ABSTRACT
[PURPOSE] To evaluate the efficacy and safety of acupuncture and moxibustion treatments in breech presentation, we report correction rates and adverse events for correcting breech presentation in our department.[PARTICIPANTS AND METHODS] Subjects were pregnant women who were diagnosed with breech presentation in our obstetrics and gynecology department and started acupuncture and moxibustion treatment between April 1, 2009 and October 31, 2018. The target patients were retrospectively investigated by medical records. The main items investigated were the status of the pregnant women at the time of acupuncture and moxibustion initiation (presence or absence of threatened preterm labor), treatment position (sitting or lateral position), correction rates and occurrence of adverse events. Successful correction was defined as the rate of head position after acupuncture and moxibustion treatments. Adverse events were defined as "unfavorable medical events occurring during or after treatment, regardless of causation."[RESULTS] There were 371 pregnant women in the study; among them 57 women were diagnosed with threatened preterm labor at the start of acupuncture and moxibustion treatment, including 21 pregnant women who were in the hospital. The sitting position was used for treatment for 45.2% (168 cases) of subjects and lateral position was used for 54.7% (203 cases). The correction rates were 72.2% (268/371). In pregnant women with threatened preterm labor who were hospitalized at the time of acupuncture and moxibustion initiation, the correction rates were 28.6% (6/21 cases), which was significantly lower than that of outpatient pregnant women. There was no significant difference in the rate of correction by treatment position between sitting and lateral position. There were no adverse events of vagal reflexes when the left lateral position was treated. The frequency of adverse events per number of procedures was 1.1% (21/1916) and per number of cases was 5.7% (21/371 cases). There were two cases of rupture of membranes with no apparent causal relationship.[CONCLUSION] The safest position for treatment in pregnant women was considered to be the left lateral position. Most of the adverse events were minor or moderate, but there were two cases of rupture of membranes with no apparent causal relationship. When performing acupuncture and moxibustion for breech presentation, it is necessary to work closely with the patient's obstetrician.
ABSTRACT
[OBJECTIVE] In recent years, acupuncture treatment for cancer patients has spread worldwide. However, in Japan, there are few facilities where acupuncture and moxibustion treatment is being carried out in a hospital, and in introducing acupuncture treatment as part of palliative care is rare. In this study, we investigated the current situation at our hospital where acupuncturists are participating in the palliative care team of the hospital.[PARTICIPANTS AND METHODS] Subjects were patients with cancer in our hospital who were hospitalized to receive the best supportive care for their condition and who had started acupuncture treatment between April 8, 2011 and November 13, 2017. The target patients were retrospectively investigated by medical records. [RESULTS] Of the 75 patients, 72 (96%) were Performance Status 3 and 4. Thirty-seven (49%) had oxygen therapy. Fifty-five patients (73%) had pleural fluid or ascites during acupuncture and moxibustion treatment, and 50 patients (67%) had edema. In the treatment of acupuncture, Contact Needle Therapy was used to avoid the risk of infection and bleeding, and in the moxibustion treatment, scarring moxibustion was not used to avoid the risk of burns and infection. Fifty-nine patients (79%) had a positive opinion of the acupuncture treatment. Forty-five patients (66%) requested acupuncture within two days of their death. There were 3 adverse events, but all were mild and transient, .[CONCLUSION] In the acupuncture treatment at our hospital for patients in the terminal stage of cancer, treatment was performed taking into consideration the risks to the patient, and there were no serious adverse events. There were many positive feedbacks from patients who received acupuncture, suggesting that acupuncture may be useful for alleviating symptoms at the end stage of cancer.
ABSTRACT
In Japan, Nordic walking (NW) has two style walking method. For one thing, the poles are used to push against the ground towards the back of the body (diagonal style: DIA). The other one, the poles put on forward and using like a cane (defensive style: DEF). This study aims to clarify differences between the two Nordic walking (NW) styles. The subjects were 12 community-dwelling middle-aged and older adults (mean age: 62.4 ± 7.8 years). All of subjects were tested to perform NW in both style for 12 minutes walking around the park. Walking distance, speed, heart rate (HR), energy expenditure (EE) and electromyogram (EMG) amplitude of the upper and lower limbs using surface EMG were assessed. A pole with a built-in load cell measured force used to push the pole into the ground (pole force), pole contact time, and pole impulse. Distances and speed in DIA was significantly higher than DEF. Significant difference in muscle activity was observed between DIA and DEF in the triceps brachii only. EE of DEF was significantly higher than DIA. Poling force and pole impulse in DIA was significantly higher than DEF. These results indicate that when prescribing NW for health promotion, it should be done according to each characteristic in DIA or DEF.
