Saitama Prefectural University

Health-Related Quality of Life (HRQOL) is an essential domain for evaluating the true success of rehabilitation. The EuroQol 5-dimension 5-level (EQ-5D-5L) is a brief and widely used HRQOL measure. However, evidence is currently lacking regarding its responsiveness following rehabilitation for musculoskeletal disorder, particularly in Japan. Assessment of HRQOL is challenging for older patients with musculoskeletal disorders, particularly those with cognitive impairments or frailty, who may have difficulty self-reporting. Therefore, evaluating the reliability of proxy assessments is crucial in this population. Furthermore, the agreement between self-ratings and proxy-ratings is generally reported to be low. In contrast, a previous Japanese study reported high agreement when an Occupational Therapist (OT) acted as a proxy for stroke patients. This study therefore aimed to clarify the change (responsiveness) in HRQOL and investigate the inter-rater reliability between patient self-responses and OT proxy responses using the EQ-5D-5L in patients with musculoskeletal disorders in a Japanese convalescent rehabilitation ward. This was a multicenter, collaborative longitudinal study conducted across five hospitals in Japan. We enrolled 77 participants with musculoskeletal disorders who were capable of self-reporting. The mean age was 77.7 years. Evaluations were conducted at initial assessment (within one week of admission) and re-evaluation (one month later). HRQOL was measured using the EQ-5D-5L. Proxies were clinical OT who were blinded to patient responses during concurrent assessment. Responsiveness was assessed using the Standardized Response Mean (SRM). Inter-rater reliability for the QOL score was assessed using the Intraclass Correlation Coefficient (ICC), and the sub-items were assessed using weighted Kappa. Significant improvement was observed in all outcome measures post-rehabilitation (p < 0.01). The SRM for the QOL score indicated a large effect size for both self-reported (0.90) and proxy-reported (0.95) responses. Inter-rater reliability for the QOL score showed substantial agreement, with the ICC at re-evaluation was 0.72 (95%CI: 0.59; 0.81), which met the threshold for “good measurement properties” (≥ 0.70) as defined by the COSMIN criteria. The kappa coefficients for the five sub-items ranged from 0.31 (95%CI: 0.17; 0.45) to 0.56 (95%CI: 0.40; 0.72) (fair to moderate agreement). The EQ-5D-5L demonstrates high responsiveness and good inter-rater reliability when administered by an OT proxy at the one-month re-evaluation in this patient population. These findings support the use of OT proxy-responses to reliably estimate the HRQOL of patients with musculoskeletal disorders in the convalescent setting, particularly when self-reporting is difficult, providing evidence that proxy assessments can reliably complement patient reports in musculoskeletal rehabilitation settings.

Abstract In academic settings, publication pressure or the demand for high publication output in prestigious journals is significantly linked to negative mental health outcomes and may lead to questionable research practices. The Revised Publication Pressure Questionnaire (PPQr) was developed to assess these pressures globally; however, this questionnaire has not been adapted to the unique academic environment in Japan. In this study, the Japanese version of the PPQr (PPQr‐J) was developed and validated in a sample of 272 researchers from various Japanese institutions. The translation and cultural adaptation methods used adhered to established guidelines. The internal consistency and test–retest reliability were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC). We then conducted exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) to validate the factor structure. Correlations with existing scales, including burnout indicators, the Survey Work–Home Interaction Nijmegen, and the Brief Job Stress Questionnaire, were examined. The EFA revealed a four‐factor model based on stress, attitude, resources, and discretion that consisted of 17 items. The PPQr‐J demonstrated acceptable to good internal consistency and moderate to good test–retest reliability, with ICC for the subscales ranging from .499 to .752. CFA supported the four‐factor model with a moderate fit. Significant correlations with existing scales confirmed the validity of PPQr‐J. This study confirmed that PPQr‐J is a reliable and valid tool for assessing publication pressure among Japanese researchers, with “discretion” added as a new element.

