The purpose of this study was to investigate the effect of a 12-week multi-component exercise program for improving gait ability, bone mineral density (BMD) and muscle mass with the goal of reducing risk factors for falls in the community-dwelling elderly. Fifteen elderly women aged 75-80 years participated in this study. Eight subjects joined the exercise group and attended the exercise program and the other served as the control group. The exercise program included stretching for 10 minutes, back extension strength training for 15 minutes followed by 30 minutes of weight bearing exercise, and 25 minutes of balance and posture training. The program was conducted 3 times a week for 12 weeks. As a result, body composition in the exercise group showed a significant improvement. The BMD of trochanter and whole body in the exercise group was significantly (p<0.05) increased after the exercise program. Regarding gait and balance ability, the exercise group had a significant improvement (p<0.05). In conclusion, the multi-component exercise training program consisting of weight bearing exercise and gait training was effective in offsetting the decline in BMD and muscle mass in elderly women. In addition, this program had a positive effect on their body composition and gait ability.

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The purpose of this study was to investigate the characteristics of body sway after standing up from a chair in the elderly population. The 275 residents participated. The mean age of the subjects was 65.1 years. All subjects signed an informed consent statement prior to participating in this study. All subjects were able to stand up from a chair independently. Subjects were asked to stand on the stabilometer without using their hands from a seated position with the knee joint at 90 degrees. Results demonstrate that from the medial-lateral data of the stabilometer after standing up, X-MdPF in the elderly subjects significantly smaller values compared with young subjects and X-area in the elderly subjects significantly larger values compared with young subjects. From the anterior-posterior data of the stabilometer after standing up, X-area in the elderly subjects significantly smaller values compared with young subjects. The correlation between Y-MdPF and age was not significantly.

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This study aimed to develop the Fall Prevention Self-Efficacy Scale (FPSE) that a scale to measure the fears of falling that elderly people in the community feel in daily life, and to verify its reliability and appropriateness. With repeating trial from item pool based interviews with local elderly with fear of falling, FPSE that including 10 items. With this scale, we measured 400 of community elderly and achieved the following results:
With consciousness of the behavior which elderly people in the community feel a fear of falling, we could measure a fall prevention self-efficacy of the people who keep wide field of activity with their fear of falling.
The reliability and appropriateness of the scale was secured in principle.
Many of the people with deficit answer had poor functional capacity, and it suggested that we have to make use of deficit answer as information in the community care.

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Objective: The purpose of this study was to measure upper and lower extremity range of motion (ROM) of shoulder, forearm, and hip joints to find potential relationships between physical characteristics and injuries in young baseball players.
Subjects: Forty-two male youth baseball players visited the orthopedic clinic (age, 13.6±1.9 years; height, 161.1±11.9 cm; weight, 51.5±11.3 kg; BMI, 19.6±2.3; right handers, 40; and left handers, 2). Of those, 31 had a history of shoulder and elbow pain. All subjects were measured for shoulder (internal/external), forearm (pronation/supination) and hip joint (internal/external) ROM.
Statistical analysis: The subjects were divided into 3 groups (all subjects, n=42; shoulder and elbow pain group, n=31; and no pain group, n=11). Statistical analysis of ROM was as follows: 1)Shoulder, forearm, and hip joint ROM of all subjects were compared between the left side and right side (paired t test). 2)ROM in the shoulder and elbow pain group and no pain group was compared between the left side and the right side (paired t test). 3)ROM in the shoulder and elbow pain group was compared with that in the no pain group (dependent t test).
Results: All subjects, shoulder and elbow pain group, and no pain group had decreased dominant shoulder internal rotation and increased dominant shoulder external rotation compared with the non dominant side but total rotation, forearm rotation and hip joint ROM did not differ significantly between the two sides.
Conclusion: Throwing motion repeatedly had changed dominant-side shoulder rotation ROM compared with the non dominant side (decreased internal rotation and increased external rotation range of motion). Further study is needed to investigate particularly whether the change in shoulder rotation ROM was because of throwing, which would be more negative? That is, throwing caused the problem.

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In 2004, Hyogo Prefecture Judo Therapists Association created and started teaching an exercise program “fall-prevention exercise” for preventing people from falling down. Composed of 18 movements including deep breathing, this exercise was developed from basic Judo techniques such as mae-ukemi and zenpo kaiten-ukemi. The subjects were seven (4 males and 3 females) frail elderly, who are users of the care center for the elderly. The average age of these subjescts were 77.1±10.0 and their care levels were as follows: one yo-shien (in need of assistance), four yo-kaigo 1 (in need of care 1), and two yo-kaigo 2. When teaching the exercise, the main focus was on 3 movements especially similar to Judo ukemi: the positioning of the hands, protection of the head, and making a step forward.
We measured the shoulder strength and choice reaction time. Shoulder strength was measured with shoulder dynamometer and choice reaction time was measured with reaction meter. Mats were placed at the right and the left in the anterior and the lateral directions. We measured the time it takes for the subjects to identify the red or the blue lamp which indicates the right or the left direction, and to step on the given mat. The measurement was carried right after starting the exercise, two months later, and four months later. At the same time, we took questionnaires on subjective effects the exercise had, both mentally and physically.
Choice reaction time decreased significantly for right anterior and right and left lateral directions. No particular tendency was observed for shoulder strength. According to the questionnaire, in terms of subjective physical effects, the following articles had positive changes: “I enjoy the meal more,” “I feel refreshed,” “I have better sleep,” “My stomach is working better,” and “My back pain lessened.” As to actions from daily life, the following had positive effects: “I can turn over in bed more easily,” “I can get up more easily,” “I can stand up more easily,” and “I can walk more easily.”
These results suggested that this exercise program “fall-prevention exercise” is effective for preventing frail elderly people from falling.

