Vaccinations may be one of the solutions to end the COVID-19 pandemic. One’s psychological state may be strongly related to one’s willingness to be vaccinated. This study investigated the relationship between the psychological state of Japanese university students and their willingness to be vaccinated. A self-report questionnaire on COVID-19, its vaccines (vaccination status, and perceived efficacy and safety), and psychological state (anxiety and depressive mood) was administered online, and 560 valid responses were obtained. The unvaccinated group reported significantly lower perceived vaccine effectiveness and importance than the vaccinated group. However, there were no differences in anxiety and depressive mood symptoms between the two groups. Multivariate logistic regression analysis was performed on the unvaccinated participants to identify the factors associated with their unwillingness to be vaccinated; there was a significant association between anxiety and unwillingness to receive the vaccine (p < 0.05). However, there was no significant association between depressive mood and unwillingness to receive the vaccine. The results suggest that timely psychological support for Japanese university students experiencing high levels of anxiety is important in accelerating vaccination programs.

Background: In response to the serious lack of physical activity among young adults, recent attempts have been made to encourage young people to exercise through exercise video distribution. However, merely distributing videos does not lead to improved physical activity levels. Metaverse space, which enables web-based interaction through avatars, allows users to watch exercise videos in the same space as other avatars. Objective: This study explored whether exercise video distribution using metaverse space is effective in improving physical activity levels, along with mental health and locomotive function, among young people. Methods: In this parallel-group randomized controlled trial participants were recruited using printed poster displays. A total of 48 young adults aged between 18 and 30 years were assigned to 3 groups of 16 each: the metaverse, YouTube, and control group. To encourage exercise, the metaverse group was given an exercise video each week with a load of around 4-8 metabolic equivalents of tasks (METs) for 8 videos delivered in the metaverse space. The YouTube group was sent a URL on YouTube every week to view exercise videos with the same content as the metaverse group. The control group was given no special instructions. The intervention period was 8 weeks. Pre- and postintervention physical activity, well-being, locomotive syndrome risk tests, and social capital were measured. Although this study was not blinded to the participants, the measurers did not know to which group the participants belonged. Mixed model repeated-measures analyses and a post hoc Wilcoxon signed rank sum test were performed to detect the effects of the intervention in all groups. Results: The results of the mixed model repeated-measures analyses showed a significant interaction between groups and before and after the intervention for total physical activity (metaverse group: pre 737.1, SD 609.5 METs/week, post 1575.4, SD 1071.8 METs/week; YouTube group: pre 661.7, SD 710.7 METs/week, post 911.9, SD 1103.3 METs/week; and control group: pre 930.6, SD 665.1 METs/week, post 844.7, SD 701.8 METs/week; P=.04) but none for the indicators of well-being (P=.40), locomotive function scale (P=.17), and social capital (P=.23). A post hoc test showed a significant increase in physical activity in the metaverse group before and after the intervention (P=.006). Conclusions: This study is the first to show that delivering exercise videos through metaverse space can increase physical activity in young adults by providing a gathering space for individuals similarly motivated for exercise practice. This way, the sense of isolation during exercise is reduced compared with merely distributing videos on YouTube. The use of metaverse space in health promotion is likely to spread, and this study provides a useful reference for its exploration. Trial Registration: ClinicalTrials.gov NCT06019156; https://ichgcp.net/clinical-trials-registry/NCT06019156

Sedentary behavior, particularly prevalent during the 2019 coronavirus disease (COVID-19), has been shown to lead to depression. In medical students, this could negatively affect the provision of healthcare. Thus, this study aimed to investigate the association between sedentary behavior and depression in Japanese medical students during the COVID-19 pandemic. An online cross-sectional survey was conducted from July 30 to August 30, 2021, using anonymous questionnaire system to assess respondents’ sociodemographic characteristics, physical activity, sedentary behavior among 1000 Japanese university students. Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2). The data of 484 respondents (48.4%) were included in a stepwise analysis, where we set the difference between medical and non-medical students as Model 1 and that between medical students with and without depression as Model 2. For group comparisons of both models, the chi-square test was used for sociodemographic characteristics, and the Mann–Whitney U-test was used for physical activity and sedentary behavior. In Model 2, factors associated with depression among medical students were analyzed by logistic regression analysis. In Model 1, medical students were less physically active (p < 0.001), had longer sedentary time (p < 0.001), and had higher PHQ-2 scores (p = 0.048) than non-medical students. In Model 2, medical students with depression had longer sedentary time (p = 0.004) and longer leisure screen time than those without depression (p = 0.007). Moreover, logistic regression analysis adjusted for potential confounders showed that sedentary time (OR = 1.001, p = 0.048) and leisure screen time (OR = 1.003, p = 0.003) were significantly associated with depression among medical students. Based on these results, it is evident that reducing Japanese medical students’ sedentary time and leisure screen time can help combat depression during the COVID-19 pandemic; thus, these results can guide the development of appropriate interventions to prevent and treat depression.

