ABSTRACT
OBJECTIVES: Sarcopenia and osteoporosis affects activities of daily living and quality of elderly people. However, little is known about its impact on elderly locomotor diseases, such as osteoporotic vertebral fracture (OVF). There is no report investigating the influence of both sarcopenia and osteoporosis on outcomes of OVF. This study aimed to evaluate the clinical outcomes of OVF in elderly patients from sarcopenic perspectives. METHODS: This prospective study was conducted with 396 patients, aged 65 years or more, hospitalized for the treatment of OVF (mean age, 81.9 ± 7.1 years; 111 males, 285 females). The primary outcome was the Japanese Orthopaedic Association (JOA) score for lumbar disease (at first visit, hospital discharge, and 1 year after treatment) and Barthel index (at the same time and before hospitalization). The second outcome was living place after discharge. Susceptibility to sarcopenia and osteoporosis were evaluated and clinical results of conservative treatment were compared. RESULTS: Sarcopenia significantly affected Barthel index at first visit and discharge. Sarcopenia patients had significantly higher rate for discharge to nursing home and living in nursing home after 1 year than patients without sarcopenia. Osteoporosis significantly affected the JOA score at the first visit and the Barthel index before hospitalization, at the first visit, discharge, and after 1 year. Osteoporosis did not affect the living place at discharge and after 1 year. CONCLUSIONS: Sarcopenia and osteoporosis affected outcomes of conservative treatment for OVF; moreover, sarcopenia affected the living place of OVF patients at discharge and after 1 year.
Subject(s)
Aged , Humans , Male , Activities of Daily Living , Asian People , Hospitalization , Nursing Homes , Osteoporosis , Prospective Studies , SarcopeniaABSTRACT
Each medical specialist certification system in internal medicine and its subspecialities was founded and controled byeach medical society, but not by the public. Thus, each system had not been harmonized each other, and not recognizedas the public system until the the Ministry of Health, Labour and Welfare (MHLW)'s declaration of permission for publicnotification of each certificated medical speciality when approved according to their criterion. Based on the longstandingdiscussion and negotiation in the special committee on internal medicine of the Japanese Board of MedicalSpecialist, on the other hand, the Japanese Society of Internal Medicine (JSIM) and the societies of subspecialities in theinternal medical fields agreed to build up the so-called 2 stair-system as the framework of medical specialist certificationsystem, where the Certified Member of the JSIM is inevitable for application or renewal of the Fellow of the JSIM andother certifications of medical specialist of the internal medical subspecialities. In face to the new compulsory postgraduateclinical training system with super-rotation for 2 years starting from 2004 fisical year, JSIM decided that 2 yearpostgraduate clinical training is included to the 3 year training period necessary for the application of the Board CertifiedMember of JSIM, because clinical training with super-rotaion system aimed to master the capability of primary medicalcare is recognized to be also an essential part of the training program for internists. For the better medical specialist certificationsystem in the future, the Japanese Board of Medical Specialist should be approved to be the public and independentorganization for quality control of Japanese medical specialist certification system as a whole to improve medicaland welfare quality which fit for the requirement of Japanese people in the 21th century.
ABSTRACT
This study was intended to examine the specific nature and an aerobic value of jumping jacks (Fig. 1) which has a greater movement in shoulders and is easy to perform in standing position without specific skill and equipment and in also a narrow place.<BR>Individual's self-selected (free) tempo in jumping jacks was determined for 92 subjects by administering it for 5 minutes.<BR>The optimal tempo was obtained from measuring energy expenditures on two subjects when they performed five minutes of jumping jacks at each tempo of 50, 60 and 70 times/min and also at one's free tempo. Exercise intensity of jumping jacks as a general endurance activity was determined from energy expenditures and % Vo<SUB>2</SUB>2max of 9 subjects who performed 5 minutes of jumping jacks at 60 times/min. Training effect of jumping jacks was examined on the basis of the changes in Vo<SUB>2</SUB>max and heart rate (jumping jacks at 60 times/min for 3 min) before and after one month of training on 7 subjects who participated 180 jumping jacks at free tempo a day, averagely 6.3 times a week. Subjects were all college male students aged between 18 and 22. Followings are the results obtained in this study.<BR>1) Individual's self-selected (free) tempo in jumping jacks was about 60 times/min.<BR>2) The optimal tempo in jumping jacks determined on the basis of energy expenditure was also about 60 times/min.<BR>3) Oxygen requirement and RMR at the optimal tempo (60 times/min) in jumping jacks were 40.9 ml/kg/min and 12.3, respectively. Percent Vo<SUB>2</SUB>max, Oxygen requirement and RMR in jumping jacks was smaller for persons who have greater Vo<SUB>2</SUB>max/body weight.<BR>4) One month of training by jumping jacks demonstrated significant increases in Vo<SUB>2</SUB>max and Vo<SUB>2</SUB>max/body weight, which were 2.59 to 2.751/min (p<0.01) and 43.5 to 46.1 ml/kg/min (p<0.05), respectively. Significant decreases in heart rate were also observed during and recovery after the exercise.<BR>5) From above results, jumping jacks could be used as an effective general endurance exercise, provided that some necessary modifications should be made according to each individual's fitness level.