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カロリー消費とメンタルヘルス

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運動と消費カロリーの計算式
運動とメンタルヘルス

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カロリー消費とメンタルヘルス

  1. 1. Japanese Society of Physical Education NII-Electronic Library Service Japanese  Sooiety  of  Physioal  Eduoation OB3NO5 酸 素 摂 取 量 か ら の 計 算 し た カ ロ リ ー 消 黄 髭 と 心 拍 法   R列R 法 お よ び 隈 法 に ょ る 値 と の 比 較 ○ 北 川  喜 一郎   酉 谷  明子   早川  宏 子   鈴 木  昭太郎 (中央大 学 保 健体 育研究所 )   心 拍 数  カ ロ リ ー消 黄量  エ ネル ギ ー RMR METS  工 . ’ ま え が き .   従来 ,被験 者 の エ ネル ギ ー代謝湿 を カ ロ リ ー恒で算出す る に は , 呼気ガ ス 重 とそ の 温 度 ,お よび 酸 素 , 二 敢化 炭棄 、ガ ス濃 度 を測定 して , 呼 吸交換比 を勘案して 間接 的熱量計 算zateよ り非 蛋 白性 代謝 工 耄 ル ギ ー量 を 算 出す る (以 下 , 常 法と呼ぶ)諳雑な過程に よ らな けれ ばな らなか v 冱6 筆 者 らは簡便 に 概算慷を求める 方怯 として ,運動時の 心拍数 か らカ 『⊃ リー磴 を 求 め る 方法 (以 下, 心 拍数法 と呼ぶ ) を 鞭告 したが , 本 眼 告 は , 性別 , 年齢, 体表面積か ら求め 粒 墓 礎 代謝量 と 運動に よっ て 定 まるエ ネ ル ギ ー代謝畢 RMR か らカ ロ リ ー値 を算出する方法 (以 下 , RMR 法 と 呼ぶ ) お よ び METS 値か ら計算す る方法 (以 下 ,   NeTstaと呼ぶ )な どに よ る 結果 を夫 々 比較 して ,心拍 法 の 実用 性 と各法 の 特 徴 を検 討 した もの で あ る 。 2 ,実 験 方法   2 .1  被険者 に つ い て   健康 な身体 条 件 の 男性 5名 (平 均 年 齢 20。2 歳 , 以 下 , M 群 で 示す) , 女性 5名 (平均年齢 2:.4 歳以下, F 群で・ 示す ) の 計 10 名 に つ い て の 測 定 星 行 な っ た。   2 .2   運動負 荷rtttつ い て   トレ ツ ド ミ 丿レ 電…使 }穏レ,速 度 を O  −  200m !面in , 傾 斜角度 0度の 運 動負荷条件を 基準 と し 卩 各被険者に 一定の 運動負荷 を 5 分間与え た後 に 5 分問 の 休 息 を行な うこ とを 一行程 と して 測定 を行な っ た 。以下 ,文 中 では運 動 負荷 量 を速度で し萄 し沌 。   2 .3   測定項巨   呼吸数   R 卿R ワ(Nノ 即in ) , 呼気量VE(1ノ 旧「n)  g 呼気艶昆 度   ( OF, 3 、諜鸞 1 )糴 騨矗                    ス (X )の 渦度,                     1 使用 し 定し た 』 呼 気 量, 酸 素ガ ス濃度 お よ び 心 拍数 値は ,測 定 が ほ ぼ 安: 定 する測 定開 始 後 1 分 か ら5 分 迄 の 値 の 平 均 を使用 し た, 呼 気 畳, 酸素 濃 度の サ ン ブ リ ング タイム 5秒(デー タ数   : C8 ) ,心 ・拍数 は 同1秒 (デ ー タ 数 240 )で あるり  2 4   常 法によ る計 算   負蕎時 毎 の 酸棄摂取 量鴨 を 測 定 し , 次式によ って工嘉 ル ギー消黄量( kca Imih )を 計 算 し 抱9 .エ ネ・・ ギ哨鰍 脚即 i ρ E ・ (P ・P.・4 鋤 ・ボ   2・ S ・1 白 数 法 己 こ よる計 r 算  次 式によって得 た値 に 被険 の 体重( kg )を掛 けてエネル ギー 消 費 ( kca ) !min )を求めた。  エ ネルギー 消黄量(kcal!kg ・ n ) = [ 2 . 324   x ( 心 拍 数                                ・3                          − 50 冫幗30rsB  〕  0  2 .6  RMR 法 に よ る計算  被験者の体表面 積 を求 め 基 礎代 謝 重(kcal !h )を墓礎 代 1 謝基準恆 (20 厳 台: 性 37.O , 女 性 34 . O ,19 な 台:勇 性38 . 2 ) よって 計算し, こ の基礎代謝 重 とエ ネル ギー 代謝率RMR から RMR によ る エ ネ ル ギ ー消 黄 量 ( allmin ) を次式に よって 計算した 。   エ ネルギ ー消 黄 量(k l / min ):( 5 + RMR )X墓礎代 . 謝量 @1 /60  2 ・ 7  勃ETS 法に よ る 計 算 @ 水平進行畤の連度 から HETS値を 次式から 求め  ド1 εTS(VO ml / 3.5隅 ;●kg・ n )   ;   匸 3 . 5 鵬 1 尋 速 度 ( 閏 ! 国ln > A’                      0 .2mlj / 3 .5 田 1 被険 の体量 V ( ) を次 式 に代入してエネル ギー消 黄量を 計算した。 エネルギー 消黄量(kca m 副. 陶 )= METS 値 xV ( k8 ) / 60 ( n ) 3 . 結  果   3 ・ 1   常法 によ っ て求めた   速 度に対 する 男女 被 険者 の エ ネ ル ギ 呻 消 鼠 量 の計算結果 では ,M 一 群 の散 布 度が F 一群 に比べてやや大 き く ,150m !即 i 演 ラ 時で 鼬 Qの範 囲R :5 . t8 ,   F 一群 D ;3 .33 で あ v た一 3 ・ , 2   心 珀法によって求めた  算出値 の 敏 布 の範 囲は常法に比ぺ て やや 大きく,t50m ! 』, in 負荷時で,   Mr 群 R :5 .4 CF 一群R :3 . 57 と な っ 拒。 3.3  RMR 法 によ7て求 た値  算 出 蠖の散 布 の 範 囲 は,M 一群 で R : 2 ,3 しF 群  R :0 . 72 と 前2 法 よ り も少な く ,ま 値 の速 度に対する変 化 が エ ネ ルギ 代謝 $の特 性 に比 例するこ とが 分か る。 3 ・ 4   MET @ に よ って求め た恒   陀 TS 法 による 算 出値 の 変 化は 線 的で ,各被険者間 の 消 黄 カロリーの違 いが 体重 の み に よ る 特 が示 れ ,M 一 群 フ範囲R :2 .23 , F 一薜は R : O . 63 と 最 も 少ない煩 なっ た , 4 .考    察 1 ) 各速度 負 荷 によ o て 険者が消黄す る 真のカロ リ ー 嶂は 常 怯 ’に 1 よ ¶っ℃求 沌値に近いものと考え ら れる 。 ’ 2 ) 心 拍法による結果を鴬法 と比 較す と,常法 の標準 偏 差 S . D . : 1 。