Ryosuke Shigematsu
Mie University, Faculty of Education, Faculty Member
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ABSTRACT Few exercises that encourage elderly persons to be physically active have been proved to exhibit both method-effectiveness (efficacy) and use-effectiveness (effectiveness) in a long-term setting. We recently developed a... more
ABSTRACT Few exercises that encourage elderly persons to be physically active have been proved to exhibit both method-effectiveness (efficacy) and use-effectiveness (effectiveness) in a long-term setting. We recently developed a square-stepping exercise (SSE) for elderly persons and assessed its effects on adherence and functional fitness in a long-term, observational setting following a randomized controlled trial (RCT). Sixty-eight people (SSE group, n = 32; walking group, n = 36) participated in a 3-month RCT. At the end of the RCT period, they were encouraged to continue the assigned exercise autonomously. We measured adherence to the assigned exercise for a total of 4 years and their functional fitness after 1 and 4 years. Functional fitness measurements at each follow-up point and at the 3-month intervention entry were compared in terms of method-effectiveness (per-protocol based [PPB]) and use-effectiveness (intention-to-treat [ITT]). At the 1-year and 4-year follow-ups, 69% and 63%, respectively, of the SSE group had continued performing the assigned exercise. These values were comparable to those of the walking group (65% and 65%). From the PPB and ITT analyses, we found that SSE was as effective—or more effective—than walking with regard to functional fitness. In conclusion, SSE is a good exercise choice that is recommended for the elderly on a long-term basis.
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Gait abnormalities and vascular disease risk factors are associated with cognitive impairment in aging. To determine the impact of group-based exercise and dual-task training on gait and vascular health, in active community-dwelling older... more
Gait abnormalities and vascular disease risk factors are associated with cognitive impairment in aging. To determine the impact of group-based exercise and dual-task training on gait and vascular health, in active community-dwelling older adults without dementia. Participants [n=44, mean (SD) age: 73.5 (7.2) years, 68% female] were randomized to either intervention (exercise+dual-task; EDT) or control (exercise only; EO). Each week, for 26 weeks, both groups accumulated 50 or 75min of aerobic exercise from group-based classes and 45min of beginner-level square stepping exercise (SSE). Participants accumulating only 50min of aerobic exercise were instructed to participate in an additional 25min each week outside of class. The EDT group also answered cognitively challenging questions while performing SSE (i.e., dual-task training). The effect of the interventions on gait and vascular health was compared between groups using linear mixed effects models. At 26 weeks, the EDT group demonstrated increased dual-task (DT) gait velocity [difference between groups in mean change from baseline (95% CI): 0.29m/s (0.16-0.43), p<0.001], DT step length [5.72cm (2.19-9.24), p =0.002], and carotid intima-media thickness [0.10mm (0.003-0.20), p=0.04], as well as reduced DT stride time variability [8.31 coefficient of variation percentage points (-12.92 to -3.70), p<0.001], when compared to the EO group. Group-based exercise combined with dual-task training can improve DT gait characteristics in active older adults without dementia.
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The aim of this study was to establish a physical performance test battery to assess the wide variation of functional fitness in older Japanese women. The criteria for sampling low/high extremity functional fitness were the amount of... more
The aim of this study was to establish a physical performance test battery to assess the wide variation of functional fitness in older Japanese women. The criteria for sampling low/high extremity functional fitness were the amount of physical activities that older women perform on a regular basis and the distance they could move by foot. Seventeen tests related to the activities parallel to daily living (APDL) were completed for 178 women, aged 60 to 91 years. Principal component analysis of the 17 performance tests in the reference group (n = 140) yielded 5 components accounting for 63.5% of the total variance. Fourteen test items were heavily loaded on the 1st principal component, so that 31.4% of the total variance was accounted for by this component. Considering these results as well as test-retest reliability, kurtosis, and skewness of each item, the following four items were selected as a combination of test battery: (X1) repetition of the bicipital flexion/extension, (X2) walking around two cones and sitting on a chair, (X3) moving beans with chopsticks, and (X4) functional reach. Principal component analysis was again applied to these four variables so as to obtain the first principal component score of each person. As a result, the following equation was drawn: the first principal component score = 0.063X1 - 0.055X2 + 0.098X3 + 0.042X4 - 2.65. The scores averaged 0.68 +/- 0.27 for the exercise group (n = 19) (those who played croquet or other similar sports activities consistently twice or more a week); and -0.76 +/- 0.55 for the sedentary group (n = 19) (those who did no exercise and confined their activities to the home). Biserial correlation coefficient as an index of criterion-related validity was 0.67 (P < 0.05) between the scores in the exercise and sedentary groups. These results indicate that a wide range of functional fitness among older Japanese women can be assessed by the four tests.
