Objective：To investigate the physical functions of peripheral arterial disease (PAD）patients undergoing endovascular treatment (EVT), and their association with physical activity before EVT.
Methods：One hundred and one PAD patients underwent EVT. Physical functions were specified as grip strength, walking speed, and the weight ratio of knee extension isometric muscle strength (KEIS). We divided the patients into 3 groups, based on the amount of physical activity per week：(a) low activity (0 kcal/week：n＝52), (b）moderate activity (0 kcal to less than 500 kcal/week：n＝22), and (c) high activity (more than 500 kcal/week：n＝27). Physical activity data were collected using an international standardized physical activity questionnaire. A multivariate regression analysis (cumulative logit model) was used to evaluate the association between physical activity (low activity, moderate activity, high activity) and KEIS＜0.4 kgf/kg.
Results：The averages of the physical functions were：grip strength (kg；Men 28.1, Women 16.6), walking speed (m/s；Men 1.10, Women 0.96), KEIS (kgf/kg；Men 0.42, Women 0.28). The prevalence of KEIS＜0.4 kgf/kg was 56.4％ (n＝57). KEIS＜0.4 kgf/kg was not significantly different between low and moderate activity groups (Odds：0.99, p＝0.98). However, KEIS＜0.4 kgf/kg was significantly different between low and high activity groups (Odds：5.02, p＝0.007).
Conclusion：Physical functions were lower in PAD patients undergoing EVT than in healthy adults of the same age, and KEIS was related to physical activity before EVT.
Objective：To identify related challenges and develop improvement plans, we examined the status of cardiac rehabilitation of elderly patients with heart failure in day-care facilities within a metropolitan area.
Methods：A mail questionnaire survey was conducted among 126 day-care facilities registered with the Japan Association for Day Care. The questionnaire consisted of 14 questions regarding the following：1) facility attributes；2) difficulties in managing patients with heart failure and the solutions applied；3) rehabilitation service contents and methods to manage risks in the facility, including sudden changes in patient conditions；and 4) if acceptance of patients with heart failure was difficult, the cause of the difficulty.
Results：The response rate was 41％．Physical therapists were the largest professional group, accounting for 67.8％ of all respondents. As for facility users, 70.4％ were aged ≥75 years. Patients with heart failure were treated in 87.6％ of the facilities. The challenges of cardiac rehabilitation in the day-care facilities are summarized in 3 points as follows：1) an increasing number of elderly patients with heart failure in communities, 2) lack of preparedness to manage patients with heart failure in community-based cardiac rehabilitation, and 3) insufficient medical information sharing between facilities and hospitals.
Conclusion：The results highlight the importance of creating guidelines on cardiac rehabilitation for community-dwelling elderly patients with heart failure and facility-hospital sharing tools that specify information useful for both parties to provide appropriate cardiac rehabilitation in day-care facilities.