154に た い し て 心多白 で は S . D , : 1 . 79 ? と な ゆ , 心 拍法の 散 布の 範 はやや大きい が,  RMR 法 ある はMErS 法とほぼ同 じ レ ベルの 消黄 カ ロリ ー激の 推 定 法 と て 使 用.が可 能 であると 考え ら れる 。 3 ) RMR 法 よ る消黄カロ リ ー埴は , 体裘面 積BSA と 速度 に る エネ ギ ー代 謝 RMR で決ま る 事から,消黄カロ リー値 とBSA の 変 動 係数 同 咳 となり, 散布の 範囲が常法と 比べ 少 な 。 4 >門ETS 法 も変数を 険者の体重のみと し ている距め , RMR 法 と 同様に散布 範囲が 常法 に 比ぺ 少ない。                文  献 1 ) 鈴木昭太郎,酉谷 子他:トレヅドミ ル の 運 動 負 荷に よ る エネル ギ ー 消黄童と 拍 数との関係,日本 体育学 会 第 3B 会大 会論 文鏑 ( 1 7) 2 ) 鈴木昭木郎,酉谷.明子他; ト ッ ドミルに る 負 荷 童 の 運 動 機 能 に 与え る影 響 , 中 夾 大 学保健体 百 研 寃所 紀
  2. 2. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation of Health Sciences J UOEH (reKEUV<#meE-S)3S (1)i1-8 {2013) l [Original] The Effectsof a Walking Intervention on DepressiveFeelingsand Social AdaptationinHealthyWorkers AtsukoIKENoucHi-SuGHAi,ReijiYbsHiMuRAi, KazunariSuGuA2,Hikaru HoRit, Kumi YAMADA3,Mayumi SAKAuE3 and JunNAKAMuRAi 'Department qlCRsychiattyfJZicultyqirMledicine,Uhiversityoj'Occupationaland EnvironmentalHealth, Jinpan, l2Jhatanishi-ku,Kitakyushu 807-8555,Jinpan 2Department of'Dermatologyhacutty ofMladicine,UhiversityofOccupationaland E"vironmental Htialth,.lapan, }hhatanishi-ku,Kitalp;ushu807-8555, Jdpan 3 7bshiba CorporationSemiconductorCompa,oLKitalyushu Ciperations.Kbkurakita-ku,Kitakyushu 803-868a .lapan Abstract : The effects of walking on mental healthproblemsamong healthyJapaneseworkers are not fu11yun- derstood. In the presentstudy, we investigatedtheeffects of a fbur-weekwalking programon the psychological functioningof a nonclinical sample ofhealthy workers in Japan. A total of 606 healthysubjects were enrolled inthe study and were evaluated by theZung SelflratingDepressionScale(SDS)and the SocialAdaptationSelievaluation Scale(SASS)bothbefbreand after the walking program. The subjects were dividedintoan exercising groupand a non-exercising group, Therewere significant differencesinthe SDS and SASS scores betweentheexercising and the non-exercising groups.Following the walking program,the non-exercising group's SDS scores decreasedand their SASS scores increasedcompared to beforethe walking program,In contrast, the SDS and SASS scores of the exer- cising groupdidnot change. These results suggest that subjects who exercise regularly experience fewerdepressive feelingsand exhibit bettersocial adaptation inthe workplace than those who do not exercise. The walking program improveddepressivefeelingsand social adaptation inthenon-exercising group, Klay wortts : walking, mental health,depression,social adaptation, healthyworker. (ReceivedNovember 2,2012, accepted December 1O,2012) Introduction Depression management inworkers isan important component inthe fieldof occupational healthbecause depressioncontributes to reduced work perfbrrnance, absence from work, and, occasionally, to suicide [1]. Regular physicalexercise provides psychologicalben- efits, includingreduced depressionand anxiety [2]. Ithas also been reported that exercise isusefu1 for preventingdepressionand fbrtreating mild to moder- ate depression[3].Althoughthe precisemechanisms by which exercise isusefu1 formental healthremain unknown [4],Severalstudies havedemonstratedthat exercise increasesthe synthesis ofbrain-derived neu- rotrophic factor(BDNF) [5],A recent study demon- strated a negative correlation between plasmaBDNF levelsand the severity ofmentaljeb stress [6]. A close negative correlation hasbeenfoundbetween depressivesymptoms and social adaptation, meaning that patientswith severe depressionhavepoor social CorrespondingAuthor]AtsukolKENoucm-SuGrm,DepattmentofPsychiatrMFacultyofMedicine.UniversityofOccupationalandEnvironmenta Japan.Ylahatanishi-ku,Kitakynshu807-8555,Japan.Tel:+ 81-93-603-1611ext2606. Fax:+81-93-692-4894, E-mail/atsuko-i@med.uoeh-u.ac.jp NII-Electronic Mbrary