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More evidence is needed in order to conclude that a specific program of exercise and/or cognitive training warrants prescription for the prevention of cognitive decline. We examined the effect of a group-based standard exercise program... more
More evidence is needed in order to conclude that a specific program of exercise and/or cognitive training warrants prescription for the prevention of cognitive decline. We examined the effect of a group-based standard exercise program for older adults, with and without dual-task training, on cognitive function in older adults without dementia. We conducted a proof-of-concept, single-blinded, 26-week randomized controlled trial whereby participants recruited from pre-existing exercise classes at the Canadian Centre for Activity and Aging in London, Ontario were randomized to the intervention group (exercise + dual-task; EDT) or the control group (exercise only; EO). Each week (2 or 3 days/week), both groups accumulated a minimum of 50 minutes of aerobic exercise (target 75 minutes) from standard group classes and completed 45 minutes of beginner-level Square Stepping Exercise (SSE). The EDT group was also required to answer cognitively challenging questions while doing beginner-leve...
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Square-Stepping Exercise (SSE), composed of movements similar to walking, involves varied movements in multiple directions and is performed on a thin mat (100 x 250 cm) that is partitioned into 40 squares (25 cm each). We introduced SSE... more
Square-Stepping Exercise (SSE), composed of movements similar to walking, involves varied movements in multiple directions and is performed on a thin mat (100 x 250 cm) that is partitioned into 40 squares (25 cm each). We introduced SSE to a group of older adults for three months as a supervised intervention. After this intervention period, the participants continued SSE without supervision for four years. The current study was conducted to determine why the participants independently continued SSE. Among 52 older adults who attended the SSE intervention, 40 continued SSE (continued group) and 12 discontinued (discontinued group). Seven in the continued group were excluded from analyses because of low attendance rates. Each of the remainder (n = 33) was independently interviewed and asked why he/she had continued SSE. The average interview time for the continued group was 12 minutes. Twelve in the discontinued group were investigated for exercise habits by postal questionnaire. The ...
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The purpose of this study was to determine the efficacy of rate of perceived exertion (RPE) to monitor exercise intensity in older adults. Middle-aged (46.9 +/- 7.0 years, n = 24) and older women (75.5 +/- 3.8 years, n = 29) performed a... more
The purpose of this study was to determine the efficacy of rate of perceived exertion (RPE) to monitor exercise intensity in older adults. Middle-aged (46.9 +/- 7.0 years, n = 24) and older women (75.5 +/- 3.8 years, n = 29) performed a graded maximal exercise test on a cycle ergometer while RPE, oxygen uptake, heart rate, and blood lactate levels were measured. The Pearson's product moment correlation coefficient between RPE and oxygen uptake for each stage of the graded exercise test was calculated for each participant. The mean coefficient for the older group (r =.954) was similar to that of middle-aged group (r =.963). The autocorrelation coefficient was much lower (r =.411) in the older group than in the middle-aged group (r =.871). Variability in RPE through the graded exercise test was similar between the two groups. In conclusion, RPE was strongly associated with oxygen uptake in the older group. These results indicate that RPE is effective in monitoring exercise intensi...
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Functional fitness age (FFA), which we previously described, is a measure of functional age that reflects a person's overall physical ability to complete daily tasks such as preparing meals and performing various household chores. The... more
Functional fitness age (FFA), which we previously described, is a measure of functional age that reflects a person's overall physical ability to complete daily tasks such as preparing meals and performing various household chores. The purpose of this study was to validate FFA in two elderly populations: 1) older subjects from different communities, and 2) older subjects participating in an exercise intervention program. FFA was calculated from 4 performance tests: performing arm curls; moving beans with chopsticks; demonstrating functional reach; and sitting and walking around two cones. The first study group was selected from 4 different communities (N=127), and was subdivided into a less active group (N=87) and an active group (N=40). The results of the 4 tests for the less active group were not significantly different from those for the original validation group used in developing the FFA equation. The FFA of the less active group (71.1+/-7.7 yrs) was not different from their...
