[Purpose] To examine the olfactory identification abilities and specify the difficult-to-identify odors in community-dwelling individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). [Participants and Methods] We included, 12 and 17 patients with MCI (MCI group) and AD (AD group), respectively, and 30 community-dwelling older adults with no history of MCI or a dementia diagnosis (control group). Scores on the Japanese odor stick identification test (OSIT-J), an olfactory identification ability test, were compared among the three groups with intergroup differences examined accordingly. Next, we performed intergroup comparisons of the ratios of correct responses for each odor, and the difficult-to-identify odors were examined. [Results] OSIT-J scores of the MCI and AD groups were significantly lower than those of the control group. There were no intergroup differences in the correct identification of pungent odors. No patients in the AD group could identify the odor of cooking gas. The ability to identify food-related odors was reduced in the MCI and AD groups. [Conclusion] Patients with MCI and AD had reduced olfactory identification abilities in comparison to community-dwelling older adults without cognitive decline. These findings suggest the importance of olfactory evaluation before providing patients with dementia with therapeutic interventions associated with olfactory stimuli.

[Purpose] Various types of Gait Exercise Assist Robot (GEAR) have been developed recently, some of which have enabled early improvement in patients with stroke. However, none has yet resulted in independent walking in these patients. Hence, we conducted an exploratory study of the effect of GEAR on achieving independent walking in stroke patients. [Participants and Methods] The participants were 16 patients with severe stroke. We evaluated patients’ ability to walk independently after GEAR training. The outcome measure was Stroke Impairment Assessment Set (SIAS) motor score (Hip Flexion, Knee Extension, Foot Pat, Abdominal and Verticality). Differences in five SIAS motor scores were compared between the independent and non-independent walking groups. [Results] There was statistically significant difference between the groups in terms of Verticality among the 5 SIAS items used in the present research . Verticality of SIAS score of 1 was the cut-off value for distinguishing walking independence. [Conclusion] Verticality of SIAS may be a marker of potential walking independence that can be used in rehabilitation plans using walking-assist robots in patients with stroke.

[Purpose] The purpose of this study is to figure out the information obtainable from ankle instability instrument (AII) survey among various factors related to the ankle instability. [Participants and Methods] This study targeted on 34 participants, divided the participants into stability group and instability group based on AII survey results, and measured the maximum isometric contraction, proprioception, dynamic balance, and maximum joint angles. The independent t-test was used. [Results] The maximum isometric contraction showed significance in the plantar flexion while the proprioceptive sense showed significance in both dorsiflexion and plantar flexion. The dynamic balanced showed significance in the anterior direction while the maximum joint angles showed significance in the dorsiflexion. [Conclusion] According to the results, the participants who were classified as ankle instability patients based on AII survey results involved problems in the maximum isometric contraction, proprioception, dynamic balance, and maximum joint angles.

[Purpose] We aimed to determine whether lower leg muscle echo intensity, an indicator of muscle quality, is a useful predictor of gait variability after examining the relationship between physical activity and gait variability in community-dwelling older and healthy young adults. [Participants and Methods] This study comprised two tasks. In the first task, 18 older and 25 young adults were included as participants. We examined the relationship between the amount of physical activity and gait variability in both groups. In the second task, muscle echo intensity related to gait variability in each group was measured using ultrasound echoes after identifying common factors related to gait variability in 19 older and 19 younger adults, and trends were compared. [Results] In the first task, gait variability was significantly higher in the younger group than in the older group. A significant negative correlation was found between the amount of physical activity and gait variability in both groups. In the second task, multiple regression analysis was performed for gait variability, and lower leg muscle echo intensity was identified as a significant factor. There was no difference in the correlation coefficient between gait variability and lower leg muscle echo intensity between the two groups. [Conclusion] Lower leg muscle quality was one of the causes of gait variability, suggesting that it is a useful predictor of gait sway status.

[Purpose] The purpose of the present study was to investigate whether the extent of shoulder internal rotation measured in the extended position of the shoulder could be a good indicator of hand-behind-back motion ability. [Participants and Methods] We measured internal rotation with the shoulder in extension in 26 healthy adults (average age, 25.2 ± 2.5 years). Internal rotation was measured passively in the supine position at 30° of shoulder extension. Additionally, a hand-behind-back motion was performed, and the hand-behind-back distance was measured. The relationship between the angle of internal rotation with the shoulder in extension and hand-behind-back distance was evaluated using Pearson’s product-moment correlation. The level of significance was set at 5%. [Results] The angle of internal rotation with the shoulder in extension and the hand-behind-back distance correlate significantly. [Conclusion] Internal rotation with the shoulder in extension is a good indicator of hand-behind-back motion.