  3. 3. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation ofHealth Sciences 2 A IBENoucHi-SuGrrA et al adaptation [7].An association betweendepressionand impairedsocial functionhaslongbeenrecognized, and itisacknowledged thatrecovery from depressionre- quiresnot only the resolution of depressivesymptoms butalso an improvementof the individual'spersonal relationships insocial situations [8,9]. Ithas been reported thatwalking can lead to sub- stantial improvementsinthe mood of patientswith major depressivedisorders[10].However,theeffect of walking on menta1 healthproblems among healthy Japanese workers isnot fu11yunderstood, We there- fore hypothesized that the interventionof walking could have a beneficialeffect on depressivefeelings and social adaptation inhealthyJapaneseworkers. To confirm thishypothesis,we investigatedtherelation- ship betweena walking interventionand the mental status or social adaptations inhealthyJapanesework- ers beforeand after participationina four-weekwalk- mg program, Methods Subjectsandprocedures We explained the effects ofwalking on physicaland mental wellness, and describedthe four-weekwalk- ingprogram through meetings and leafletspresented to the 1,193 healthyworkers includedinthisstudy, excluding workers who were on medical leave.We recommended 30 minutes of walking per daywithout regulating either the distanceor speed inthe wallcing program period.In November 2008, 587 ofthese 1193 subjects didnot wish to participate,and the remaining 606 subjects (508males and 98 females;age, mean ± SD = 41.02± 8.16years)agreed to participateinthe walking program.The 606 subjects were dividedinto an exercising group (n= 151) and a non-exercising group(n= 455) basedon responses toa questionnaire [14].Subjectswho had the habitof exercising forat least20 minutes twice per week were includedinthe exercising group, while those who didnot have exer- cise habitsfbrat least20 minutes twice perweek were included in the non-exercising group. The members of the exercising group didnot stop theirregular ex- ercise duringthiswalking program study (Fig.1).All the participantsused a pedometer. Participantswere dividedinte five-person groups,and each group re- corded theirtotalsteps, competing against each other, duringthestudy period. All the participantswere evaluated by the Zung SelflratingDepression Scale (SDS)and the Social AdaptationSelfievaluationScale (SASS)both be- fbreand after the walking program. In addition, to rule out any psychiatricdisorders,all the participants were screened by the StructuredClinicalInterviewfbr DSM-IV-TR Disorders(SCID)[11-13].None of the participantshadpsychiatricdisorders,This study was approved by the EthicsCommittee of the University of Occupationaland EnvironmentalHealth.Allthe participantsgave their written informedconsent to participateinthestudy. Fig.1.Walking program study flow chart.
