過でも、満足する結果を得ることができた。(著者抄録)

目的:スクリーンタイム(ST)とメタボリックシンドローム(MetS)該当の有無との関連を検討すること。方法:40〜69歳の2009年藤沢市特定健診受診者のうち、質問紙に回答のあった2,449名を分析対象とし、ST(4分位)とMetS該当との関連を解析した。結果:身体活動量や食生活、基本属性などを調整してもなお、STが長いほどMetS該当者が多かった(P for trend<0.001)。結語:MetS対策には身体活動促進に加え、座位行動減少を考慮する必要性が示唆された。(著者抄録)

本研究の目的は、アスリートの陳旧性足関節外側靱帯損傷に対して短腓骨筋腱を用いた足関節外側靱帯再建術を行った症例を調査し本手術法の有用性と問題点を検討することである。術前に日常的にスポーツを行っていた20例22足を対象とした。性別は男8例、女12例で、年齢は平均24.0歳であった。手術方法は短腓骨筋腱を半切遊離して移植腱として用い、前距腓靱帯、踵腓靱帯を解剖学的位置に再建した。術後経過観察期間は平均4年8ヵ月であった。疼痛は著しく改善され、元のレベルへのスポーツ復帰は平均6.1ヵ月であった。アスリートの陳旧性足関節外側靱帯損傷に対して短腓骨筋腱を用いた足関節外側靱帯再建術は、4年8ヵ月の経過でも、満足する結果を得ることができた。(著者抄録)

Background:This aim of this study was to clarify prognosis after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS) and to identify baseline factors associated with mortality.Methods and Results:We prospectively enrolled 257 consecutive elderly persons with AS who were referred to Keio University Hospital and who underwent assessment of cardiac, physical (walking speed), cognitive, and renal functions, nutritional status, activities of daily living (ADL), instrumental ADL (IADL) assessed with the Frenchay activities index (FAI), and comorbidities. The primary outcome was postoperative death. Differences in basic characteristics were compared between a group that survived for a median of 661 days (IQR, 0–1,289 days) after TAVI and a group that did not. Multivariate hazard ratios (HR) were calculated for independent factors selected in Cox proportional hazard models. Thirty-one individuals died during follow-up. Walking speed was significantly faster (0.87±0.25 vs. 0.70±0.24 m/s, P<0.001) and FAI was significantly higher (21.2±8.0 vs. 15.7±8.0, P=0.026) in the survival group compared with those who died. Multivariate HR for mortality according to walking speed was 0.05 (95% CI: 0.028–0.091) in model 1 and 0.04 (95% CI: 0.020–0.081) in model 2, and those for FAI were 0.94 (95% CI: 0.92–0.95) and 0.92 (95% CI: 0.90–0.92), respectively.Conclusions:Preoperative walking speed and IADL are crucial factors associated with prognosis after TAVI even after adjustment.