The purpose of this study was to obtain the cutoff point for the depth of surface imprint method for the identification of pitting edema. We enrolled 65 patients (39 men and 26 women) diagnosed as having pitting edema who showed stable symptoms and 35 controls (11 men and 24 women) who were community-dwelling healthy elderly adults. We instructed the subjects to sit on the edge of a chair and lightly press the soles of their foot onto the floor. We measured the left and right depths of the surface imprint in the back of the third metatarsal head using an edema gauge. In the statistical analysis, multiple logistic regression analysis was performed using the presence or absence of pitting edema as dependent variables, and the depth of surface imprint, sex, age, height, weight,and body mass index as independent variables. Then, a cutoff point was obtained from the receiver-operating characteristic (ROC) curve, and the sensitivity and specificity were calculated. Consequently, the depth of the surface imprint was extracted as a factor that affects the presence or absence of pitting edema, with an odds ratio of 135.0. From the ROC curve, the cutoff point of the depth of surface imprint was 2.25,with a sensitivity of 0.83 and a specificity of 1.00. The present study suggests that the depth-of-surface imprint method is a useful evaluation tool for discriminating the presence or absence of pitting edema, with a pathological identification value of 2.25 mm.

[Purpose] The purpose of this study was to investigate preoperative factors that affect gait in patients after total knee arthroplasty (TKA). [Subjects] Ninety-nine patients after TKA. [Methods] Measurement outcomes were the period to get a gait, Japanese version of the modified gait efficacy scale (mGES), pain catastrophizing scale (PCS),rest pain, walking pain, the range of motion of knee flexion and extension, isokinetic knee extension strength and normal walking speed. In statistical analysis, the relationship between the period to get a gait and preoperative factors was evaluated using Pearsonʼs correlation coefficient. Stepwise multiple regression analysis was used to evaluate the dependent variable of gait, factors that showed a significant difference in the comparison of gait as independent variable. [Results] Pearsonʼs correlation coefficient indicated the preoperative factors related to gait were mGES (r=­0.40), PCS (r=0.27), isokinetic knee extension strength (r=­0.24) and normal walking speed (r=­0.25). The multiple regression analysis indicated that mGES affect the period to get a gait among other factors. [Conclusion] These results showed that not only muscle strength and walking speed but also mGES affect the number of gait days in patients after TKA.

To clarify easy-to-use methods of lower-extremity functional assessmentfor day- care providers, 34 elderly females using day services were assessed using the 30- second Chair Stand Test (CS-30) and 10-second Chair Stand Test for the FrailElderly (Frail CS-10), in addition to measuring their quadriceps femoris muscle strength, and the correlations between these test scores/the quadriceps femoris muscle strength and each physical function parameter were analyzed. The quadriceps femoris muscle strength showed a significant correlation only with the hand grip strength, whereas both CS-30 and Frail CS-10 scores were significantly correlated with the hand grip strength, time needed to walk 5 m at the maximum gait velocity, Timed Up Go Test score, and Trail making test Part A score. The Frail CS-10 score was also significantly correlated with the time needed to walk 5 m at a normal gait velocity. The results support the usefulness of Frail CS-10,which allows service providers to conveniently and promptly conduct assessment without special devices, to assess the walking ability and dynamic balance of elderly day- care users.

Purpose: The purpose of this study is to identify the impact of apathy on physical activity in community-dwelling elderly. Subjects: The subjects were Three hundred and twenty-eight community-dwelling older adults living in Kasama City. Methods: Apathy, physical activity, depression, and social network were assessed using a self-administered questionnaire. In addition, we measured physical performance (grip strength, five-times sit-to-stand test, one leg stand, sit and reach distance, timed up and go test) and cognitive function (5 cognitive tests, Trail Making Test). Results: Seventy-six participants (23.2%) showed apathy in the absence of depression, forty participants (12.2%) had depression but no apathy, fifty participants (15.2%) had both apathy and depression. The results of the multiple regression analyses were revealed that apathy, social network, sit and reach distance, 5 cognitive tests, and Trail Making Test had significantly impact on physical activity. In contrast, depression had not impact on physical activity. Conclusion: Our data suggest that apathy and depression exist independently, and apathy is one of the multiple factors affecting physical activity.

[Purpose] This study aimed to determine the influence of toe grip strength exertion in the sitting position at low seat height on toe grip strength and muscle activity in order to identify the appropriate measurement position. [Subject and Methods] The study subjects were 20 healthy women. We compared toe grip strength and muscle activity between two positions, hip and knee joints at 90°flexion position on the edge of a seat and sitting position at low seat height. The activities of the following leg muscles were recorded: rectus femoris, biceps femoris, medial head of the gastrocnemius, and tibialis anterior. We then calculated the percent integrated electromyography values during toe gripping. [Results] We found that toe grip strength was significantly lower in the sitting position at low seat height than when the hip and knee joints were at 90°flexion. Moreover,the percent integrated electromyography values of the rectus femoris and tibialis anterior in the sitting position at low seat height were significantly higher than those of the hip and knee joints at 90°flexion. [Conclusion] The results of this study suggest that the toe grip strength in the sitting position at low seat height was kept low to inhibit the increase in muscle activity.

To confirm the relative and absolute reliabilities of 3 tests: the 5-m Walk Test (5 MWT), Timed Up & Go Test (TUG), and 10-m Walk Test with Obstacles (10 MWT-OB), 18 outpatients with Parkinsonʼs disease were assessed using them. These 2 types of reliability were calculated using the intraclass correlation coefficient (ICC) and Bland-Altman analysis, respectively. The ICCs for 5 MWT, TUG, and 10 MWT-OB were 0.97, 0.94, 0.89,respectively. There was no systematic error for 5 MWT or TUG, and the minimum detectable changes were 0.6 and 1.8 seconds, respectively. In contrast, there were fixed errors for 10 MWT-OB, and the range of allowable error was 0.1 to 2.9 seconds. Thus,5MWTand TUG were highly reliable to assess patients with Parkinsonʼs disease, whereas the relative reliability of 10 MWT-OB was sufficient, but its absolute reliability was insufficient, as there were fixed errors, and second measurement values walking speeds tended to be higher than the first ones.

The purpose of this study was to examine the relationship between the 30- second chair-stand test (CS-30) score and the physical function of elderly people requiring long-term care. The subjects were 44 elderly people requiring long-term care who attended a daycare facility. Physical functions measured included grip strength, quadriceps muscle strength, and toe grip strength. To examine the relationship between physical function and CS-30 scores, we performed partial correlation analysis usingthedegreeof care required as a control variable and multiple regression analysis using CS-30 as a dependent variable. The partial correlation coefficients indicated that quadriceps muscle strength was significantly correlated with CS-30 scores; multiple regression analysis results indicated that quadriceps muscle strength is an independent factor related to CS-30 scores. These results suggest that CS-30 was associated with quadriceps muscle strength in the elderly people requiring long-term care attending a daycare facility. Some daycare facilities do not have equipment that can quantitatively evaluate lower limb muscle strength; therefore, the CS-30, which can gauge quadriceps muscle strength simply with no dedicated equipment, can be a useful index for use in daycare facilities for elder adults.