[Purpose] To evaluate the inter-examiner reliability of our novel parameter, the lumbar paraspinal muscle atrophy index, in identifying the lumbar paravertebral muscle atrophy. [Participants and Methods] The study group consisted of 225 adults, with a mean age of 64.7 (range, 21–89) years, who underwent posterior lumbar spinal surgery for degenerative spinal disease at our hospital between July 2013 and June 2017. Preoperative axial T2-weighted magnetic resonance images were used to evaluate the lumbar paraspinal muscle atrophy index and observe the presence or absence of severe lumbar paraspinal muscle atrophy. The lumbar paraspinal muscle atrophy index was calculated at each intervertebral level, from L1-2 through L4-5, once by two examiners, and the Cohen’s kappa statistic was used to calculate the inter-examiner agreement of the classification of the presence or absence of atrophy at each level. [Results] The agreement was high (kappa, 0.79–0.88) for the lumbar paraspinal muscle atrophy index at all levels, except at the L3-4 level (kappa, 0.49). The lower kappa statistic at L3-4 likely reflects the unique morphological characteristics at this level. [Conclusion] The lumbar paraspinal muscle atrophy index is a new, simple, easy-to-use, and sufficiently reliable parameter to identify lumbar paraspinal atrophy.

[Purpose] This study evaluated the effects of ankle elastic bandaging, taping, and kinesiology taping on the neuromuscular control of the lower extremities before and after their application and after exercise in soccer athletes. [Participants and Methods] Fifty-five amateur soccer players were randomly divided into four research sub-groups either receiving bandaging (n=15), taping (n=15), and kinesiology taping (n=15) on their ankle or serving as controls (n=10). The dynamic stability of the non-dominant limb was assessed through the star excursion balance test (SEBT) in three research conditions: a) before sports taping application, b) after the application, and c) after a 15 min laboratory simulation of soccer activities. [Results] Taping and kinesiology taping improved the dynamic stabilization of the lower limb more statistically significantly than bandaging. The addition of exercise significantly improved the SEBT results in the taping and kinesiology taping more than the bandaging and control groups. [Conclusion] Exercise activates the proprioceptive mechanisms of the lower limb and improves its neuromuscular control. This functional improvement of the lower limb appears to be enhanced after ankle taping and kinesiology taping compared with elastic bandaging and controls.

[Purpose] To describe the functional activity and the communication-social ability levels of youths with developmental disabilities and to determine whether demographic factors predict these levels. [Participants and Methods] A mixed, observational and qualitative, study in which parents of students with developmental disabilities were interviewed based on the WeeFIM questions. Both quantitative and qualitative data were analysed. [Results] Data were collected for 30 youths with mild to severe developmental disabilities with mean age 18.5 ± 2.7 years (19 males). Mean WeeFIM total score was 106.2 ± 10.9, indicating relatively high functional and communication-social ability. No significant difference was observed for the total WeeFIM score between males and females and between adolescents and young adults with developmental disabilities. Main themes emerged from the interviews were: Difficulties with smooth and stable walking, transfers to/from bathtub and stairs. Also, youths are expressing a need for independence in self-care, while relationships with their peers are difficult and problems are primarily solved with help from their parents. [Conclusion] Despite the high functional and communication-social ability levels of a group of youths with developmental disabilities, parents revealed that youths had certain difficulties. Therapy should address such difficulties to promote independence and participation of these young people in the community.

[Purpose] To clarify the relationship between lower extremity function and activities of daily living and characterize lower extremity function in hospitalized middle-aged and older adults with subacute cardiovascular disease. [Participants and Methods] The Short Physical Performance Battery, 6-minute walk distance, and functional independence measure tests were conducted in 79 inpatients with subacute cardiovascular disease (mean age, 76.7 ± 11.9 years; 34 females). Multiple regression analysis used the functional independence measure score as the dependent variable and the Short Physical Performance Battery and 6-minute walk distance scores as independent variables. Cross-tabulations were performed for each age group, and patients who performed the Short Physical Performance Battery and 6-minute walk distance tests were divided into two groups by their respective cutoff values. [Results] Only the Short Physical Performance Battery (β=0.568) and 6-minute walk distance (β=0.479) scores were adopted as significant independent variables in each multiple regression model. The age <75 years group had the most patients with both good lower extremity function and aerobic capacity, whereas the age ≥75 years group had the most patients with both functions impaired. [Conclusion] Although cardiovascular disease is generally associated with decreased aerobic capacity, many older patients with cardiovascular disease in this study had decreased lower extremity function, too.

[Purpose] To characterize the case report evidence of Chiropractic BioPhysics^® (CBP^®) technique methods applied to increase cervical lordosis and improve forward head posture. [Methods] The CBP Non-profit website as well as PubMed and Index to Chiropractic literature were searched for case reports/series documenting the increase of cervical lordosis and improvement of forward head posture in the treatment of various craniocervical spinal disorders by CBP technique methods. [Results] Sixty patients were reported in 41 unique manuscripts detailing the improvement in cervical spine alignment by CBP technique methods. On average, there was a 14° improvement in cervical lordosis and a 12 mm reduction in forward head position after 40 treatments over 16 weeks with a 5-point reduction in pain rating scores. Thirty-eight percent of cases included follow-up showing only slight loss of lordosis, but maintenance of pain and disability improvements after an average of 1.5 treatments per month for 1.8 years. [Conclusion] An abundance of reports document improvement in craniocervical and other ailments by CBP methods that increase cervical lordosis. Routine radiographic imaging of the spine is recommended as it is safe and the only current practical method of screening for critical biomechanical biomarkers of sagittal spine alignment.