The Short Physical Performance Battery (SPPB) is a physical fall-risk screening tool and predictor of adverse health effects for the older. Its limited use in Japan is due to the relative ease for high-functioning older adults to achieve perfect scores. Japanese researchers thus created a community-based SPPB (SPPB-com). This study investigated whether the SPPB-com score can distinguish between older patients classified as “fallers” and “non-fallers.” Participants comprised 185 older outpatients aged 65 and above who self-reported their history of accidental falls and relevant physical activity. Fall risk was assessed using SPPB and SPPB-com. Handgrip strength, maximum isometric knee extensor strength, and maximum walking speed were measured as physical functions. Multivariate logistic regression and receiver-operating characteristic analyses determined criteria indicating faller status. Fallers were older and had lower physical function, physical activity, SPPB, and SPPB-com scores than non-fallers. Multivariate logistic regression analysis showed SPPB (OR 0.76, 95% CI 0.59–0.99, p = 0.045) and SPPB-com (OR 0.63, 95% CI 0.45–0.87, p = 0.005) scores were both independently associated with prior falls. The SPPB-com score may function as a fall-risk assessment tool for older outpatients, and its combined use with SPPB can increase the accuracy and precision of distinction between fallers and non-fallers.

Background and Objectives: The effectiveness of multiple ultrasound evaluations of the peroneus muscles morphology, including muscle cross-sectional area (CSA) and connective tissue, after lateral ankle sprain (LAS) is unknown. This study aimed to measure the peroneus muscles after LAS at three points, adding distal 75% to the conventional measurement points, in order to obtain a detailed understanding of the post-injury morphology and to propose a new evaluation index of the peroneus muscles for multiple LAS. Materials and Methods: Participants with and without LAS (LAS and control groups, 16 each) were recruited. The muscle cross-sectional area (CSA) and muscle echogenicity were measured using a B-mode ultrasound system at 25%, 50%, and 75% proximal to the line connecting the fibular head to the lateral malleolus. The ankle evertor strength was measured using a handheld dynamometer. Simultaneously, the peroneus longus (PL) and peroneus brevis (PB) muscle activities were measured using surface electromyography. Measurements for the LAS side, non-LAS side, and control leg were performed separately. Results: The CSA was significantly higher at 75% on the LAS side than on the non-LAS side and in the control leg. Muscle echogenicity of the LAS side at 75% was significantly lower than that of the non-LAS side and the control leg. Muscle activity of the PL was significantly lower and the PB was higher on the LAS side than on the non-LAS side and in the control leg. Conclusions: The PL was less active than the PB, while the PB was found to be overactive, suggesting that PB hypertrophy occurs due to an increase in the percentage of muscle fibers and a decrease in the connective tissue. Therefore, it is necessary to evaluate the condition of the PL and PB separately after LAS.

This study aimed to investigate the muscle contractile response of the peroneus longus (PL) and tibialis anterior (TA) in groups with and without chronic ankle instability (CAI) using tensiomyography. Twenty-three adults, 12 with CAI and 11 healthy participants, participated in this study. All subjects underwent a tensiomyographic assessment of the PL and TA to measure delay time, contraction time and maximal displacement. The ankle evertor and invertor normalized peak torques, maximum work done and muscle thickness of the PL and TA were calculated. The delay time and contraction time of the PL in the CAI side were significantly higher than those in the healthy group (p < 0.05); however, no significant difference could be detected in the TA between groups. Furthermore, there was no significant difference in the normalized peak torques, maximum work done and muscle thickness of the PL and TA between groups. The CAI side demonstrated a delayed muscle contractile response of the PL when compared with the healthy group although there was no difference in muscle strength and muscle size. Clinicians should consider the muscle contractile response of the PL for rehabilitation of the ankle evertor with CAI.