Objective: This study aimed to clarify the factors associated with changes in frailty status over time among community-dwelling older adults during the coronavirus disease 2019 countermeasures.

Methods: A prospective cohort study every 6 months was conducted. The baseline data were collected from May to July 2020. The second and third surveys were conducted 6 and 12 months later, respectively. A total of 1,217 community-dwelling older adults who returned their baseline survey forms were included. The survey forms were distributed to and returned by mail. They included the frailty screening index for the assessment of frailty, questionnaire for medical checkup of old-old to evaluate health conditions, and questionnaire to evaluate changes related to lifestyle and physical or psychological conditions. At baseline, the participants were divided into non-frailty or frailty groups based on assessment using the frailty screening index.

Results: Multiple logistic regression analysis using frailty status over time as the dependent variable revealed that in the non-frailty group, subjective leg muscle strength (odds ratio [OR] 3.35) was significantly correlated with frailty status at the 6-month follow-up and occasional choking (OR 1.68) and smoking habits (OR 2.48) were significantly correlated at the 12-month follow-up. In the frailty group, falls (OR 31.98) and opportunities of talking to people (OR 2.84) were correlated with frailty status at the 6- and 12-month follow-ups, respectively.

Conclusion: The factors associated with changes in frailty status over time were subjective leg muscle strength, choking, smoking habits, falls, and opportunities of talking to people.

Objective: The purpose of this study was to investigate the measurement conditions to ensure the accuracy and reliability of knee extensor muscle strength measurement as the effectiveness of a simple, inexpensive manual muscle strength meter.

Methods: Five physical therapists (three males and two females) measured knee extensor strength in healthy adults. The reliability indices were the intra- and interinspector reliability of each measurer and the measurement error, which is absolute reliability. The measurement conditions that ensure reliability were also calculated.

Results: The intra-examiner reliability [ICC (1.1)] was 0.88, 0.92, and 0.94 for male subjects, and 0.71 and 0.82 for female subjects. The inter-observer reliability [ICC (2.1)] was 0.36 for the five assayers, 0.89 for the male assayer, and 0.32 for the female assayer, with good values only for the male assayer. The reliability of the measurement was assured when the measurement was performed more than once by one person when the measurement was performed only by a male or female measurer, or more than three times by one person or more than two people when the measurement was performed regardless of gender.

Conclusion: An inexpensive simple manual muscle strength test can provide reliable results when used by male measurers.

Objective: The purpose of this study was to clarify the relationship between physical function and hospitalization, mortality in community-dwelling older people with disabilities, and to determine the cut-off values of the physical function tests that are predictable of the occurrence of hospitalization and mortality events.

Method: We analyzed 143 community-dwelling older people aged 65 years and older who had non-full marks for the Barthel index. The subjects were followed up for 3-years and the cut-off values that identified the occurrence of hospitalization and mortality events for physical function tests were calculated. We also investigated the relationship between the occurrence of hospitalization and mortality events and physical function by Cox regression analysis.

Result: During an average follow-up of 749±386 days, 65 (44%) people were hospitalized or died. The cut-off values of physical function that predict the occurrence of hospitalization and mortality events were grip strength of 15.6 kg, knee extension strength of 15.2 kgf, and comfortable walking speed was calculated as 0.89 m/s. Cox regression analysis showed that grip strength less than 15.6 kg and comfortable walking speed less than 0.89 m/s were significantly associated with the occurrence of hospitalization or mortality events, even if confounding factors were adjusted.

Conclusion: The cut-off values of the physical function tests (grip strength: 15.6 kg, knee extension strength: 15.2 kgf, comfortable walking speed: 0.89 m/s) were calculated, and those could predict hospitalization and mortality events in community-dwelling older people with disability of ADL. Especially, among physical functions, assessment of grip strength and comfortable walking speed has been shown to be useful for the prediction of hospitalization and mortality events.

Objective: To investigate the practice, requirements, and barriers to the development and disperse of standardized outcome measures (SOM) for community-based physical therapy.

Methods: A web-based questionnaire was sent to members of the Japanese Society of Community-based Comprehensive Physical Therapy who are engaged in day-care, home-visit, and facility services to people requiring long-term care.

Results: A total of 188 responded to the survey. While 83.5% recognized the importance of using outcome measures, only 44.7% used them routinely. The top two requirements were reliability and detectability of change for the scale characteristics, and the measurement method were the preparation and financial burden required for the assessment, and the time required to conduct the assessment. The top two barriers were lack of education and lack of opportunities to talk with peers.

Conclusion: We found a gap between the recognition of the importance of outcome measures and their implementation. In order to reach routine use of outcome measures, it is necessary to development SOM that take into account practicality and address barriers characteristic of community-based physical therapy.

Objective: The purpose of this study was to clarify the cutoff values of the modified five-repetition Sit-to-Stand and the One-Leg Stand tests, which discriminate life-space mobility in community-dwelling older adults certified as needing support or care.

Methods: Data obtained from 66 adults (age: 80.9±7.6 years, 39 women) who were using either day-care rehabilitation or home-visit nursing stations were analyzed cross-sectionally. Participants were classified into two groups according to the degree of life-space mobility as determined by Life Space Assessment. Cutoff values and discriminant accuracy of both tests were calculated using the Youden Index and area under the curve (AUC) based on the receiver operating characteristic curve.

Results: The respective AUCs and cutoff values were 0.905 (sensitivity: 0.889, specificity: 0.754) and 12.82 sec for the modified five-repetition Sit-to-Stand test and 0.860 (sensitivity: 0.778, specificity: 0.842) and 7.25 sec for the One-Leg Stand test.

Conclusion: The results suggest that lower-limb muscle strength and balance ability are important indicators for life-space mobility in community-dwelling older adults needing support or care. The findings of this study contribute to decision making in goal setting and intervention planning in physical therapy aimed at improving social participation in older adults.