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Background and purpose: a program that is called “Ikigai Day service” has been offered in a rural area, Japan. This program aims at preventing the dependence for daily life and house bound. “Ikigai Day service” supports going outdoor of frail community elderly so that they gather in one hall and enjoy a social exchange. The purpose of this research is to investigate the state and changing mobility and fear of falling of participants of the program and discuss about the effect and the problem of the program.
Method: this longitudinal study was executed from May, 2002 to August, 2003. Objects are 68 participants of “Ikigai Day service” in 2002. There were 2 males and 66 females. Their average age was 82.0±4.5 (74-94) years old. Control group was 47community elderly from 75 to 91 years old who live in the same village. Mobility, fall prevention self-efficacy scale, frequency of going outdoors, and the destination were measured in 2002 and 2003.
Result: participant of “Ikigai Day service” was older, lower mobility, lower independence of going outdoors, fewer frequencies of going outdoors and lower fall prevention self-efficacy compared with control group. The number of those who avoid going out had increased from 2002 to 2003. In addition, 10 participants (15%) had become depended in one year. More preventive care is necessary for them.

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This study was attempted to clarify a fear of falling and its related factors among elderly men living in a rural community of Japan.
Tests on mobility and questionnaires were conducted on community-dwelling elderly over 65 years of age living in Kitamimaki-Village (Tomi-City), Nagano, Japan, during May-July, 2000. Valid sample was 214 of 572 total target population; rate of participation was 37.4%. The four test items of mobility were the 10-m walking time, the maximal step length, the 40-cm step test, and tandem walk. Questionnaires comprised the number of falls in the past year, the degree of a fear of falling (Visual Analogue Scale), the degree of subjective happiness (VAS), the Index of Competence, exercise habit, and so on.
Average age of the sample was 74.5±6.3y. The degree of a fear was 38.2±31.6% (0-100%). Numbers of fall in the past year was 1.2±0.5 times (0-10). Correlation coefficients with a fear were: r=0.172 (p<0.01) for age, r=0.285(p<0.001) for the 10-m walking time, r=-0.231 (p<0.001) for the maximal step length, r=-0.250 (p<0.001) for the Index of Competence, r=-0.161 (p<0.01) for the degree of subjective happiness, and r=0.186 (p<0.01) for the number of falls. The multiple regression analysis of a fear (criterion variable) showed coefficient of determination at 0.358. The standard partial regression coefficients were respectively, 0.197 (p<0.05) for age, 0.225 (p<0.01) for the 10-m walking time, 0.145 (p<0.05) for an Index of Competence, and 0.150 (p<0.05) for the number of falls. In elderly men, the cause of fall-related fear may be more complex than in women.
This study showed that a fear of falling of the elderly men had a significant, but weak correlation with age, mobility, and the degree of activity.

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In this study, we classified the courses of 2 local health promotion programs that we have continued in cooperation with local governments from the circumstances of their starts to reporting of the outcomes into the stages of “planning”, “execution”, and “outcomes”, and evaluated problems to be solved for more efficient and effective development of such projects by comparing these aspects between the two projects.
This study clarified problems with these projects and identified ensuring the convenience of the facilities and the availability of air-conditioners, organization of classes in a manner suited for the ages and fitness levels of the participants, accurate grasping of the state of attendance, and reevaluation of parameters of the outcomes as items that need further evaluation.

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For reformation of the care insurance system,“a transformation to a system laying stress on the prevention of long time care need” is recommended. This emphasizes the basic idea of care insurance, i.e.“support for independence”.
Elderly persons needing care may be classified into “elderly persons with cerebrovascular diseases,”“elderly persons with osteoarticular diseases,” and “elderly persons with dementia.” Transition to the “elderly persons with osteoarticular diseases” is the most important target of the prevention of long time care need. This is called the “disuse syndrome model” and is characterized by a large number of elderly persons who need care at a moderate level and whose activities of daily living decrease gradually because of conditions such as disuse syndrome or osteoarthritis. In this model, numerous causes can lead elderly persons into the state in which care becomes indispensable. In addition, much scientific evidence supports the efficacy of preventative measures. Therefore, this model will conceivably increase in importance.
Beginning in 2000, we developed a community project for the prevention of long term care need based on evaluation of mobility of the elderly. The purpose of this article is to construct a project model useful in the future while taking into account the reformation of the care insurance system. For evaluation of mobility, we measured the Good walker's index (Kenkyakudo), which has been found to be effective in reliability, simplicity, and the actual feeling in daily life.
The main problems in the project development are the following three issues: (1) encouraging participation in evaluation of mobility, (2) repetition of evaluation at consistent intervals and support of preventative activity; and (3) follow-up of the elderly who need guidance. If we succeed in constructing a project for the prevention of long term care need in which these problems can be overcome, it is may be possible to establish a consistent, continuous, and overall care prevention system in the community.

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