Transcript
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Join us as we explore Medical Frontiers.
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According to the World Health Organization,
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physical inactivity is the 4th leading risk factor for death in the world.
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Walking has gained attention as one of the most effective ways of combatting a sedentary lifestyle.
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Japanese researchers have published reports
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suggesting that a unique walking method developed in the country
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improves conditions such as diabetes and hypertension.
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This method is revolutionizing cardiac rehabilitation.
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There are also new findings regarding running.
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Researchers have discovered that "slow running" may activate the brain.
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Today, we focus on these discoveries and introduce easy exercises that you can start right away to improve your health.
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So, let's begin!
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Located about three hours northwest of Tokyo by train is the city of Matsumoto.
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While global studies traditionally emphasized the number of steps,
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researchers in Matsumoto are pioneering a unique approach that goes beyond mere step count.
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This method, known as Interval Walking Training, or IWT,
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involves alternating between slow walking and fast walking.
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A study was conducted with middle-aged and older participants, divided into three groups:
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one that did no walking, another that walked 10,000 steps a day
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and a third that did 30 minutes of daily IWT.
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Five months later, the IWT group showed a decline in systolic blood pressure
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over four times greater than the 10,000-step group.
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Additionally, their diastolic blood pressure had decreased 2.5 times.
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If this new result can be maintained for five years, the risk of stroke is believed to drop by 40 percent.
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Another study found that IWT lowered the depression index
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by 50 percent in middle-aged and older people with depression symptoms.
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It also extended their sleep efficiency by 12 percent.
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Interval Walking Training was developed by a team at Shinshu University in Matsumoto.
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The university is playing a leading role in teaching IWT to middle-aged and older people.
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I'm 82.
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I thought exercise would be good for my health.
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I used to get sick often, but now,
I rarely catch colds. It's a major change.
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Before beginning IWT, participants wear a device that can measure the amount of exercise they do.
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3,2,1... Go!
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Participants begin by walking at their own pace.
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They walk at a relaxed speed, as if taking a stroll.
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Three minutes later...
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Now, swing your arms vigorously.
1,2,1,2! Make it bigger!
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Following the instructions, they speed up.
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They take large steps, swinging their arms widely and opening their chest.
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They increase their pace until they're slightly out of breath.
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After three more minutes...
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Slow down when the music begins.
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The participants return to a slower walking pace.
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They take the opportunity to catch their breath or stretch.
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Three minutes of slow walking followed by three minutes of fast walking make up one set.
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Five sets are required, totaling 30 minutes.
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IWT was initially designed for athletes
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to boost their fitness by alternating between intense exercise and short breaks.
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It has been transformed into a walking method that anyone can do.
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It's refreshing. I'm sweating a lot.
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I'm not that tired. I've gotten used to it.
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A team led by Shinshu University Professor Masuki Shizue has been studying IWT.
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Dr. Masuki, it is great to have you on the program.
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It's my pleasure.
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Such groundbreaking and fascinating research.
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Our strength is that we have data on the effects
of different amounts and intensities of walking.
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We have accumulated such data from nearly
10,000 people who took part in our studies.
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Masuki's team did an experiment with a group that did no walking,
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another that walked 10,000 steps a day, and a third that did IWT.
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After five months, the results showed that the hamstring muscles, necessary for raising the legs,
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were 12 percent stronger in the IWT group than in the 10,000-step group.
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Peak oxygen uptake, a measure of aerobic endurance, was also 10 percent higher in the IWT group.
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The exercise had improved their physical strength.
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Masuki believes that the group that walked 10,000 steps daily
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may not have walked with sufficient intensity and speed to improve their fitness.
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IWT can improve physical strength
and provide other benefits.
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The key is to do it at a certain intensity
for a certain duration.
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Michael Joyner, an expert in sports medicine, was among the first in the world to recognize the significance of IWT.
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I think it's a real breakthrough.
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And what's great about it is you have the community involvement, you've got the university involvement,
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and you've got principles of the same sorts of training that the elite athletes use to apply to older people.
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So it's really a just a great kind of three fold way to send a message and do good things for older people.
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In 2020, the American Physiological Society featured IWT in a textbook used by physicians and researchers worldwide.
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These are becoming textbook studies, widely cited and again, both the specifics of their program,
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but also as people try to learn lessons from their success
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and see how those lessons can also be applied to their own programs.
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Interval Walking Training was developed by Nose Hiroshi, under whom Masuki studied.
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Professor Nose, so lovely to meet you.
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Nice to meet you.
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How do we actually do it?
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We start by warming up.
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Nose recommends stretching before IWT.
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The proper posture is crucial for walking without fatigue.
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Look straight ahead, lift your hands as high as possible, then lower them.
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Begin with a slow walk.
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Walk leisurely, enjoying the surroundings.
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First is nice and slow. So we can have a conversation.
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Big stride? Or not such a big stride?
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Keep it small.
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I have to ask how old are you? You look so incredibly young.
