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高齢者における転倒予防のための複数課題条件下での座位運動介入法の開発

Research Project

Project/Area Number 11J02998
Research Category

Grant-in-Aid for JSPS Fellows

Allocation TypeSingle-year Grants
Section国内
Research Field Applied health science
Research InstitutionNagoya University

Principal Investigator

上村 一貴  名古屋大学, 医学系研究科, 特別研究員(DC1)

Project Period (FY) 2011 – 2013
Project Status Completed (Fiscal Year 2013)
Budget Amount *help
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2013: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2012: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2011: ¥700,000 (Direct Cost: ¥700,000)
Keywords高齢者 / 転倒 / 姿勢制御 / リハビリテーション / 注意 / 認知機能 / ステップ動作 / 予測的姿勢調節
Research Abstract

本研究の主たる目的は、注意負荷を生じる視覚課題がステップ動作時における姿勢調節メカニズムに及ぼす影響を、特に予測的姿勢調節(APA)に着目して明らかにすることにより、動作時の注意・選択の過程に着目した新しいリスク評価法や介入プログラムを開発することである。昨年度、軽度認知機能障害(MCI)を有する高齢者376名を対象とした実験を行った結果、転倒経験のある対象者では、歩行速度などの一般的な運動機能検査や座位姿勢における選択注意課題反応時間には低下がみられないが、立位ステップ動作において、注意負荷が加わった場合に、潜在エラーが生じ、APAが遅延していることが明らかとなった。
この結果から、立位での動作中における注意機能を強化する運動プログラムが、MCI高齢者の転倒予防には重要であることが考えられ、運動中に副次的に認知課題を実施させ、動作時の注意、判断や素早い反応を強化するプログラムを作成し、転倒発生に及ぼす影響を検討するためのRCTを実施した。対象はClinical Dementia Scaleが0.5、あるいは主観的な記憶機能低下を訴える高齢者528名に対してリクルートを行い、PetersenらのMCI判定基準に該当した高齢者89名とした。週2回、1回90分、12か月間の運動教室を実施する介入群44名と、期間中に3回の健康講座を受講するコントロール群45名にランダムに割付を行った。介入開始から6ヵ月後、6~12か月後の各期間における転倒の発生状況を調査し、x^2検定を用いて群間比較を行ったところ有意な差はみられなかった(6ヶ月, 介入群29.5%, コントロール群19.1% ; 6~12か月, 介入群20.5%, コントロール群13.3%)。運動介入群では、屋外でのウォーキングなどを含む運動習慣を新たに開始したことにより、外的環境変化等の危険にさらされやすく、転倒が発生しやすくなった可能性が考えられる。介入期間中における転倒予防効果の発現はみられなかったが、今後は介入終了後の転倒発生を追跡調査し、本研究で開発した特異的エクササイズの転倒予防効果を検証する必要がある。

Current Status of Research Progress
Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

1年間の運動介入試験を期間内に完了することができ、研究成果として、4つの英語論文を執筆し、うち2つは採択発行済みであることから、全体としておおむね順調に進展していると考える。

Strategy for Future Research Activity

今後の展望として、本研究で開発した動作中における注意機能に着目した特異的介入プログラムの頻度および強度が不十分であった可能性が考えられるため、より大きなサンプルサイズで、頻度および強度により群分けを行ったRCTを実施し、転倒予防に有効なプログラムとその至適量・強度について明らかにする必要がある。

Report

(3 results)
  • 2013 Annual Research Report
  • 2012 Annual Research Report
  • 2011 Annual Research Report
  • Research Products

    (43 results)

All 2014 2013 2012 2011

All Journal Article (31 results) (of which Peer Reviewed: 31 results) Presentation (12 results)

  • [Journal Article] Olfactory identification and cognitive performance in community-dwelling older adults with mild cognitive impairment2014

    • Author(s)
      Makizako M, Makizako H, Doi T, Uemura K, Tsutsumimoto K, Miyaguchi H, Shimada H
    • Journal Title

      Chem Senses

      Volume: 39(1) Issue: 1 Pages: 39-46

    • DOI

      10.1093/chemse/bjt052

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Using two different algorithms to determine the prevalence of sarcopenia2014

    • Author(s)
      Yoshida D, Suzuki T, Shimada H, Park H, Makizako H, Doi T, Anan Y, Tsutsumimoto K, Uemura K, Ito T, et al
    • Journal Title

      Geriatr Gerontol Int

      Volume: 14 Suppl 1 Issue: S1 Pages: 46-51

    • DOI

      10.1111/ggi.12210

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] The combined status of physical performance and depressive symptoms is strongly associated with a history of falling in community-dwelling el derly : Cross-sectional findings from the Obu Study of Health Promotion for the Elderly (OSHPE)2014

