山田 晃司

Constipation is a prevalent condition that negatively impacts health and quality of life. Inadequate physical activity is a known contributing factor, often associated with reduced gut motility. However, the physiological mechanism linking physical activity and constipation remains unclear. Particularly research on the immediate effects of physical activity on peristalsis is scarce. Therefore, we aimed to elucidate this mechanism by examining the immediate effects of physical activity on gut motility in healthy adults. Twenty-one participants were instructed to walk on a treadmill for 20 min. Bowel sounds were assessed at rest and at intervals up to 15 min after walking. Bowel sounds were used as indirect markers of gut motility. We calculated the sum of the absolute signal amplitudes of bowel sounds, the percentage of bowel sounds duration, and number of discrete bowel sounds, which have been proposed as indices of gut motility. All the indices increased significantly 1-2 min post-exercise compared to resting values. This increase may be attributed to changes in the autonomic nervous system and local reflexes caused by biomechanical oscillations. In addition, gut motility activation might explain the effects of physical activity intervention on constipation and offer insights into its potential role in managing the condition.

OBJECTIVE: To elucidate the relationship between social participation and quality of life (QOL) in patients with traumatic brain injury. METHODS: This study included 128 community-dwelling patients with head injuries (average age: 41.8 years; average time since injury: 3126 days). We employed the Community Integration Questionnaire (CIQ; scoring range 0-29), a disease-specific scale for head injury patients, along with the Quality of Life after Brain Injury (QOLIBRI; scoring range 0-100%). An adjusted nonlinear regression analysis was used to explore the relationships between the CIQ (total score and subscales: home integration, social integration, productivity) and QOLIBRI (total score and subscales). RESULTS: A significant relationship was observed only between the Total CIQ and the Self subscale of the QOLIBRI (p=0.006). The Self subscale score of the QOLIBRI increased with the Total CIQ score up to 15, after which it plateaued. Additionally, a significant positive relationship was found between the Social Integration subscale of the CIQ and the Self subscale of the QOLIBRI (p=0.018). The QOLIBRI Self score increased with the CIQ Social Integration score up to 8, beyond which it remained stable. No associations were found between the CIQ's Home Integration and Productivity subscales and the QOLIBRI scores. CONCLUSION: The findings indicate that for individuals with traumatic brain injury, an increase in social participation, particularly in social integration, correlates with an enhanced sense of self-satisfaction up to a certain point. However, beyond this level, further advances in social participation do not yield additional gains, suggesting that factors other than social participation play a role in enhancing QOL. This underscores the multifaceted nature of QOL in this context.