  4. 4. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation of Health Sciences INleilkingand Mental Health 3 SDS The SDS isa 20-questionselflrating measure to as- sess depressivesymptoms inadults over the previous week. The advantages of the SDS includeitsease of administration and itsbrevity[11].The SDS shows good psychometricpropertiesas a screening tool for depression,and has beenused to assess outcomes in response totreatment ina wide range ofresearch. The SDS has beenalso widely used to assess depressed feelingsinthe generalpopulation[15-17]. SL4ss Socialbehaviorshavebeen shown to exert a strong infiuenceon determiningacceptance and rejection be- tween strangers and friends[18].Deficitsinsocial ski11s (e.g.,lackof smiling, sad facialexpression, avoidance ofeye contact, monotonic speech, and lackof verbal re- sponses) have been shown to be common among those with low levelsof social contact and in depressedpa- tients[19,20]. Thesesorts of behaviorwere foundto result insocial rejection by strangers and friends[21]. Such behavioraltraitshavealso beensuggested toplay an importantrole inthe etiology and maintenance of depressivesymptoms, Thus, inthe etiology of depres- sive disorders,social adaptation skills are considered importantforadjustment to theworkplace, Bosc et aL demonstratedthatsocial motivation could bemeasured bythe SocialAdaptation SeleevaluationScale(SASS), a 20-item selfreport questionnaire[12].The SASS has beenshown to possess adequate psychometric proper- tiesand good internalconsistency. Dubiniet al. fbund thatdepressedpatientsreported lowerSASS scores than didhealthyvolunteers [22].Furtherrnore,depressedpa- tientshavebeenfoundto generallyhavelesssocial sup- port. The Japaneseversion of theSASS was produced by Goto et al.,who confirmed thatthe translatedinstru- ment was suitable forevaluating social adaptation inthe Japanesepopulation[23],The SASS hasalso beenvali- datedand foundtobeeasy touse and sensitive tochang- es indifferentsocial functioningareas [24,25].We have recently reported thata significant negative correlation was obtained betweenSASS and the Stressand Arousal Check List(SACL),which assessesjob stress inhealthy workers. Thus, we considered that some healthywork- ers can wotk even ifthey have poorsocial adaptation [6,26]. Statisticaianalysis Tb compare the baselinecharacteristics ofthe SDS and SASS, Student'st-testwas used to assess difTer- ences betweenage and sex intheexercising and non- exercising group. Apaired t-testwas also used to ex- amine differencesinthe SDS and SASS scores before and after the walking program.ANOVA was used to determinethe interactionof the effects of exercise habitsand the walking program.Allstatisticalanaly- ses were carried out using SAS version 9,1. Results Characteristicsof the panicipantsare presentedin fable1.Age and sex hadno significant interactionef fectson the aims ofstudy. The exercising grouptook significantly more steps than the non-exercising group duringthe walking program period (P< O,OOO1). All participantscompleted the program. Table1.Characteristicsofthe walking program participants Characteristic Exercisinggroup Non Exercisinggroup Men Wbmen All Men Wbmen All NumberAge (mean± SD) Mean steps inthe walking program !day(rnean± SD) Wbrkingpattern (shiftwork lnonshift work) 12740.8 ± 9.8 2446.8 ± 11.7 12S65,O± 5399.812452.0± 41972 45 f82 4120 ISI41.7 ± 10,3 1254S.4± 5218.6 491102 38140.9 ± 7.9 7441.6 ± 9.7 45541.0 ± 82 10811,9± 4461,S 9904,4± 3151.710661.4± 4282,4 188f193 25f49 213 f 242 SD: standard deviation