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- Mentally young.
- That's the most important thing.
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It's so important to be mentally young.
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You should feel relaxed and be able to enjoy conversation during slow walking.
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Then what sort of pace are we walking at for the high-intensity walking?
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Take big strides.
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After 1 to 2 minutes, you'll start to breathe
slightly harder, and your heart rate will increase.
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Take longer strides than usual.
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So the key thing is this really nice long stride.
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Long stride, long stride.
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- Make sure that your heels touch the ground first.
- OK, great, so heel-toe.
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By bending your arms at a right angle and swinging them back and forth widely,
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you will be able to walk with large strides naturally and comfortably.
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For slow walking, go as slow as you like.
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For fast walking, aim for a speed that slightly tightens your calf muscles.
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How many minutes do we need to be aiming for?
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- It's important to do 60 minutes of fast walking a week.
- OK, great.
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So the 60 minutes is really the key thing a week.
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There's no need to do this all at once.
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Spreading it out into a few minutes' walk several times a day will give you similar effects.
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The team at Shinshu University is conducting joint research with a local hospital
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to explore the possibility of introducing IWT into the rehabilitation of heart disease patients.
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Onozawa Koichi suffered a myocardial infarction in 2015.
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For a while, he couldn't walk properly and had difficulty standing up.
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There are significant challenges in the rehabilitation of heart disease patients.
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Heart disease patients tend to avoid exercise,
but it's crucial, particularly after diagnosis.
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Even after recovering from heart disease,
low physical fitness can lead to a poor prognosis.
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Before starting rehabilitation,
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heart disease patients are given an accurate assessment of their physical fitness and cardiovascular function.
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Based on the results, doctors determine a walking speed that can be comfortably managed.
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The patients wear a device that records heart rates and other data during IWT.
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Onozawa has been doing IWT for three months.
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Please start.
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Tailored to each individual's fitness level,
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IWT can be done comfortably and safely, even by those with heart conditions.
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Switch to fast walking.
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Onozawa can now walk quickly without experiencing shortness of breath or palpitations.
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Initially, walking 10 minutes was a challenge, but he can now walk continuously for 40 minutes.
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In daily life, he can easily walk up slopes.
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After the session, the exercise data is shared with the hospital,
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allowing doctors to remotely check the patient's heart condition.
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In some hospitals, rehabilitation sessions are provided only once a week, instead of the optimal three times,
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due to labor shortages or patients living in distant areas.
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However, by introducing IWT, which can be done at home and remotely monitored,
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it will become possible to offer rehabilitation three times a week.
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IWT is easy to do.
It can be done anytime, anywhere.
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It lowers the barriers for patients to start exercising
and once they've begun, it's easy to continue.
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The research team conducted a study involving 10 heart disease patients, divided into two groups:
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one exercised using machines once a week
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and the other group, in addition to machine training, did IWT at least twice a week.
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After six months, the results showed an improvement in the pumping ability of the heart in the IWT group.
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The researchers also measured levels of a hormone called BNP, or brain natriuretic peptide,
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which is secreted when the heart is under stress.
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The IWT group showed improvement.
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However, the patients who did only machine training didn't see improvement, due to insufficient exercise.
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Onozawa's current goal is to resume running - something he used to love doing.
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I've gained muscle after starting IWT.
I can now stand up and move around easily.
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I want to stay healthy for a long time.
If that requires walking, I can easily do it.
15:49
Research on Interval Walking Training is progressing around the world.
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Kristian Karstoft at the University of Copenhagen is exploring its introduction into diabetes treatment.
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We thought that the fairly low intensity was good for our population
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because at least in Denmark, most of the individuals who have type two diabetes are not that fit.
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They have not been used to doing that much exercise.
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Karstoft conducted a study involving middle-aged and older people with diabetes.
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They were divided into 3 groups: one did no walking, one walked at a normal pace, and one did IWT.
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For four months, he examined fluctuations in their blood sugar levels.
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He found that only the IWT group showed a 10-percent decline in blood sugar level variability.
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Smaller fluctuations indicate a better control of blood sugar levels, suggesting an improvement in diabetes.
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We would have to look into adherence, how we can optimize long term adherence to interval walking training
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and how we can maintain the intervention in large populations.
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The Shinshu University team is working to create a system in which IWT can be utilized
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not only in hospitals, but also in the broader community, with pharmacies playing a central role.
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Welcome.
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A type two diabetes patient visits the pharmacy.
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You're working very hard. Great job!
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I can walk for longer periods than before.
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You're probably less likely to get tired.
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I don't feel tired even after 20 minutes.
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First, patients deemed by doctors to need exercise therapy visit a pharmacy with a prescription.
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In addition to medications, the pharmacy provides guidance on IWT.
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Patients then carry out IWT at home and submit a device with their walking records to the pharmacy once a month.
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Pharmacists share this data with the patient's doctor.
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The doctor can use the data as a reference for the next examination.
