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许 德, 韩 红, 左 伟, 冯 志. [Dynamic and Static Complementary Balance Theory-Based Functional Exercise Combined With Stepwise Rehabilitation Training Improves Postoperative Hip Function Recovery in Patients Undergoing Total Hip Replacement]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:1014-1019. [PMID: 39170000 PMCID: PMC11334279 DOI: 10.12182/20240760603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Indexed: 08/23/2024]
Abstract
Objective To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement (THR). Methods The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected. Among the patients, 57 were given perioperative stepwise rehabilitation training (the control group), and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period (the combination group). The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded. During postoperative recovery, the patients were assessed for pain with the visual analogue scale (VAS) and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale (SER). Hip function was measured and compared between the two groups at 2 weeks, 4 weeks and 8 weeks after surgery. Results With regard to the primary outcome indicator, the postoperative length-of-stay was (7.63±1.36) d in the combination group, which was shorter than the (8.22±1.48) d in the control group, and the difference was statistically significant (t=2.257, P=0.026). As for the secondary outcome indicators, no statistically significant difference was observed in the incidence of postoperative complications between the two groups (4.92% vs. 14.04%) (P>0.05). The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test (P<0.05). The postoperative VAS scores in both groups declined significantly compared to the preoperative scores (P<0.05), and the VAS score decreased gradually over time after surgery (P<0.05). The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group (P<0.05). At 14 days after surgery, the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery (P<0.05), with the combination group showing higher scores than the control group did (P<0.05). After surgery, the scores for the dimensions of deformity, pain, function, and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test (P<0.05), with these scores increasing gradually over time after surgery (P<0.05), and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group (P<0.05). Conclusion The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients, relieving the postoperative pain, shortening the length-of-stay, and improving the hip function in patients.
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Affiliation(s)
- 德龙 许
- 武汉市第四医院 康复医学科 (武汉 430000)Department of Rehabilitation Medicine, Wuhan Fourth Hospital, Wuhan 430000, China
| | - 红 韩
- 武汉市第四医院 康复医学科 (武汉 430000)Department of Rehabilitation Medicine, Wuhan Fourth Hospital, Wuhan 430000, China
| | - 伟 左
- 武汉市第四医院 康复医学科 (武汉 430000)Department of Rehabilitation Medicine, Wuhan Fourth Hospital, Wuhan 430000, China
| | - 志勇 冯
- 武汉市第四医院 康复医学科 (武汉 430000)Department of Rehabilitation Medicine, Wuhan Fourth Hospital, Wuhan 430000, China
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Ide K, Yamato Y, Hasegawa T, Yoshida G, Hanada M, Banno T, Arima H, Oe S, Yamada T, Watanabe Y, Kurosu K, Hoshino H, Niwa H, Togawa D, Matsuyama Y. Implications of the diagnosis of locomotive syndrome stage 3 for long-term care. Osteoporos Sarcopenia 2024; 10:89-94. [PMID: 39035232 PMCID: PMC11260008 DOI: 10.1016/j.afos.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/10/2024] [Accepted: 05/06/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship. Methods A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018. Results Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan-Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451-3.447). Conclusions Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a high-risk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.