  5. 5. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation ofHealth Sciences 4 AIKENoucm-SuGIT)tetal ANOX4XoftheSDSandSASSresultsrevealedsignifi icantdifferencesbetweenthetwo groups,At baseline, beforestarting thewalking program,the SDS scores in the exercising group(mean± SD = 34.7± 9.35)were significantly lewer than those inthe non-exercising group(38.6± 7.80,P< O.OOI) (Fig.2A).The baseline SASS scores (38.1± 6.07)inthe exercising groupwere significantly higherthanthoseinthenon-exercising group(35.0± 6.98)(Fig.2B).The SDS scores of the non-exercising group significantly decreased(37,2± 8.0,P= O.045)(Fig.2A),and theirSASS scores signifi- cantly increased(36,1± 7.1,P == O.O12)(Fig.2B)after thewalking program,On the other hand,the SDS and the SASS scores (SDS;34.9± 8.3,SASS; 37.9± 5.7) of theexercising groupdidnot change beforeand after the walking program.ANOXCeLrevealed no significant interactioneffect betweenexercise habitsand thewalk- ingprogram. The exercising group's scores were sig- nificantly higher in the baselineSASS sub-items 1,3, 4, 5,8,9,10, 11, 12, 14, 15, 16, and 18 than those in thenon-exercising group.The scores inthe SASS sub- items3,5,6,7,9,10,12,14,15,and 16were signifi- cantly higherinthenon-exercising group after thewalk- ing programcompared to beforetheprogram([lable2). A40 38Ave= 36'5ema 34ca 32 30before after B40 38Ave='6 36eenca< 34ca 32 30 F---------I ** before after Fig.2. A. Changes inzung selfrating DepressionScale(SDS)scores forthe exercising and thenon-exercising groups:thebaselineSDS scores intheexercising group(mean± SD)were significantly lower than thoseinthe non-exercising group (P<O.OOI).The SDS scores in the non-exercising group decreasedsignificantly after thewalking program, ': P=O.045, B. ChangesinSocialAdaptationSelfievaluationScale(SASS)scores forthe exercising and the non-exercising groups:thebaselineSASS scores inthe exercising group (mean± SD)were significantly higherthan these inthe non-exercising group (P<O.OOI).The SASS scores in the non-exercising group increasedsignificantly after the walking program. **: P=O.O12, - - : exerclsmg groups,- : non-exerclsmg groups.
  6. 6. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation of Health Sciences Whlkingand Menta1Health 5 Table 2. Means and SD of SASS sub-item scores Statement Before After ExercisingNon-exer- group clsmggroupPaExercising Non-exer- group cising groupP" score SD score SD score SD score SD Beforeversus after PbP, 1.Jobinterest 2.Housework interest 3.Work enioyment 4.Interestinhobbies 5. Qualityofspare time 6.Familyseekingbehavior 7.Familyrelationship quality 8,Gregariousness 9.Relationshipseekingbehavior lO, Externalrelationship quality 11.Externalrelationship appreciation 12.Socialattractiveness 13.Socialcernpliance 14.Communityinvolvement 1S.Socialinquisitiveness 16.Intellectualinterest 17,Communicationdienculties 18.Rejectionsensitivity 19.Vainness 20.DiMcultiesincoping with resources 21.Controlofsurroundings 2.14 O.73 2.00 O.68 1,86 O.77 1.68 O.76 2,42 O.60 2.09 O.74 2.16 O.71 1.75 O.76 2.03 O.70 1.99 O,76 2,21 O.70 2.11 O.78 2.06 O.61 1.84 O.61 1.59 O.73 1.36 O.68 1.87 O.S9 1.67 O.61 1.96 O.62 1.82 O.64 1.81 O.51 1,65 O.57 2.42 O.53 2.36 O.54 1,41 O.95 O.93 O.81 1,89 O.65 1.69 O.67 1,85 O.82 1.70 e.78 1.63 O.71 1.58 O.71 2.33 O.69 2.20 O,70 1.35 O.75 1.45 O.70 1.75 O.78 1.72 O.79 1.46 O.63 1.45 O.65 O.046* O.O04*<o,eol*<O.OOI*O.350O.167O.OOI*O.OOI*O.OOI*O.049*O.OIO*O.255< 2.08 O.63 2.01 O.62 1.87 O.66 1.79 O.72 2.47 O.66 2,15 O.71 2.27 O,53 1.84 O.71 2.11 O.73 2.11 O.71 2.23 O.76 2.20 O.74 2.08 O.58 1.84 O.63 1,63 O.63 1.48 O.74 1.96 O,52 