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The university uses the accumulated data to explore even more effective instructional methods.
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This patient had high fasting blood sugar levels, but they declined 8 percent after 5 months of IWT.
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I don't exercise regularly, so I was surprised
I was able to continue. It's easy to do.
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It's also great that the pharmacist
helped me to care for my health.
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Many patients are told by their doctors to just
walk, and they're unsure about what to do.
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We can do more than just
provide patients with medication.
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We hope to play a central role in
managing their health.
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IWT has also had a significant impact on patients' medical expenses.
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We have found that as physical fitness improves,
all age-related conditions are alleviated.
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This leads to a reduction in healthcare costs.
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We have demonstrated that engaging in IWT
for 5 months reduces medical expenses by 20%,
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when compared with a group not doing IWT.
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There some research which is now going on based on your incredible research on Interval Walking Training
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by you and your teams. How does it make you feel?
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Comparing different ethnic backgrounds, including
genetics, can give us a better understanding.
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This provides a broader perspective on the effects
of IWT, not limiting our focus to Japan.
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Looking ahead, I hope that daily IWT will become
as natural as drinking water or having meals.
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I would be very happy to see IWT spreading
not only in Japan, but also around the world.
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- So thank you so much.
- Thank you.
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A Japanese research team has discovered that a simple exercise could improve brain function.
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It involves "slow running," at a pace similar to fast-walking.
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In running, there are moments when both feet are off the ground,
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while in walking, one foot is always on the ground.
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Slow running is a bit more demanding than walking,
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but the key is to run at a pace slow enough to keep a smile on your face.
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Soya Hideaki has been studying the impact of exercise on the brain for many years.
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Continuing moderate to vigorous-intensity
exercises requires high motivation.
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If you stop, the benefits end. But there are
questions on the effectiveness of light exercise.
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Soya's team examined how slow running affects the hippocampus in the brain, using rats.
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The hippocampus is responsible for memory.
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A dysfunction of neurons in the hippocampus is thought to result in memory decline and may trigger depression and dementia.
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In the experiment, the rats underwent 30 minutes of light- and moderate-intensity running.
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While many reports suggest that running boosts memory, it was unclear whether slow running has the same effect.
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Soya's team investigated the quantity of genes that improve the function of hippocampal neurons.
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The finding reveals that the results of slow running are similar to those in normal running.
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In another experiment, the team had the rats run for six weeks, then examined changes in the hippocampus.
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These images show neurons in the hippocampus of the rats.
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One group did no exercise, another did light-intensity running and a third did vigorous-intensity running.
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Showing in red are the newly born neurons.
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The number of new neurons increased 1.3-fold in the rats that did vigorous-intensity running,
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compared with those without exercise.
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But the increase in rats that ran at light-intensity running was about 1.7 times that of the no-exercise group.
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Light-intensity running is relaxing and easy,
while vigorous-intensity running requires willpower.
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It's tiring and triggers the release of stress
hormones, which negatively affect the hippocampus.
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That's why I believe vigorous-intensity running
is not as effective as light-intensity running.
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Soya also conducted an experiment to determine whether light-intensity exercise affects the human hippocampus.
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Healthy, young participants underwent a pedaling exercise, followed by a memory test.
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Neural activity in the hippocampus during this test was observed using a high resolution functional MRI.
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Light-intensity exercise improved their test accuracy, compared with when they did no exercise.
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Soya also used functional MRI
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to examine how neural activity in the hippocampal subregions related to memory changed during the test.
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Neural activity significantly improved compared with when the participants did no exercise,
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showing that even brief, light exercise can activate the memory system.
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Soya also investigated how exercise affects the prefrontal cortex.
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Often dubbed the "brain's command center," the prefrontal cortex governs attention and decision-making.
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He did a study comparing the decision-making speed of participants
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when they did no exercise with when they did light-intensity exercise.
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First, the participants took a cognitive test.
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Then, for the next 10 minutes, they either did slow running or no exercise.
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After that, they took another test.
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The results showed that after slow running,
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the participants were faster at answering questions than when they did no exercise.
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What's more, when examining the changes in neural activity in the left prefrontal cortex,
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it was clear that lateral part had become activated.
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Neural activity improved when they ran, compared with when they did no exercise.
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Exercise activates the brain and muscles
and helps us to feel positive.
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It's extremely important for us to feel pleasant.
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Exercise is a mood changer.
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Emotions are said to form when neural pathways in
the hippocampus or the prefrontal cortex are activated.
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Any type of exercise can affect our emotions.
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Soya's team is studying whether listening to a groovy rhythm while doing exercise can activate the brain further.
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If you think about it, exercise derives from play.
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The more you focus on the fun side of exercise,
the more you can benefit from it.
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Interval Walking Training and slow running are fairly easy to continue.
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The key to longevity through exercise is to continue it in a way that is enjoyable and suited to each person.
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And I really hope you'll join in making it a regular habit.
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