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We attempted to determine the effectiveness of exercise prescription for women with hyperlipidemia (HL), because some HL women showed no significant improvement in serum lipid and lipoprotein profiles despite the continuation of exercise... more
We attempted to determine the effectiveness of exercise prescription for women with hyperlipidemia (HL), because some HL women showed no significant improvement in serum lipid and lipoprotein profiles despite the continuation of exercise conditioning. We therefore tested the hypothesis that exercise can be clinically beneficial even when there are no alterations in total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and/or triglycerides (TG). Twenty-three women with HL (aged 54.3 +/- 7.6 yr) participated in our outpatient-supervised exercise conditioning program for 90 minutes each session, twice a week for 1 year, and also did home-based exercise three days a week. Vital age (VA) is a useful index for assessing functional status, especially the risk of coronary heart disease (CHD) and is computed from 11 independent variables measured not only when a person is at rest but also during exercise. Although TC and LDLC did not change significantly after the exercise cond...
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The goal of this study was to determine an intraabdominal fat (IF) area target value for improving coronary heart disease (CHD) risk factors in response to weight reduction. Subjects were 279 obese Japanese women, 21 to 66 years old, who... more
The goal of this study was to determine an intraabdominal fat (IF) area target value for improving coronary heart disease (CHD) risk factors in response to weight reduction. Subjects were 279 obese Japanese women, 21 to 66 years old, who were divided into diet-alone and diet-plus-exercise groups and participated in a 14-week weight reduction program. The IF area was measured by computerized tomography scans. Systolic blood pressure > or = 140 mm Hg, diastolic blood pressure > or = 90 mm Hg, total cholesterol > or = 5.70 mM, triglycerides > or = 1.70 mM, and fasting plasma glucose > or = 6.99 mM were defined as CHD risk factors. The best trade-off between sensitivity (probability of correctly detecting true positive) and specificity (probability of correctly detecting true negative) was found at 100 cm2 pretreatment in combined data of the two groups. At posttreatment, although a slight difference was found in the target value between the treatment groups (60 cm2 for diet alone and 50 cm2 for diet plus exercise), the combined data showed that the best trade-off occurred at 60 cm2 (sensitivity and specificity were 0.55 and 0.63, respectively). The percentage of subjects having no CHD risk factors was significantly lower in the group that had large IF areas (> or = 60 cm2) (46%) compared with the group that had normal IF areas (<60 cm2) (65%). However, the percentage of subjects having multiple CHD risk factors was significantly greater in the group that had large IF areas (16%) compared with the group with normal IF areas (7%) at posttreatment. Our longitudinal data suggest that obese Japanese women should reduce their IF areas to < 60 cm2 through weight reduction to improve CHD risk factors independent of treatment.