In this study, we aimed to determine whether the semitendinosus (ST) and biceps femoris long head (BF) exhibit systematically distinct preferred directions (PDs) and to evaluate the biomechanical mechanisms underlying the PDs. A total of 21 healthy young adults performed isometric torque tasks in 16 sagittal-plane directions while surface electromyography (EMG) signals were recorded from six lower limb muscles. Joint torque was estimated with inverse dynamics, and muscle PDs were determined through linear regression of EMG against torque data. Optimal PDs were predicted with static optimization modeling that incorporated both moment arm and physiological cross-sectional areas. Mechanical-only PDs were also estimated based solely on moment arm geometry. Experimentally derived PDs differed significantly between ST and BF (P < 0.001). The ST exhibited significantly greater alignment with optimization-based predictions (mean cosine similarity = 0.96 ± 0.08) than with mechanical-only predictions (0.82 ± 0.15, P = 0.0007), whereas the BF showed comparable levels of agreement with both models (optimization = 0.70 ± 0.35, mechanical = 0.76 ± 0.20, P = 0.3096). These findings indicate that muscle-specific neural modulation contributes to directional tuning, particularly in the ST, and highlight the necessity of incorporating both biomechanical and neural factors to understand spatial organization of muscle activity during complex multijoint motor tasks.NEW & NOTEWORTHY This study demonstrates that the semitendinosus and biceps femoris long head exhibit distinct preferred directions during multijoint isometric torque tasks. Whereas biceps femoris shows high interindividual variability despite anatomical alignment, semitendinosus consistently deviates from mechanical predictions, suggesting stable neural modulation. These findings reveal how the central nervous system selectively tunes muscle activity in a muscle-specific manner, balancing anatomical structure and task-dependent control across multijoint muscles.

Abstract Despite a notable increase in the desistance literature, Asia remains a significant gap in this field. We conducted a scoping review to provide an overview of the current state of desistance research in Asia and to identify the factors that facilitate desistance in this region. In January 2024, literature searches were conducted across seven databases in January 2024: CINAHL, MEDLINE, ProQuest, PubMed, PsychINFO, Scopus, and Web of Science. After screening, we identified nine relevant studies. Our scoping review revealed that desistance research in Asia remains at a nascent stage and is disproportionately focused on East Asia. Additionally, we identified four key areas of focus in the region’s desistance research: (1) family relationships, (2) social networks and support, (3) religion, and (4) culture.

Non-restorative sleep (NRS)-a subjective feeling of unrefreshing/insufficient rest despite adequate sleep duration-an important sleep-quality indicator is associated with depression and mortality. We examined whether insoluble dietary fiber intake is associated with NRS in Japanese adults, after adjusting for socioeconomic, lifestyle, and dietary factors. Using cross-sectional data from 5034 adult (≥20 years) respondents of the National Health and Nutrition Surveys (2014 and 2018), Japan, self-assessed NRS (coded as 1, absence as 0) was analyzed with insoluble fiber intake (g/1000 kcal) modeled as a continuous variable; logistic regression analyses with progressive adjustments included Model 1, adjusted for sex, age, and body mass index; Model 2, comprising socioeconomic and lifestyle factors; Model 3, adjusted for sleep duration; and Model 4, which included dietary energy, protein, fat, vitamin D, and magnesium. Among 19.3% of participants with NRS, the median (interquartile range) insoluble dietary fiber intake was 5.45 (4.10-6.97) g/1000 kcal, with higher NRS prevalence among younger adults (<60 years), non-drinkers (no habitual alcohol consumption), and individuals with short sleep (<6 h). Higher insoluble dietary fiber intake was consistently associated with a lower NRS likelihood, before and after adjustment for potential confounders. In the fully adjusted model, younger age (<60 years), no habitual alcohol consumption, and short sleep (<6 h) were independently associated with greater odds of NRS. Higher insoluble dietary fiber density correlated with lower odds of NRS, indicating a significant association, rather than causation, that warrants longitudinal clarification of the temporal relationship between dietary fiber intake and perceived sleep restorativeness.