1,82 O.60 1.93 O.57 1.84 O.63 1.83 O.42 1.71 O.56 2.43 O.52 2.37 O.51 1,36 O,83 1.10 O.87 1,89 O,61 1,79 O.58 1,81 O,71 1,75 O.78 1.69 O.72 1.59 O,73 2.33 O.66 2.16 O.69 1.29 O.75 1.42 O.70 1.65 O.76 1.62 O.83 1.60 O.57 1.51 O.65 O.205 O.843 o.lsg e.3oo <O.OOI* O.321 <O.OOI* O.117 O,679 O,106 O.439 O.454 O.O02* O.254 O.054 O.843 O.O03* O.088 O.086 O.454 O.068 O.349 O.225 O.321 O.021*O,373 e.094 e.373 0252 O.454 O,121 O.859 O,O17* O.634 O.496 O,415 O.482 O.151 O.139 O.211 O.751 O.O14*O.084O.O05* a: Exercisinggroup versus Non-exercisinggroup, b: Exercisinggroupversus Exercising group, C: Non-exercising greupversus Non-exercisinggroup, ': P < O.05,SD: standard deviation,SASS: SocialAdaptationSelfievaluationScale Discussion The most important findings in the presentstudy were thatthe SDS scores significantly decreasedand the SASS scores significantly increasedinthe non- exercising group after the walking program compared to baseline. These results suggest thata walking pro- gram can relieve feelingsof depression and improve social adaptation inworkers with regular fitnesshab- its,Also,workers who haveregular fitnesshabitsnot only feellessdepressedand have higherselfiesteem, butthey are also more eager to be incontact with other people and to participateinsocial activities that rnight be associated with improvingtheirmood. Ib the best of our knowledge,thisisthe firstreport demonstrat- ingthatwalking exercise infiuencesboth depressive feelingsand social adaptation. Using meta-analyses, Guszkowska hasreported the positiveeffects of exer- cise on emotional states, includinganxiety, depression, and mood disorders,in healthypeople and inclinical populations,regardless ofage and sex [27].Another study demonstratedthat exercise and social contact both result in significant reductions inthe totaland the psychologicalsubscale of the Beck Depression Inven- tory(BDI)[28].Theseresults indicatethatshort term exercise has a broadereffect than control conditions in reducing symptoms ef depressionin moderately depressedelderly populations,butthe precisemecha-
  7. 7. The UOEH Association of Health Sciences NII-Electronic Library Service The UOEHAssociation of Health Sciences 6 A IKENoucm-SuGrm et al nisms by which exercise influencesemotional states remain unlcnown. The influenceof exercise on blood IevelsofBDNF are well established [29].The results of thisstudy suggest thatdailyexercising contributes to a good menta1 condition, and the non-exercising sub- jectsshowed significant improvementintheirmental condition by starting and continuing to exercise. The participantswithout a regular fitnessroutine had improvementsinsocial adaptation. Itisplausible thatsubjects who havedepressivefeelingsare proneto withdraw from theirsocial contacts, since ithasbeen shown thatdepressedpatientstend to interpretsocial inforrnationina negative way, feelingrejected and thereforeavoiding social interaction[30].Recently, we reported that the optimal SASS score cut offpoint was between 2S and 26 [31].The mean scores in the exercising and the non-exercising groupsat baseline were 38,1and 35,O,respectively, meaning thatmost ofthe participantsinthe presentstudy were adapted to their dailysocial living.We speculated thatjoining the walking programwith ether employees might prevent them fromfeelingsocially isolatedinthe workplace. A limitationof thisstudy isthat,forethical reasons, we could not obtain explanations forwhy some work- ers didnot participateinthis study, Also,we could not analyze a repeated randomized clinical trial(RCT).An- other limitationisthatwe ceuld not