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Affiliation(s)
- Koichiro Ide
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Yu Yamato
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Go Yoshida
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Mitsuru Hanada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiro Banno
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Hideyuki Arima
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Shin Oe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Yuh Watanabe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Kenta Kurosu
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Hironobu Hoshino
- Department of Orthopaedic Surgery, Fujieda Municipal General Hospital, 4-1, Surugadai, Fujieda, Shizuoka, 426-0077, Japan
| | - Haruo Niwa
- Department of General Medicine, Toyonemura Medical Office, 24-1 Naganoda Kamikurogawa, Toyone-mura, Kitashitara-gun, Aichi, 449-0404, Japan
| | - Daisuke Togawa
- Department of Orthopaedic Surgery, Kindai University Nara Hospital, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
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Nakae I, Hashida R, Otsubo R, Iwanaga S, Matsuse H, Yokosuka K, Yoshida T, Fudo T, Morito S, Shimazaki T, Yamada K, Sato K, Shiba N, Hiraoka K. Impact of spinal surgery on locomotive syndrome in patients with lumbar spinal stenosis in clinical decision limit stage 3: a retrospective study. BMC Musculoskelet Disord 2023; 24:851. [PMID: 37898742 PMCID: PMC10612310 DOI: 10.1186/s12891-023-06966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Locomotive syndrome (LS) is characterized by reduced mobility. Clinical decision limit (CDL) stage 3 in LS indicates physical frailty. Lumbar spinal canal stenosis (LSS) is one of the causes of LS, for which lumbar surgery is considered to improve the CDL stage. This study aimed to investigate the efficacy of lumbar surgery and independent factors for improving the CDL stage in patients with LSS. METHODS This retrospective study was conducted at the Department of Orthopaedic Surgery at our University Hospital. A total of 157 patients aged ≥ 65 years with LSS underwent lumbar surgery. The 25-Question Geriatric Locomotive Function scale (GLFS-25) was used to test for LS, and the Timed Up and Go test (TUG) was used to evaluate functional ability. Lower limb pain was evaluated using a visual analog scale. Patients with at least one improvement in the CDL stage following lumbar surgery were included in the improvement group. Differences in lower limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. The Spearman's rank correlation coefficient was used to determine correlations between Δ lower limb pain and Δ GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS. RESULTS The proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). Δ Lower limb pain was significantly reduced in the improvement group compared with that in the non-improvement group (51.0 [36.3-71.0] vs 40.0 [4.0-53.5]; p = 0.0107). Δ GLFS-25 was significantly correlated with Δ lower limb pain (r = 0.3774, p = 0.0031). Multiple logistic regression analysis revealed that TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07-1.47). CONCLUSIONS Lumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.
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Affiliation(s)
- Ichiro Nakae
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Ryuki Hashida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Ryota Otsubo
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Sohei Iwanaga
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroo Matsuse
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimiaki Yokosuka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tatsuhiro Yoshida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takuma Fudo
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Morito
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takahiro Shimazaki
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kei Yamada
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimiaki Sato
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoto Shiba
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Koji Hiraoka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
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Hisamoto K, Okubo N, Fukushima H, Yamanaka T, Okizuka Y, Matsui T, Shinjo H, Morihara T, Takahashi K. Can the measurement of Locomo Age improve motivation for exercise in fitness club users? Geriatr Gerontol Int 2023. [PMID: 37385723 DOI: 10.1111/ggi.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/16/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
AIM In 2022, the Japanese Orthopaedic Association developed "Locomo Age," which can be used to measure mobility. The potential effects of measuring Locomo Age on motivation to exercise are yet to be explored. This study aimed to determine whether the measurement of Locomo Age improved motivation for exercise. METHODS In total, 90 fitness club users (17 men and 73 women) were enrolled in the study. The participants performed the locomotive syndrome risk test. These results were entered on a smartphone website, and their Locomo Age was automatically calculated. Questionnaires about impressions of Locomo Age and changes in motivation for exercise after measuring Locomo Age were surveyed. RESULTS The mean Locomo Age of the participants was 84.4 ± 8.5 years, which was significantly higher than their actual age (75.9 ± 7.2 years, P < 0.001). Questionnaires showed that 55 participants (61.1%) felt that their Locomo Age was higher than expected; 42 participants (46.7%) had increased motivation for exercise, and only two participants (2.2%) had decreased motivation. The rate of improvement in motivation for exercise was higher in the group of participants who reported having an older Locomo Age than they expected compared with that of the group with a Locomo Age that was the same as they expected (P < 0.05). CONCLUSIONS The measurement of Locomo Age improved the motivation for exercise. This result remained true even when the Locomo Age was higher than expected, as it did not decrease the participants' motivation. Locomo Age allows for the comprehension of participants' mobility without medical knowledge. Geriatr Gerontol Int 2023; ••: ••-••.