    • Author(s)
      Makizako H, Shimada H, Doi T, Yoshida D, Tsutsumimoto K, Uemura K, Anan Y, Park H, Lee S, Ito T, Suzuki T
    • Journal Title

      Arch Gerontol Geriatr

      Volume: 58(3) Issue: 3 Pages: 327-331

    • DOI

      10.1016/j.archger.2014.01.001

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults2014

    • Author(s)
      Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Yoshida D, Anan Y, Ito T, Lee S, Park H, Suzuki T
    • Journal Title

      Maturitas

      Volume: (In press) Issue: 1 Pages: 62-66

    • DOI

      10.1016/j.maturitas.2014.02.018

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Development of measurement system for task oriented step tracking using laser range finder2013

    • Author(s)
      Matsumura T, Moriguchi T, Yamada M, Uemura K, Nishiguchi S, Aoyama T, Takahashi M
    • Journal Title

      J Neuroeng Rehabil

      Volume: 10(1) Issue: 1 Pages: 47-47

    • DOI

      10.1186/1743-0003-10-47

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Combined Prevalence of Frailty and Mild Cognitive Impairment in a Population of Elderly Japanese People2013

    • Author(s)
      Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Ito T, Lee S, Park H, et al
    • Journal Title

      J Am Med Dir Assoc

      Volume: 14(7) Issue: 7 Pages: 518-524

    • DOI

      10.1016/j.jamda.2013.03.010

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Performance-based assessments and demand for personal care in older Japanese people : a cross-sectional study2013

    • Author(s)
      Shimada H, Suzuki T, Suzukawa M, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Ito T, et al
    • Journal Title

      BMJ Open

      Volume: 3(4) Issue: 4 Pages: 1-7

    • DOI

      10.1136/bmjopen-2012-002424

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] A novel infrared laser device that measures multilateral parameters of stepping performance for assessment of fall risk in elderly individuals.2013

    • Author(s)
      Nishiguchi Shu
    • Journal Title

      Aging Clin Exp Res

      Volume: 25(3) Issue: 3 Pages: 311-316

    • DOI

      10.1007/s40520-013-0042-9

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment2013

    • Author(s)
      Makizako H, Shimada H, Doi T, Park H, Yoshida D, Uemura K, Tsutsumimoto K, Liu-Ambrose T, Suzuki T
    • Journal Title

      BMC Neurol

      Volume: 13(1) Issue: 1 Pages: 102-102

    • DOI

      10.1186/1471-2377-13-102

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Brain activation during dual-task walking and executive function among older adults with mild cognitive impairment : a fNIRS study2013

    • Author(s)
      Doi T, Makizako H, Shimada H, Park H, Tsutsumimoto K, Uemura K, Suzuki T
    • Journal Title

      Aging Clin Exp Res

      Volume: 25(5) Issue: 5 Pages: 539-544

    • DOI

      10.1007/s40520-013-0119-5

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 日本語版-改訂Gait Efficacy Scaleの信頼性および妥当性2013

    • Author(s)
      牧迫飛雄馬, 島田裕之, 吉田大輔, 阿南祐也, 伊藤忠, 土井剛彦, 堤本広大, 上村一貴, Brach. Jennifer, 鈴木隆雄
    • Journal Title

      理学療法学

      Volume: 40(2) Pages: 87-95

    • NAID

      110009604096

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of speed and accuracy strategy on choice step execution in response to the flanker interference task2013

    • Author(s)
      Uemura K, Oya T, Uchiyama Y
    • Journal Title

      Hum Mov Sci

      Volume: 32(6) Issue: 6 Pages: 1393-1403

    • DOI

      10.1016/j.humov.2013.07.007

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Cognitive activities and instrumental activity of daily living in older adults with mild cognitive impairment2013

    • Author(s)
      Doi T, Shimada H, Makizako H, Lee S, Park H, Tsutsumimoto K, Uemura K Yoshida D, Anan Y, Suzuki T
    • Journal Title

      Dement Geriatr Cogn Dis Extra

      Volume: 3(1) Issue: 1 Pages: 398-406

    • DOI

      10.1159/000355553

    • Related Report
      2013 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Factors associated with life-space in older adults with amnestic mild cognitive impairment2013

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Geriatrics Gerontology International

      Volume: 13 Issue: 1 Pages: 161-166

    • DOI

      10.1111/j.1447-0594.2012.00878.x

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment2013

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Clinical Interventions in Aging

      Volume: 8 Pages: 97-102

    • DOI

      10.2147/cia.s39434

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] A lower prevalence of self-reported fear of falling is associated with memory decline among older adults.2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Gerontology

      Volume: 58(5) Issue: 5 Pages: 413-418

    • DOI

      10.1159/000336988

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effect of dual-tasking on the center of pressure trajectory at gait initiation in elderly fallers and non-fallers2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Aging Clinical & Experimental Research

