[Purpose] We evaluated the reproducibility and validity of our “cognitive function test using shiritori". [Subjects and Methods] The subjects consisted of 71 elderly outpatients (mean age, 82.4±8.7 years) visiting an outpatient rehabilitation facility. As a task, a word was presented using a word table we developed, and the subject said a word starting with the last syllable of the presented word, and this procedure was repeated. The reproducibility of this test was analyzed using the intraclass correlation coefficient (ICC),and its validity was evaluated using analysis of the correlation with MMSE. [Results] The reproducibility of the shiritori cognitive function test was markedly high (ICC=0.915), and a moderate-strong significant correlation was observed between this test and MMSE irrespective of sex. According to the severity of cognitive impairment, there was a moderate correlation between this test and MMSE in the groups with moderate or severe cognitive impairment but only a weak correlation in the group with mild impairment andthe healthy group. [Conclusions] The cognitive function test using shiritori has a high reproducibility, suggesting its clinical applicability as a simple cognitive function test, but its detection ability was limited in patients with mild cognitive impairment.

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[Purpose] This study examined factors affecting the wheelchair velocity in stroke patients. [Subjects] Subjects were 58 stroke patients. [Methods] Measurement items included the wheelchair velocity, Br stage, grip strength, abdominal, lower-limb, and toe muscles, lower limb loading force in a sitting position, sitting and standing balance,hemispatial neglect, and plantar perception. To extract factors affecting the wheelchair velocity, a stepwise multiple regression analysis was performed. [Results] The abdominal muscle and standing balance were selected as factors affecting the wheelchair velocity.

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The effect of ankle foot orthosis attachment was investigated in 9 stroke hemiplegia patients (mean age: 67.6±12.4 years) using a gait analyzer. Regarding the gait parameters, the walking speed and step frequency significantly increased during ankle foot orthosis attachment, compared to those with naked feet. In addition to a reduction in asymmetry of the legs, the duration of the stance phase was significantly shortened and that of the swing phase was significantly prolonged on the non-paralytic side. Based on these findings, ankle foot orthosis attachment influences the non-paralytic limb, rather than the paralytic limb, suggesting the importance of including the non-orthosis-attached limb in evaluation on gait analysis of stroke hemiplegia patients.

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Aim: The purpose of study was to examine the elderly requiring long-term-care and cutoff values in walking time over a period 5 years. Methods: Walking time was calculated with the health assessment survey in ACityin 2007.The subjects of the survey were 158 residents. This study investigated for preventive long-term care among the independence elderly and the elderly requiring mild-longTerm-Care in the same city during the period of five years. Results: Preventive long-term care-related increase for Walking time was confirmed in the longitudinal as well as cross-sectional data. In the ROC analysis, AUC (area under the curve) of Walking time in preventive long-term care showed high score 0.79. Conclusion: We found that Walking time was effective to assess preventive long-term care of community elderly residents.

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The purpose of this study was to clarify the contribution of lower limb muscles in different walking speed in elderly inpatients. Parameters of walking at the maximum and slowest speeds were measured in elderly inpatients using an optical gait analysis system. In addition, the quadriceps femoris muscle strength and grip force of the foot were evaluated as representative values of the lower limb muscles. The association between the walking conditions and lower limb muscles was investigated. The grip force of the foot was significantly correlated with the cadence, step length, stride length, and stance and swing phase durations on walking at the slowest speed. The quadriceps femoris muscle strength was significantly correlated with the cadence and stance and swing phase durations on walking at the maximum speed. The grip force of the foot on walking at the maximum speed and quadriceps femoris muscle strength on walking at the slowest speed showed no correlation with any gait parameter. These findings suggested that the grip force of the foot is involved in stabilizing the posture during walking at the slowest speed,whereas the quadriceps femoris muscle strength plays a major role as a driving force moving the body forward.

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Regarding15frail elderly (frail elderly group in the following, 4 males and 12 females) and 15 stroke hemiplegic patients (hemiplegic group in the following, 6 males and 9 females), we evaluated walking capacity and amount of physical exertion tomakeacomparative review of two groups. In the result, the frail elderly group was significantly superior in the 10-m maximum walking speed, the 10-m optimal walking speed, the 3-minnute optimal walking speed, and walking efficiency compared with hemiplegic group. However, no significant difference was observed in the amount of physical exertion. These results indicated a possibility that the frail elderly group donʼt perform physical activities that fit to their ambulatory ability. Therefore, it was suggested that there would be a need to evaluate not only the ambulatory ability but also the amount of physical exertion when considering a health promotion for the frail elderly.

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The maximal dorsiflexion of the ankle is considered a stable position knownas the closed-pack position due to bony conformity. However, no in vivo study has examined stability of the ankle in maximal dorsiflexion. We defined the ankle allowing for passive internal rotation in maximal dorsiflexion as “the ankle with unstable mortise (AUM)". This study investigated the prevalence of AUM and examined the effectiveness of ankle internal rotation exercise on improvement of AUM. Seventy-six young athletes were randomly allocated to an intervention group or a control group. AUM and sports performances in all subjects were evaluated before and after intervention. The prevalence of AUM was very high in young athletes. The intervention tended to improve AUM, but not sports performances. It was suggested that the prevalence of AUM is very high in young athletes and ankle internal rotation exercise may improve AUM.

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