ABSTRACT
To estimate how much physical activity is needed to improve overall health status in female patients with ischemic heart disease (IHD), the dose-response relationship between the duration of daily aerobic exercise and change in vital age (VA) was assessed for 4 months of exercise training. VA was considered as an index of physical health status and was computed from various coronary risk facotrs and physical fitness elements. Eighteen female patients with IHD, aged 54.3±9.1 yrs, continued the supervised exercise training 1-2 d/wk and the self-controlled exercise training 1-5 d/wk for 4 months. The intensity of exercise was set at individually determined lactate threshold. Daily duration of aerobic type exercise calculated for each patient averaged 21.1±11.0min/d, rang ing from 4.6 to 46.7 min/d. After the 4-month exercise training, VA decreased from 59.6±12.1 yrs to 54.2±11.8 yrs (P<0.05) . Significant correlation was found between daily duration of exercise and the change in VA (Spearman's rho=-0.60 ; Pearson's r=-0.62) . In this relationship, 10 min/d of exercise induced the decrease in VA and no further decrease in VA was found over the 30 min/d of exercise. In the 11 variables which constitute the equation of VA, oxygen uptake at lactate threshold (Spearman's rho=0.65; Pearson's r=0.64) and balancing on one leg with eyes closed (Spearman's rho=0.48; Pearson's r=0.51) significantly correlated with daily duration of aerobic exercise. From these results, it is suggested that the amount of moderate intensity exercise required to improve physical health status in female patients with IHD may be 10-30 minutes per day.
ABSTRACT
To determine the minimum duration of exercise for improving the aerobic capacity of patients with coronary heart disease (CHD), 23 female patients with CHD and/or hypertension, aged 52.8±8.7 years, were studied. After pre-testing, all the patients were conditioned for 4 months in order to elicit improvements in their aerobic capacity and other healthrelated factors. Duration and contents of daily activities were recorded by each patient. After 4 months, oxygen uptake at lactate threshold (VO<SUB>2LT</SUB>) and VO<SUB>2peak</SUB> were increased significantly from 12.9±2.6 to 16.0±3.4m<I>l</I>/kg/min and from 18.5±4.2 to 22.3±5.6m<I>l</I>/kg/min, respectively. Duration of exercise conditioning for the 4 months averaged 23.8±12.2min per day, ranging from 4.6 to 49.7min. Correlational analyses were applied in order to determine the extent to which the improvement in aerobic capacity was associated with the individual mean duration of exercise conditioning. As a result, changes in VO<SUB>2LT</SUB> and VO<SUB>2peak</SUB> correlated significantly with the exercise duration (Pearson's r=0.51, Spearman's rho=0.47 for VO<SUB>2LT</SUB>; Spearman's rho=0.58 for VO<SUB>2peak</SUB>) . Both VO<SUB>2LT</SUB> and VO<SUB>2peak</SUB> tended to improve markedly when daliy exercise duration was 20 min or longer. Furthermore, it was shown that the improvement in aerobic capacity remained almost the same within a range of exercise duration of 20 to 60min. We suggest that the minimum exercise duration for improving the aerobic capacity of cardiac patients is 20 to 30min per day or 140min or more per week.
ABSTRACT
Biological age based on the assessment of various physiological factors measured in a resting state has been proposed as an appropriate index of aging. We have recently developed an equation for estimation of physical fitness age (PFA), which is composed of eight age-related physical fitness variables. These include oxygen uptake corresponding to lactate threshold (Vo<SUB>2</SUB>@LT), maximal oxygen uptake (Vo<SUB>2</SUB>max), side step, grip strength, vertical jump, foot balance with eyes closed, trunk extension, and trunk flexion. In this study, the validity of PFA as a critical index of physical health and/or aging status was investigated from a longitudinal standpoint on the assumption that exercise habituation does contribute to health promotion. The subjects were 14 Japanese middle-aged and elderly men, aged 50 to 70 years, all of whom were patients with coronary heart disease (CHD) . The subjects participated in a supervised exercise conditioning program for 90 to 120 min each session, 2 times weekly for 4 months. Analyses of the data indicated that the mean PFA of the subjects (66.0±9.0 yr) after conditioning was significantly (P<0.05) lower than the mean PFA (72.8±8.6 yr) obtained before conditioning. After the exercise program, significant increases were documented in Vo<SUB>2</SUB>@LT (17%), Vo<SUB>2</SUB>max (12%), side step (26%), trunk flexion (109%), trunk extension (7%), vertical jump (12%), and foot balance with eyes closed (31%) . Therefore, we conclude that our exercise conditioning program may alter the overall physical fitness of patients with CHD, and that PFA could be a valid physical health and/or aging index.