The usual walking step length of older adults aligns with a simple formula: height - 100 cm. This study aimed to examine the clinical significance of this simple formula for calculating step length. A total of 1 33 elderly women were divided into three groups based on their measured step lengths during usual walking compared to the step length calculated using the simple formula to establish a reference step length: a group with shortened step length below the reference value (n=19), a group with slightly increased step length that does not exceed “reference value ＋10 cm” (n=53), and a group with step length that exceeds the reference value by at least 10 cm (n=61). The physical functions of these three groups were compared. The results showed that lower limb muscle strength (as measured by knee-extension strength and a 30 s chair-stand test) was significantly lower in the groups with shortened and slightly increased step lengths than in the group with increased step length. Furthermore, the timed up and go test performed to assess dynamic balance revealed significantly longer completion times in the group with shortened step length than in the groups with slightly increased and increased step lengths. These findings indicate the potential utility of measuring step length to be less than “reference value +10 cm” as a useful screening indicator for detecting decline in lower limb muscle strength and measuring step length to be “below the reference value” for detecting not only decline in lower limb muscle strength but also reduced dynamic balance.

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The purpose of this study was to examine the validity of a simple method for assessing knee varus alignment by the distance between the medial epicondyles of the femur by measuring the femoro-tibial angle (FTA) and distance between the medial epicondyles of the femur in patients with knee OA. METHODS: The subjects were 20 patients with knee OA (14 men, 6 women, 73.5±8.5 years). The distance of between the medial epicondyles of the femur was measured with calipers in the upright position and the distance between the right and left medial epicondyles of the femur was determined in relation to the FTA.RESULTS: A significant and extremely high correlation was found between the FTA and the distance between the medial epicondyles of the femur (r＝0.91, p＜0.01). Furthermore, a single regression analysis using FTA and the distance between the medial epicondyles of the femur showed that the regression equation obtained was FTA＝1.405 × distance between the medial epicondyles of the femur ＋ 174.944, with an adjusted R2 of 0.81 for the regression equation (p＜0.01). CONCLUSION: The results suggested that the distance between the medial epicondyles of the femur is useful assessment method the knee varus alignment.

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The purpose of this study was to examine the significance of measuring predicted maximum stride length in relation to muscle strength, balance, and walking ability by combining predicted and measured maximum stride length. The subjects were 100 elderly women living in the community. The predicted and measured maximum stride length, 30-second chair standing test, knee extension muscle strength, one-leg standing time, and normal walking speed were measured, and correlation analysis was conducted between maximum stride length and the other measures. In addition, multiple regression analysis was conducted using the predicted value of maximum stride length as the dependent variable. As a result, a strong positive correlation was found between the predicted and measured maximum stride lengths. Furthermore, the predicted and measured maximum stride lengths showed significant positive correlations with all other measures. A multiple regression analysis revealed that walking speed was independently associated with the predicted value of maximum stride length, and the cutoff value of the predicted value of maximum stride length was calculated to be 77.5cm, indicating a decrease in walking speed. These results suggest that the predicted value of maximum stride length can be used as a screening test for reduced walking ability.

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Advanced Trail Making Test (ATMT) is a modified version of Trail Making Test, which has been reported to be useful in discriminating general cognitive decline, but its reliability and validity are unclear. The objectives of this study were first, to examine the reliability and validity of ATMT, and second, to examine the utility of ATMT in discriminating generalized cognitive decline. Retest reliability was low, but validity studies showed that the results of Spearman's correlation analysis revealed that brain function age is an index that comprehensively reflects quickness, energy of brain, and effective utilization, and that quickness is an index of processing speed, energy of brain is an index of selective and sustained attention, and effective utilization is an index of effective utilization. The results of a comparison of the two groups based on the presence or absence of general cognitive decline showed that the group with general cognitive decline was significantly older than the normal group in terms of age and brain age, and that there was a significant decline in quickness, brain vitality, and processing speed. The ROC curves were calculated for the items that showed significant differences, and the highest AUC value was observed for brain age. The cutoff value of brain age was 77.5 years, AUC was 89.8％ , sensitivity was 88.9％ , and specificity was 83.6％ , suggesting that the cutoff value of brain function age measured by ATMT may be useful as a screening for general cognitive decline.

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This study examined elderly women living in mountainous and flat areas to compare their motor function and living conditions. We measured their hand grip strength, CS-30 score, quadriceps muscle strength, sit-and-reach test score, duration of standing on one leg with the eyes open, walking time, and timed up & go test (TUG) score. We also interviewed them about their social isolation and exercise habits. The values representing the hand grip strength and duration of standing on one leg with the eyes open were significantly higher, but the quadriceps muscles were significantly weaker among elderly women in the mountainous compared with flat areas. Furthermore, in the former, social isolation was significantly more prevalent, and the rate of those with exercise habits was significantly lower. We speculated that in the mountainous area, life adapted to the terrain improves the motor balance, while the decrease in the frequency of going out is associated with a decline in lower limb muscle strength. The results revealed regional differences in motor function, indicating the necessity of understanding the differences among the elderly in different regions, and adopting tailored measures for each region.

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