consider informa- tion about confounding factorssuch as working time, jobtype,jobtitle,and various personalitycharacteristics. Furtherinvestigationwill ideallyinvolvea RCT. Conclusion The four-weekwalking program improveddepres- sive feelingsand social adaptation inhealthyJapanese workers who didnot haveregular fitnesshabits. Acknowledgements Fundingforthisprojectwas received fromtheHealth and Labor SciencesResearchGrants,Comprehensive Researchon DisabilityHealthand Welflire. Disclosureof conflicts of interest The authors have no conflicts ofinterest todeclare. L 2. 3. 4. 5. 6. 7, 8. 9. 10. ll. I2, References HiltonMF, Scuffham PA, NlecchioN & WhitefordHA (2010):Using the interactionof menta1 healthsymp- toms and treatment status to estimate lostemployee productivity. AustN Z J Psychiatry44: 151-161 Saeed SA, Antonacci DJ & Blech RM (201O):Excr- cise, yoga,and meditation fordepressiveand anxiety disorders.Am Fam Physician81:981-986 DavidsonJR (2010):Majordepressivedisordertreat- ment guidelinesinAmerica and Europe. J CIinPsy- chiatry 71 SupplE1: e04 PajonkFG, Wbbrock T,GruberO et al (201O):Hippo- campal plasticityinresponse to exercise inschizophre- nia. Arch Gen Psychiatry 67:133-143 Berchtold NC, CastelloN & Cotman CW (20IO):Ex- ercise and time-dependent benefitsto learningand memory. Neuroscience167:588-597 Mitoma M, Ybshimura R, SugitaA, Umene Wl Hori H, Nakano H,Ueda N & Nakarnura J (2008):Stressat work alters serum brain-derivedneurotrophic factor(BDNF) levels and plasma 3-methoxy-4-hydroxyphenylgly- col (MHPG)levelsin healthyvolunteers: BDNF and MHPG as possiblebiologicalmarkers ofmenta1 stress? Prog Neuropsychopharmacol Biol Psychiatry32] 679- 685Dickerson F, Origoni A, StallingsC, Khushalani S, DickinsonD & Medoff D (2010):Occupationalstatus and social adjustmcnt six months after hospitalization early in the course of bipolardisorder:a prospective study. BipolarDisord12:10T20 PaykelES, Weissman MM & PrusoffBA (1978):So- cial maladjustment and severity ofdepression. Compr Psychiatry19:121'128 Leader JB & Klein DN (1996):Socialacljustment in dysthymia,doubledepressionand episodic major de- pression. JAffectDiserd37:91-101 SextonH, Maere A& Dahl NH (1989):Exerciseinten- sity and reduction inneurotic symptoms, A controlled follow-upstudy. ActaPsychiatrScand 80:231-235 Zung WW (1965):Aselfratingdepressionscale. Arch Gen Psychiatry12:63-70 Bosc M, DubiniA& PolinV(1997): Development and validation ofa secial functioningscale, the SocialAd- aptation SelflevaluationScale.EurNeuropsychophar- macol 7 Suppl 1:SS7-S70
  8. 8. The UOEH Association of Health Sciences NII-Electronic Library Service TheUOEHAssociation ofHealth Sciences Walking and Mental Health 7 13. 14. rs. 16. 17. 18. 19. 20. 21. 22. 23. Dodd S,WilliamsLJ,Jacka FN, Pasco JA, Nerkeset O & Berk M (2009):Reliabilityofthe Mood Disorder Questionnaire:comparisonwiththeStructuredClinical Interviewforthe DSM-IV-TR ina populationsample. AustN Z JPsychiatry43:526-530 Hassmen R Koivula N & UutelaA (20eO):Physical exercise and psychologicalwell-being: a population study inFinland.PrevMed 30: 17-25 Kawada T, InagakiH, Wakayama Y Katsumata M, Li Q,Li YJ & Otsuka T (2011):Depressive state and subsequent weight gaininworkers: A 4-yearfo11ow-up study. Wbrk 38: 123-l27 Kawakami N, RobertsRE, Lee ES & Araki S (1995): Changesinrates ofdepressive symptoms ina Japanese working population:life-tableanalysis from a 4-year fo11ow-upstudy. PsycholMed 25: 1181-1190 Kawada T & SuzukiS (1993):Factorstmcture ofZung selflrating depressionscale forworkers. Jpn JPsychia- try Neurol47:23-27 