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Affiliation(s)
- Kazufumi Hisamoto
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoki Okubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | | | | | | | - Toru Morihara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Marutamachi Rehabilitation Clinic, Kyoto, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Miyazaki S, Yamako G, Arakawa H, Sakamoto T, Kawaguchi T, Ito K, Chosa E. Weight-shifting-based robot control system improves the weight-bearing rate and balance ability of the static standing position in hip osteoarthritis patients: a randomized controlled trial focusing on outcomes after total hip arthroplasty. PeerJ 2023; 11:e15397. [PMID: 37214101 PMCID: PMC10199675 DOI: 10.7717/peerj.15397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Background After a total hip arthroplasty (THA), standing and walking balance are greatly affected in the early stages of recovery, so it is important to increase the weight-bearing amount (WBA) on the operated side. Sometimes, traditional treatments may not be enough to improve WBA and weight-bearing ratio (WBR) on the operated side in a satisfactory way. To solve this problem, we came up with a new weight-shifting-based robot control system called LOCOBOT. This system can control a spherical robot on a floor by changing the center of pressure (COP) on a force-sensing board in rehabilitation after THA. The goal of this study was to find out how rehabilitation with the LOCOBOT affects the WBR and balance in a static standing position in patients with unilateral hip osteoarthritis (OA) who had a primary uncemented THA. Methods This randomized controlled trial included 20 patients diagnosed with Kellgren-Lawrence (K-L) grade 3 or 4 hip OA on the operative side and K-L grade 0 normal hip on the nonoperative side. We used the minimization method for allocation and randomly assigned patients to either the LOCOBOT group or the control group. As a result, 10 patient seach were randomly assigned to the LOCOBOT and control groups. Both groups received 40 min of rehabilitation treatment. Out of the 40 min, the LOCOBOT group underwent treatment for 10 min with LOCOBOT. The control group performed COP-controlled exercises on a flat floor instead of using LOCOBOT for 10 of the 40 min. All theoutcome measures were performed pre-THA and 11.9 ± 1.6 days after THA (12 days after THA). The primary outcome measure included WBR in the static standing position. Results After12 days of THA, the LOCOBOT group exhibited significantly higher mean WBR and WBA (operated side) values than the control group. Furthermore, the LOCOBOT group exhibited significantly lower mean WBA (non-operated side) and outer diameter area (ODA) values than the control group. From pre-THA to 12 days after THA, the LOCOBOT group exhibited a significant improvement in mean WBR and WBA (operated side). Moreover, the mean WBA (non-operated side) and ODA significantly decreased. From pre-THA to 12 days after THA, the control group showed a significant increase in total trajectory length and ODA. Conclusions The most important finding of this study was that patients were able to perform the LOCOBOT exercise as early as the second day after THA, and that WBR and ODA significantly improved by the 12th day after THA. This result demonstrated that the LOCOBOT effectively improves WBR in a short period of time after THA and is a valuable system for enhancing balance ability. This expedites the acquisition of independence in activities of daily living after THA and may contribute to optimizing the effectiveness of medical care.
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Affiliation(s)
- Shigeaki Miyazaki
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Japan
| | - Go Yamako
- Department of Mechanical Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Hideki Arakawa
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Japan
| | - Takero Sakamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tsubasa Kawaguchi
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Japan
| | - Kirari Ito
- Department of Mechanical Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Etsuo Chosa
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Jung H, Tanaka S, Tanaka R. A cutoff value for body composition on the severity of locomotive syndrome in Japanese older women: A cross-sectional study. Health Care Women Int 2022:1-13. [PMID: 35766463 DOI: 10.1080/07399332.2022.2083620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/19/2022] [Accepted: 05/25/2022] [Indexed: 10/17/2022]
Abstract
We aimed to investigate the relationship between body compositions and locomotive syndrome in older women and derive body composition cutoff values to evaluate locomotive syndrome severity. In total, 236 women were included in this study. The percentage of body fat and skeletal muscle mass index was measured using multi-frequency bioelectrical impedance analysis. The locomotive syndrome severity (stage 0-3) was determined using the standup test, the two-step test, and a self-administered questionnaire. The receiver operating characteristic curve analysis indicated that the cutoff value for body fat percentage was 33.1% for locomotive syndrome stage 1 in women. This finding may aid in designing exercise and nutritional interventions to prevent locomotive syndrome in older women.
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Affiliation(s)
- Hungu Jung
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- Department of Sports, Health and Well-being, Hiroshima Bunka Gakuen University, Akigunsakacho, Japan
| | - Shigeharu Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ryo Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
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