Toe grip-related training requires individuals to actively exercise muscles that are not frequently used; therefore, it may improve not only toe grip strength but also cognitive function. The purpose of this study was to examine the effects of toe grip-related training on predictors of physical performance and cognitive function in nursing home residents. A total of 35 nursing home residents (35 left and 35 right feet; mean age, 82.1 ± 7.9 years) were included in this study. The participants were divided into two groups: a training group and a control group. The Mini-Mental State Examination (MMSE) was used to assess the cognitive function of the participants, and the Fall Risk Index (FRI) was used to evaluate the risk of falls. Toe grip-related physical function was also assessed. Baseline endpoints were evaluated and the effects of toe grip-related training were examined following a 12-week training intervention. The training group showed significant improvements in MMSE score, FRI score, toe grip strength, and the toe skill (TS) test; however, the control group did not show these changes. The training group showed significant increases in Δ MMSE, Δ toe grip strength, and Δ TS (right foot) than the control group. Stepwise regression analysis revealed that Δ toe grip strength is an independent factor of Δ MMSE. Toe grip training improves not only toe grip strength itself, but also cognitive function. Furthermore, change in toe grip strength was an independent factor of change in MMSE in those populations. UMIN, UMIN000027437 . Registered on 26 May 2017.

While people with obesity have been found to chew fewer times and for shorter durations, few studies have quantitatively evaluated mastication among this group. This study examined the relationship between the mastication characteristics of people with obesity and the factors correlated with obesity. To this end, 46 people with obesity and 41 healthy participants placed an earphone-style light sensor in the aperture of their outer ear. We also examined the partial correlation between this, their body composition, and various biochemical markers by gender. A two-way analysis of variance (ANOVA) regarding the masticatory index, gender, and the presence/absence of obesity for all three food items revealed the main effects in the gender difference and the presence/absence of obesity. Additionally, the number of times the salad was chewed showed an interaction between the gender and the presence/absence of obesity. In the BMI-corrected partial correlation analysis of the chewing index and the glucose/lipid metabolism index, the chewing time and the number of chews of all the food items negatively correlated with hemoglobin A1c(HbA1c), fasting plasma glucose (FPG), immunoreactive insulin (IRI), and homeostasis model assessment of insulin resistance (HOMA-R) in the female obese group. These findings might be used in weight-loss interventions for men with obesity and treatments that target the metabolic function among women with obesity.

Standard methods for swallowing function evaluation are videofluoroscopy (VF) and videoendoscopy, which are invasive and have test limitations. We examined the use of an earphone-type sensor to noninvasively evaluate soft palate movement in comparison with VF. Six healthy adults wore earphone sensors and swallowed barium water while being filmed by VF. A light-emitting diode at the sensor tip irradiated infrared light into the ear canal, and a phototransistor received the reflected light to detect changes in ear canal movement, including that of the eardrum. Considering that the soft palate movement corresponded to the sensor waveform, a Bland–Altman analysis was performed on the difference in time recorded by each measurement method. The average difference between the time taken from the most downward retracted position before swallowing to the most upward position during swallowing of the soft palate in VF was −0.01 ± 0.14 s. The Bland–Altman analysis showed no fixed or proportional error. The minimal detectable change was 0.28 s. This is the first noninvasive swallowing function evaluation through the ear canal. The earphone-type sensor enabled us to measure the time from the most retracted to the most raised soft palate position during swallowing and validated this method for clinical application.

Although exercise is a standard treatment for postoperative osteoarthritis, interindividual differences have been reported. Epigenetic modification (DNA methylation), a factor causing interindividual differences, is altered by the environment and may affect all tissues. Performing a tissue biopsy to investigate methylation of skeletal muscle fat metabolism genes is invasive, and less invasive and convenient alternatives such as blood testing are desired. However, the relationship between tissue and blood is still unclear. Here, we examined the relationship between DNA methylation of the PDK4 gene in skeletal muscle and peripheral blood. Five patients who underwent artificial knee arthroplasty between April 2017 and June 2018 at Kansai Medical University Hospital were included (2 men and 3 women; average age, 75.2 years; body mass index, 26.1 kg/m²). We measured the body composition of the patients using dual-energy X-ray absorptiometry. Peripheral blood was collected at the time of hospitalization and 5 months after surgery; skeletal muscles were collected at the time of surgery and 5 months after surgery. Rehabilitation was performed according to the clinical procedure for 3 months after surgery. Patients performed resistance training and aerobic exercise using an ergometer for 20 min twice a week. Biopsy samples were treated with bisulfite after DNA extraction, and the methylation rate was calculated at different CpG islands downstream from the transcription initiation codon of the PDK4 gene. No significant change in body composition was observed before and after postoperative exercise therapy, and no significant change was noted in the methylation at each position in the promoter region of PDK4 in the skeletal muscle and peripheral blood. However, changes in the methylation rate at CpG1 in peripheral blood significantly correlated with those in skeletal muscle (P = 0.037). Furthermore, the amount of change in the methylation rate of CpG1 in the skeletal muscle was significantly correlated (P = 0.037) with the average methylation rate at the promoter region in peripheral blood. Methylation rates at CpG1 in the skeletal muscle and peripheral blood were significantly correlated, suggesting that skeletal muscle methylation could be analyzed via peripheral blood rather than skeletal muscle biopsy.

Background: Remote cardiac rehabilitation (RCR) is emerging alternative to outpatient rehabilitation. However, evidence related to its effect on health-related quality of life (HRQOL) is limited. Methods: This is a sub-analysis of the RecRCR study, a multi-center, nonrandomized trial evaluating the efficacy and safety of RCR with real-time telemonitoring in patients with CVD, after discharge. The Short-Form Health Survey-8 was employed to evaluate the HRQOL before and 2–3 months after RCR. Based on the improvement of exercise tolerance, the patients were divided into I group (>10% improvement) and NI group (≤10% improvement). Results: Of 57 patients who completed RCR, 31 patients were included for analysis of HRQOL, including 15 (I group) and 16 patients (NI group). The physical (PCS) (45.5 ± 8.0 to 52.5 ± 4.0, p < 0.001) and mental (MCS) component scores (47.5 ± 7.9 to 51.0 ± 5.6, p = 0.005) improved significantly in all populations following RCR. The PCS improved significantly in the I and NI groups, respectively. By contrast, only in the I group, the MCS improved. However, the change in PCS or MCS was not significantly different between the two groups. The increases of MCS significantly associated with days from admission to the beginning of RCR (rs = −0.51, p = 0.007). Conclusions: In multifaced contents of HRQOL, the scores in PCS or MCS changed differently from the change in exercise capacity.