PaddockJR&NowickiSJrC(1986):Thecircumplex- ityofLeary's InterpersonalCircle:a multidimensiona] scaling perspective.JPersAssess50:279-289 CohenS,SherrodDR & ClarkMS (1986):Socialskills and thestress-protective role of social support. J Pers SocPsycholSO:963-973 SegrinC & Abramson L;Y(1994):Negativereactions to depressivebehaviors:a communication theories analysis. JAbnorm Psychol 103:65S-668 Tse WS & Bond AJ (2003):Consequencesofdisplay- ingabnormal social behavior:avoidance and reduction ofsocial reinforcement. JAffectDisord75:49-58 DubiniA, Bosc M & PolinV (1997):Do noradrenaline and seretonin differentiallyaffect social motivation and behavior?Eur Neuropsychopharrnacol7 suppl 1: S49-S55Gote M, Ueda N, Ybshimura R et al (2005):Reliability 24. 25. 26. 27. 28. 29. 30. 31. and validity ofthe Japaneseversion ofthe SocialAdap- tation SelflevaluatingScale(SASS).Seishinigaku47: 483-489 (inJapanese) Chida F,Okayama A, NishiN & SakaiA (2004):Fac- toranalysisofZung Scalescores ina Japanesegeneral population. PsychiatryClinNeurosci58:420-426 Bosc M (2000):Assessment of social functieningin depression.Compr Psychiatry41: 63-69 Okuno K, Ybshimura R, Ueda N, Ikenouchi-Sugita A, Umene-Nakano W, Hori H, Hayashi K, KatsukiA, Chen HI & Nakamura J(2011):Relationships between stress, social adaptation, persona]itytraits,brain-de- rived neurotrophic factorand 3-methoxy-4-hydroxy- pheny]g]ycolplasma concentrations in employees at a publishingcempany inJapan. PsychiatryRes 186: 326-332Guszkowska M (2e04):Effectsof exercise on anxiety, depressionand mood. PsychiatrPol 38:611-620 McNeil JK, LeBlanc EM & JoynerM (1991):The efi fectofexercise on depressivesymptoms inthe moder- ately depressedelderly. PsycholAging 6:487L488 LaskeC,BanschbachS,StranskyE,Bosch S,StratenG, Machann J,FritscheA, Hipp A, NiessA & Eschweiler GW (2010):Exercise-inducednormalization of de- creased BDNF serum concentration inelderly women with remitted major depression.IntJ Neuropsyche- pharmacol 13:595-602 Tse WS & Bond AJ (2e04):The impactof depression on social skills. J Nerv Ment Dis 192:260-268 Ueda N, Suda A, Nakagawa M, Nakano H, Umene- NakanoW, Ikenouchi-SugitaA,Hori H, Ybshimura R & Nakamura J (2011):Reliability,vaLidity and clini- cal utility of a Japaneseversion of theSocialAdaption SelflevaluationScaleas calibrated using theBeck De- pressionInventory.PsychiatryClinNeurosci65:624- 629
  9. 9. The UOEH Association of Health Sciences NII-Electronic Library Service The   UOEH   Assooiation   of   Health   Soienoes 8 A   ouc 田 一SUGITA ei ai 健康 な 勤労 者 に お け る ウ ォ ーキ ン グ の 抑 うつ お よ び 社会 適応 の 改 善効 果 杉 田  篤子 1 ,吉村  玲児 1 ,杉 田  和 成 2 ,堀    輝 1 ,山 田  久美 3 ,坂 上  真弓 3 ,中村  純 1 1 産 業医 科大学 医 学部 精 神医学教 室 2 産 業医科 大学 医学部 皮膚科学教 室 3   東芝 北 九 州工 場 健康支援 セ ン タ ー 要 旨 : 勤 労者 の うつ 病対 策 は重要 な課題 で ある .健康 な 目本 人労働者 に お い て ,ウ ォ ーキ ン グ に よ る メ ン タ ル ヘ ル ス 不調へ の 予防効果 は 明 らかで は ない .本研 究 で は,企業 に お い て ,勤労者 の うつ 病予 1坊対 策 と して ,ウ ォ ー キ ン グの 有用性 を検討 した.事 前 に 運動 習慣 を確 認 した 上 で ,606 人 の 勤労 者 を対象に 4 週 間 の ウ ォ ーキ ン グ プ ロ グ ラム を実施 し,プロ グ ラ ム 前後 の Zung SelfLrating Depression Scale(SDS )と Social Adaptation SelfLevaluation Scale (SASS )を評 価 した .結 果,ウ ォ ーキ ン グ プ ロ グ ラ ム を 実施前 の SDS は ,運 動習慣 有群 (有群 )で は 運動習慣 無群 (無 群 )に 比 して 低 く(P < 0.001 ),SASS は ,有群 は 無 群 に 比 して 高 か っ た (P 〈 0.001).実施 後 は ,有群 の SDS ,  SASS は 変化 しなか っ たが ,無 群の SDS は低 下 し,SASS は 上 昇 した .有群 は,無群 に 比 べ 抑 うつ 度が 低 く社 会適応 度が 高い . 無群 で ,ウ ォ ーキ ン グ プロ グ ラ ム 実施 に よ り抑 うつ 度 が 改善 し社会 適 応 度が 増加 した . キ ーワ ー ド : ウ t 一キ ン グ ,メ ン タ ル ヘ ル ス ,うつ 病,社 会適応.勤労者 . JUOEH (産業 医大 誌)35 (1): 1 − 8 (2013) N 工 工 一Eleotronio  Library  

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