A decrease in the range of motion（ROM）on ankle dorsiflexion（DF）has been reported in diabetic patients, and this is a risk factor for the development of foot ulcers due to increased plantar pressure in the forefoot. Stretching, a typical therapeutic method against ROM restriction, of the triceps surae muscle has been reported to be effective for increasing the ROM on ankle DF in healthy subjects; however its effects for diabetic patients are unclear. In this study, we evaluated the effects of weight-bearing（WB）stretching on the ankle dorsiflexion ROM in diabetic patients. The ROM on ankle DF was measured before and after WB stretching. Patients underwent stretching for 20 min with rest. The ankle DF ROM in the knee-extended or flexed position increased after WB stretching in all patients, and this change was significant（p < 0.05）. This study demonstrated the efficiency of WB stretching for increasing ankle DF ROM in diabetic patients.
Objective: Aging leads to skin frailty and a consequent increase in the incidence of wounds. This study aimed to develop and validate a tool to screen for skin frailty in older adults in a community setting. Methods: The present cross-sectional study enrolled individuals aged 65 years or older. Based on a review of the current literature and the expert opinions of a dermatologist, typical symptoms of skin frailty were selected. A questionnaire with simple, dichotomous questions was developed for validation. The tool was tested on the non-dominant forearm of each participant. In addition, a nursing researcher independently evaluated the tool using photographs. Exploratory factor analysis was performed using the scores submitted by the nurse. Stratum corneum hydration and the viscoelastic properties of the skin were assessed, and skin thickness was measured by ultrasonography for concurrent validity. Results: In total, 192 participants were analyzed. The mean age was 75.2 yrs., and 181 subjects were female. Factor analysis extracted two factors: “ low elasticity ” with four items and “ dryness ” with six items. “ Low elasticity ” score correlated with increased skin looseness R0（r=0.18, p=0.021）, decreased elasticity R2（r=－0.39, p< 0.001）, and decreased thickness（r=－0.42, p< 0.001）. “ Dryness ” score correlated with decreased stratum corneum hydration（r=－0.40, p< 0.001）. Frail participants showed higher scores than the healthy controls for the “ low elasticity ” Conclusion: A tool to screen for skin frailty was developed for community-based assessment of the elderly. Construct and concurrent validity were confirmed for the scores evaluated by the nurse.