      Volume: 24 Pages: 152-156

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of exercise intervention on vascular risk factors in older adults with mild cognitive impairment : a randomized controlled trial2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Dementia & Geriatric Cognitivc Disorder Extra

      Volume: 2 Issue: 1 Pages: 445-455

    • DOI

      10.1159/000343486

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Impaired choice stepping in response to a visual-spatial attention demanding task among older adults at high risk of falling : a pilot study2012

    • Author(s)
      Kazuki Uernura
    • Journal Title

      Aging Clinical & Experimental Research

      Volume: 2 Pages: 361-364

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Reaction time for peripheral visual field increases during stepping task in older adults2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Aging Clinical & Experimental Research

      Volume: 24 Pages: 365-369

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of visual interference on initial motor program errors and execution times in the choice step reaction2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Gait Posture

      Volume: (Epub ahead of print) Issue: 1 Pages: 68-72

    • DOI

      10.1016/j.gaitpost.2012.10.016

    • Related Report
      2012 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Maladaptive turning and gaze behavior induces impaired stepping on multiple footfall targets during gait in older individuals who are at high risk of falling2012

    • Author(s)
      Minoru Yamada
    • Journal Title

      Geriatrics Gerontology International

      Volume: 54 Issue: 2 Pages: 102-108

    • DOI

      10.1016/j.archger.2011.08.012

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Faster decline of physical performance in higher levels of baseline locomotive function in older adults2012

    • Author(s)
      Minoru Yamada
    • Journal Title

      Geriatrics Gerontology International

      Volume: (in press) Issue: 2 Pages: 238-246

    • DOI

      10.1111/j.1447-0594.2011.00757.x

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Complex obstacle negotiation exercise can prevent falls in community-d welling elderly Japanese aged 75 years and older2012

    • Author(s)
      Minoru Yamada
    • Journal Title

      Geriatrics Gerontology International

      Volume: (in press)

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of dual-task switch exercise on gait and gait initiation performance in older adults : Preliminary results of a randomized controlled trial2012

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Archives of Gerontology and Geriatrics

      Volume: (in press) Issue: 2 Pages: 167-171

    • DOI

      10.1016/j.archger.2012.01.002

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effects of Balance Training on Muscle Coactivation During Postural Control in Older Adults : A Randomized Controlled Trial2012

    • Author(s)
      Koutatsu Nagai
    • Journal Title

      The Journals of Gerontology, Series A : Medical Sciences

      Volume: (in press) Issue: 8 Pages: 882-889

    • DOI

      10.1093/gerona/glr252

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults2011

    • Author(s)
      Minoru Yamada
    • Journal Title

      Geriatric Nursing

      Volume: 32(3) Pages: 188-194

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Older adults at high risk of falling need more time for anticipatory postural adjustment in the precrossing phase of obstacle negotiation2011

    • Author(s)
      Kazuki Uemura
    • Journal Title

      The Journals of Gerontology, Series A : Medical Sclences

      Volume: 66(8) Issue: 8 Pages: 904-909

    • DOI

      10.1093/gerona/glr081

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effect of resistance training on physical performance and fear of falling in elderly with different levels of physical well-being2011

    • Author(s)
      Minoru Yamada
    • Journal Title

      Age Ageing

      Volume: 40(5) Issue: 5 Pages: 637-641

    • DOI

      10.1093/ageing/afr068

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Measurements of stepping accuracy in a multi-target stepping task as a potential indicator of fall risk in elderly individuals2011

    • Author(s)
      Minoru Yamada
    • Journal Title

      The Journals of Gerontology, Series A : Medical Sciences

      Volume: 66(9) Issue: 9 Pages: 994-1000

    • DOI

      10.1093/gerona/glr073

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Fear of falling is associated with prolonged anticipatory postural adjust ment during gait initiation under dual-task conditions in older adults2011

    • Author(s)
      Kazuki Uemura
    • Journal Title

      Gait and Posture

      Volume: 35(2) Issue: 2 Pages: 282-286

    • DOI

      10.1016/j.gaitpost.2011.09.100

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Presentation] 選択ステップ反応における速さまたは正確性の重視戦略が姿勢調節に及ぼす影響2013

    • Author(s)
      上村一貴, 内山靖
    • Organizer
      日本健康行動科学会第12回学術大会
    • Place of Presentation
      札幌国際大学
    • Year and Date
      2013-09-28
    • Related Report
      2013 Annual Research Report
  • [Presentation] Choice step reaction to a selective attention task is prolonged by errors of postural preparation in older adults2013