ObjectiveWalking in a straight line is considered the simplest form of locomotion for healthy individuals. However, in daily life, the ability to walk along curved paths is essential for tasks such as avoiding obstacles and turning corners. Evaluating gait patterns that involve directional changes along curved trajectories offers a more ecologically valid assessment of functional mobility, thereby contributing to the development of rehabilitation strategies that are better aligned with daily living activities. The present study aimed to investigate differences in knee joint rotational angles between straight and curved walking in older adults, using the point cluster technique. Furthermore, the study sought to determine whether distinct knee rotational patterns exist between gentle and sharp curved walking, both categorized under curved walking.MethodsA total of 40 community-dwelling older adults participated in the study. Each participant performed one trial of straight walking, gentle curve walking (with a curvature radius of 2 meters), and sharp curve walking (with a curvature radius of 1 meter). During each walking condition, reflective markers attached to the body were recorded at a sampling frequency of 100 Hz. From the recorded trajectories of the reflective markers, knee joint angles for flexion-extension, abduction-adduction, and internal-external rotation were calculated.ResultsThe maximum flexion angle was 45.3 ± 10.1° during straight walking, 19.1±9.8° during gentle curve walking, and 23.5 ± 11.7° during sharp curve walking, with a significant difference observed by ANOVA (p < 0.01). Additionally, post hoc multiple comparisons showed significant differences between straight walking and gentle curve walking (p < 0.01), straight walking and sharp curve walking (p<0.01), and gentle curve walking and sharp curve walking (p < 0.05).The maximum external rotation angle was 8.4 ± 7.17° during straight walking, −2.3 ± 7.6° during gentle curve walking, and −5.8 ± 8.2° during sharp curve walking, with a difference observed by ANOVA (p < 0.05). Additionally, post hoc multiple comparisons showed significant differences between straight walking and gentle curve walking (p < 0.05).ConclusionDuring walking along a curved path, individuals adopt a gait strategy that involves internally rotating the knee joint prior to entering the curve. The internal rotation angle of the knee joint during the early stance phase was greater in sharp curve walking than in gentle curve walking, indicating that a smaller curvature radius requires a larger internal rotation angle. These findings suggest that curved walking demands a greater range of knee joint rotation compared to straight walking.

Abstract Background Following the discontinuation of the conventional Action Research Arm Test (ARAT) import in Japan, a domestically manufactured version with identical assessment protocols but modified equipment was developed. We aimed to evaluate the psychometric properties of the newly developed ARAT and compare it with the conventional ARAT in patients with stroke. Methods This single-center cross-sectional study enrolled 64 patients with stroke and hemiparesis who met predefined inclusion criteria. Participants were randomly allocated to a reliability validation (n = 33) or criterion validity validation (n = 31) group. The reliability group underwent duplicate assessments with the new ARAT at 15-min intervals, with video recording for independent inter-rater evaluation. The validity group received both the new and conventional ARAT assessments in randomized order. Convergent validity was assessed using Spearman correlation coefficients with Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), grip strength, Motor Activity Log (MAL), and Jikei Assessment Scale for Motor Impairment in Daily Living (JASMID). Results Intra-rater reliability demonstrated excellent agreement (intraclass correlation coefficient [ICC]: 0.997–1.000, 95% confidence interval [CI]: 0.995–1.000) across all subscales and total scores. Inter-rater reliability showed equally excellent agreement (ICC: 0.979–0.999, 95% CI: 0.963–0.999). Bland–Altman analysis revealed limits of agreement within clinically acceptable ranges for all measures. The new ARAT demonstrated very strong convergent validity with FMA-UE (ρ = 0.934, p &lt; 0.001) and BBT (ρ = 0.917, p &lt; 0.001), and moderate-to-strong correlations with grip strength (ρ=0.683, p &lt; 0.001), MAL subscales (ρ = 0.610–0.666, p &lt; 0.001), and JASMID subscales (ρ = 0.806–0.808, p &lt; 0.001). Conclusions The new ARAT demonstrates measurement properties equivalent to the conventional version with excellent reliability and strong criterion-related validity. Its robust convergent validity with established upper limb assessments supports its clinical utility for comprehensive stroke rehabilitation evaluation.