Yukiharu Hhiguchi
Chief Therapist, Center for Sports Science and Health Promotion
National Rehabilitation Center Hospital for Persons with Disabilities

1. Current State of Persons with Disabilities

According to the Annual Report on the Government Measures for Persons with Disabilities (2020 edition), the total number of persons with disabilities including children is about 9.7 million, which means about 7.6% of the population have some kind of disability[1].  According to the types of disability, as for the number of persons with physical disabilities who stay at home, those aged 65 and older have increased; for persons with intellectual disabilities, those aged 18 to 64 have increased, and for persons with mental disabilities, people other than those aged 35 to 44 have increased1.  From these facts, we can say that the generations affected by aging and secondary disabilities caused by lifestyle-related diseases are increasing.

2. Japan’s Health Promotion Measures

Regarding boosting health in Japan, based on the “Health Promotion Act,” measures that enhance an active lifestyle, such as “Health Japan 21 (the second term)” [2] and “Active Guide +10”[3] are being promoted.”  Moreover, under the “Basic Act Concerning Countermeasures for Stroke, Heart Diseases and Other Cardiovascular Diseases to Extend Healthy Life Expectancy,”[4] the “Japanese National Plan for the Promotion of Measures Against Cerebrovascular and Cardiovascular Diseases”[5] was formulated, thereby comprehensively promoting a wide range of medical and welfare measures and services.  Enacting such laws and formulating such measures are important for promoting the health of persons with disabilities.  However, concrete measures still need to be improved.

3. Health Status of Persons with Disabilities

In regard to the current status of the health of persons with disabilities, according to the survey conducted during the comprehensive medical examinations of 100 people with spinal cord injury, about 80% of them had risk factors for lifestyle-related diseases and metabolic syndrome[6].  In addition, in terms of body mass index (BMI) which indicates obesity, it is reported abroad that the percentage of persons with disabilities with a BMI above the standard range (BMI ≥ 30) is 1.2 to 3.9 times as much as that of person without disability[7]. 　On the other hand, in a survey conducted together with related facilities in the Kanto region, the percentage of weight loss among those with a BMI below the standard range (BMI ≤ 20) was found to be about 20% of the total. 　We believe that their inactivity has adverse health effects and causes a decline in their bodily functions; and thus, persons with disabilities must pursue their own health care more zealously than person without disability.

4. Center for Sports Science and Health Promotion:

(1) Background of its Establishment:

This center was established in October 2010 with the aim of building a support system according to the individual’s life stage, taking into consideration the health status of persons with disabilities whose decline in bodily functions must be prevented as much as possible.

(2) Role of This Center:

According to the Annual Report on Government Measures for Persons with Disabilities, the function of this center is to disseminate information and enhance the health of persons with disabilities throughout the country by conducting activities with specialized agencies in each region.  We shall provide medical/rehabilitative care for the improvement of health services that maintain and improve people’s health, and prevent the decline of bodily functions through the disciplines of sports, nutrition and health1.

(3) Activities in This Center:

A. Establishment of the Outpatient Department for Health Promotion and Sports:

By opening this new department, we are working on contributing to the health of the people in the community.  In this department, experts in nutritional education, health guidance, and exercise therapists, who specialize in sports science for persons with disabilities, are promoting the prevention of the decline and the improvement of bodily functions, according to specified programs.

B. Health Checks through Medical Examinations, including Comprehensive Medical Examinations:

Before embarking on a health improvement program, it is important to undergo thorough and comprehensive medical examinations.  However, since the consultation rate is low, we are working on medical checkups in collaboration with local governments.

C. Practicing Health Promotion in Welfare Institutions:

In welfare institutions, as part of the services based on the Act on the Comprehensive Support for the Daily and Social Life of Persons with Disabilities, we hold classes focusing on health and provide programs and venues for those who need to address their lifestyle-related disorders.

D. Nationwide Expansion and Cooperation with Community Activities:

Through the “Community Cooperation Model Project to Establish and Disseminate Health Promotion Programs for Persons with Disabilities”[8], with the cooperation and guidance of the institutions around the Kanto region, we made a prototype of an exercise program[9].  Currently, we are devising and implementing the programs according to the characteristics of disabilities.  Moreover, our experts are dispatched to local governments, companies, and institutions in different communities to hold health classes.

E. Holding Seminars:

Every year, we hold a “Seminar on the Promotion of Health for Persons with Disabilities” which provides lectures and practicums related to the specialized fields of government services, disability characteristics, sports, nutrition, and health.  In fiscal year 2021, we plan to hold the seminar online, considering we are under the pandemic of COVID-19.

F. Research:

We also conduct research on health promotion.  Particularly in the research of exercise programs, we study the health promotion programs and exercise indicators and other programs according to disability characteristics, and implement health promotion measures that contribute to the extension of a healthy life expectancy.

5. Future Issues and Developments

For the implementation of health promotion measures for persons with disabilities and the prevention of the decline in their bodily functions, it is indispensable to have experts that provide the expertise and a nationwide support system that executes practical programs for persons with disabilities.

In this center, while continuing to implement the above-stated (3) A to F, we are working on creating an environment where persons with disabilities can attend to their health in cooperation with the institutions and facilities nationwide that work on health promotion.