    • Author(s)
      Uemura K, Takahashi S, Togo H, Kako M, Uchiyama Y
    • Organizer
      Joint World Congress of International Society for Posture and Gait Research and Gait & Mental Function
    • Place of Presentation
      秋田ビューホテル
    • Year and Date
      2013-06-24
    • Related Report
      2013 Annual Research Report
  • [Presentation] 不全脊髄損傷者の屋外歩行自立に関連する下肢機能と歩行能力2013

    • Author(s)
      長谷川隆史, 原田康隆, 上村一貴, 杉山統哉, 田中宏太佳, 内山靖
    • Organizer
      第48回日本理学療法学術大会
    • Place of Presentation
      名古屋国際会議場
    • Year and Date
      2013-05-26
    • Related Report
      2013 Annual Research Report
  • [Presentation] 頚部固定および予告の有無が振り向き動作時の姿勢制御に与える影響2013

    • Author(s)
      杉浦友香里, 堀真里南, 上村一貴, 春田みどり, 高橋秀平, 東口大樹, 大矢敏久, 内山靖
    • Organizer
      第48回日本理学療法学術大会
    • Place of Presentation
      名古屋国際会議場
    • Year and Date
      2013-05-25
    • Related Report
      2013 Annual Research Report
  • [Presentation] 軽度認知障害高齢者では選択的注意課題に対するステップ反応分析で転倒リスクが顕在化する2013

    • Author(s)
      上村一貴, 大矢敏久, 東口大樹, 高橋秀平, 土井 剛彦, 牧迫飛雄馬, 島田裕之, 内山靖
    • Organizer
      第48回日本理学療法学術大会
    • Place of Presentation
      名古屋国際会議場
    • Year and Date
      2013-05-24
    • Related Report
      2013 Annual Research Report
  • [Presentation] 軽度認知障害を有する高齢者におけるdual-task歩行能力と前頭前野内の灰白質2013

    • Author(s)
      土井剛彦, 牧迫飛雄馬, 島田裕之, 堤本 広大, 上村 一貴, 朴 眩泰, 吉田大輔, 阿南 祐也, 伊藤忠, 鈴木隆雄
    • Organizer
      第48回日本理学療法学術大会
    • Place of Presentation
      名古屋国際会議場
    • Year and Date
      2013-05-24
    • Related Report
      2013 Annual Research Report
  • [Presentation] グループ単位の運動介入実施により軽度認知障害を有する高齢者のQOLは向上するのか? ―ランダム化比較試験による検討―2013

    • Author(s)
      堤本広大, 土井剛彦, 島田裕之, 牧迫飛雄馬, 吉田大輔, 上村一貴, 阿南祐也, 伊藤忠, 李相侖, 朴眩泰, 鈴木隆雄
    • Organizer
      第48回日本理学療法学術大会
    • Place of Presentation
      名古屋国際会議場
    • Year and Date
      2013-05-24
    • Related Report
      2013 Annual Research Report
  • [Presentation] Effects of selective attention task on postural adjustment during choice step reaction2012

    • Author(s)
      上村一貴
    • Organizer
      Nagoya-Yonsei University Research Exchange Meeting
    • Place of Presentation
      名古屋大学大幸キャンパス(名古屋)
    • Year and Date
      2012-11-23
    • Related Report
      2012 Annual Research Report
  • [Presentation] 軽度認知障害を有する高齢者に対する運動介入によるTimed Up & Go Testの向上には認知機能が影響する2012

    • Author(s)
      上村一貴
    • Organizer
      第47回日本理学療法学術大会
    • Place of Presentation
      神戸ポートピアホテル(神戸)
    • Year and Date
      2012-05-27
    • Related Report
      2012 Annual Research Report
  • [Presentation] 選択的注意課題における視覚的干渉はステップ(踏み出し)動作を遅延させる2012

    • Author(s)
      上村一貴
    • Organizer
      第47回日本理学療法学術大会
    • Place of Presentation
      神戸ポートピアホテル(神戸)
    • Year and Date
      2012-05-25
    • Related Report
      2012 Annual Research Report
  • [Presentation] Dual-task Switch Exerciseが高齢者の歩行および歩行開始能力に及ぼす影響-無作為化比較試験-2011

    • Author(s)
      上村一貴
    • Organizer
      第46回日本理学療法学術大会
    • Place of Presentation
      シーガイアコンベンションセンター(宮崎県)(招待講演)
    • Year and Date
      2011-05-29
    • Related Report
      2011 Annual Research Report
  • [Presentation] 高齢者の機能的視野は運動中に狭窄する-中心・周辺視野における反応時間の分析による検討-2011

    • Author(s)
      上村一貴
    • Organizer
      第46回日本理学療法学術大会
    • Place of Presentation
      シーガイアコンベンションセンター(宮崎県)(招待講演)
    • Year and Date
      2011-05-27
    • Related Report
      2011 Annual Research Report

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Published: 2011-12-12   Modified: 2024-03-26  

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