Research Interests: Obesity, Multidisciplinary, Adipose tissue, Humans, Blood Glucose, and 17 moreBlood Pressure, Weight Loss, Cholesterol, Female, Body Composition, Exercise, Body Mass Index, Risk factors, Triglycerides, Aged, Middle Aged, Adult, Coronary heart disease, Body Weight, Risk Factors, X ray Computed Tomography, and Abdomen
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The purpose of this study was to evaluate whether strength or recreational activities are a useful addition to aerobic training in patients with chronic obstructive pulmonary disease (COPD). Thirty-three patients with moderate to severe... more
The purpose of this study was to evaluate whether strength or recreational activities are a useful addition to aerobic training in patients with chronic obstructive pulmonary disease (COPD). Thirty-three patients with moderate to severe COPD were randomly assigned to 12 weeks of aerobic combined with strength training (AERO+ST) or combined with recreational activities (AERO+RA). The AERO regimen consisted of three weekly 20-min walking exercise sessions; the ST regimen included three series of 10 repetitions of four exercises; and the RA regimen consisted of training using exercise balls to perform smoothly for instrumental activity of daily living. Baseline and after-training measurements of peripheral muscular strength and endurance, cardio respiratory fitness, and 6-min walking distance were obtained, whereas quality of life was assessed with the Short Form 36 questionnaire. Change in grip strength showed a significant difference between the AERO+ST group (8.3+/-6.7%) and the control group (-1.3+/-10.5%), and AERO+RA group (-4.7+/-5.6%) (P<0.05). A significant increase was found in percentage change in peak (.)V(O2) between the AERO+ST group (5.1+/-11.8%) and the control group (-9.2+/-8.6%) (P<0.05). In the health-related quality of life scores, there was a significant difference in mean percentage change in physical functioning between the AERO+ST group (7.9+/-24.4%) and the control group (-14.8+/-19.1%) (P<0.05). A significant difference was found in mean percentage change in social functioning between the AERO+RA group (9.4+/-20.0%) and the control group (-14.9+/-23.2%) (P<0.05). A significant difference in mean percentage change in mental health was also found between the AERO+RA group (12.2+/-12.4%) and the control group (-5.0+/-7.8%) (P<0.05). It is preferable to introduce various forms of exercise that use different muscles involving the whole body, such as recreational activities, as they are an appropriate approach to stimulating physical activity and to improving functional fitness gradually while improving health-related quality of life, though it is necessary to practice exercises for maintenance and improvement in patients with COPD.
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The relationship between functional fitness status and life satisfaction was assessed in older Japanese people from the perspective of quality of life (QOL). A total of 123 older men and women (M = 74.3 years, SD = 5.4) participated in... more
The relationship between functional fitness status and life satisfaction was assessed in older Japanese people from the perspective of quality of life (QOL). A total of 123 older men and women (M = 74.3 years, SD = 5.4) participated in the study. The questionnaire contained 21 questions covering eight structural factors pertaining to the feelings of life satisfaction in older people. The functional fitness test consisted of nine items representing the following five areas of fitness: muscular strength, agility, coordination, balance, and flexibility. The analysis revealed no overall correlation between the total fitness and the total life satisfaction scores, but some of the life satisfaction factors were significantly related to some functional fitness items (P < .01). The results suggest it is important for older people to maintain their functional fitness in order to manage a high quality of life.
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Research Interests: Genetics, Health Behavior, Epidemiology, Japanese, Life Style, and 27 morePhysical Activity, Brazil, Public Health, Japan, Acculturation, Comparative Study, Cardiovascular disease, Humans, Cholesterol, Female, Male, Immigrant, Lipoprotein(a), Waist Circumference, Triglycerides, LDL-cholesterol, Health Status, European, Middle Aged, Adult, Public health systems and services research, Sex Factors, Asian Continental Ancestry Group, Reference Values, Cross Sectional Studies, Blood Lipids, and Total Cholesterol
OBJECTIVE—To compare the prevalence of the metabolic syndrome using two definitions: one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood... more
OBJECTIVE—To compare the prevalence of the metabolic syndrome using two definitions: one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult ...
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The Japan Society for the Study of Obesity originally proposed a cutoff value of >100 cm(2) for the intra-abdominal fat area (IFA) as a definition for... more
The Japan Society for the Study of Obesity originally proposed a cutoff value of >100 cm(2) for the intra-abdominal fat area (IFA) as a definition for "visceral fat obesity" in Japanese adults. There are no studies on the cutoff or target values after weight reduction in pre- and post-menopausal women. In the present study 149 pre-menopausal obese women (PreM, 43.3 years, 27.3 kg/m(2)) and 58 post-menopausal women (PostM, 53.9 years, 27.7 kg/m(2)) participated in a 14-week weight reduction program. The IFA was measured by computed tomography. The program induced significant reductions in body weight (8.6 kg in PreM and 7.8 kg in PostM). The IFA decreased significantly from 80.4 +/- 41.3 to 50.7 +/- 23.8 (PreM) and from 115.4 +/- 38.0 to 75.7 +/- 30.5 (PostM). The receiver-operating characteristic curve analyses revealed that the appropriate cutoff values were 80 cm(2) (PreM) and 110 cm(2) (PostM) before the program, and after the program the appropriate target values were determined as 60 and 70 cm(2), respectively.