Cognitive decline and dementia have a significant impact on feeding and swallowing functions and ADLs. Therefore, I would like to summarize the relationship between dementia and ADL, feeding and swallowing function, and diet from the perspective of dementia prevention in this paper. Rehabilitation for dementia will also be touched upon.It is speculated that ADL declines from IADL ability, which is even more complex and advanced cognitive function than self-care such as eating. It is important from a preventive perspective to investigate more specific problems and intervene early, rather than simply assessing whether the patient is assisted or independent.In terms of eating and swallowing function, the addition of mastication insufficiency to aging may cause a significant decline in cognitive function, leading to a vicious cycle of decreased food intake and reduced opportunities for mastication due to changes in food forms that do not require mastication. Therefore, measures against oral frailty are important for the prevention of dementia.Regarding dietary intake of vegetables, fruits, and fish, and the risk of developing dementia, we have not yet reached a certain conclusion, and there is insufficient evidence to support this conclusion. In the area of dementia rehabilitation, there have been reports of improvement in cognitive function test results after FEP intervention, but again, sufficient evidence has not yet been obtained.In the future, it will be important to clarify evidence on the relationship between feeding and swallowing, diet, and cognitive function, as well as the effects of dementia rehabilitation.

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This study examined changes in total quasi-WOMAC functional scores and the percentage of patients with difficulties in each item, as well as changes in each functional item by severity of illness, in outpatients with knee osteoarthritis during a 3-month period of physical therapy intervention. The subjects were 40 outpatients (8 males and 32 females) diagnosed with knee osteoarthritis, with a mean age of 73 (54-88) years. The total quasi-WOMAC functional score and each item were evaluated. Each functional factor, isometric knee extension muscle strength, knee joint flexion and extension ROM, walking speed, stride length, and gait rate in a 10-m walk, Timed up and go test, postural stability index in the standing position, and distance of center of gravity shift from front to back and left to right, were evaluated at the initial evaluation and after 3 months, respectively.The total quasi-WOMAC functional score improved significantly in all subjects and in the mild and severe groups. The percentage of subjects with difficulty in each item and the change in each functional factor between the time of initial intervention and after 3 months of intervention were greater in all subjects and the mild group than in the severe group. Conclusion: General outpatient physical therapy intervention for knee OA may be effective in improving ADL ability and basic physical function. The results suggest that general outpatient physical therapy intervention for knee OA may be effective in improving ADL and basic physical functions．

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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In this study, we investigated the effect of combined vibration stimulus and thermal therapy on the flexibility of the hamstrings. The subjects were 10 healthy participants. First, bilateral popliteal angles were measured. Then, hot packs were applied to the posterior surface of the thighs bilaterally in the prone position for 10 minutes. For the last 3 minutes, vibration stimulus （76.6 Hz） was applied to the hamstrings tendons on one side. After the treatment, the bilateral popliteal angles were measured again. On a different day, vibration stimulus was applied to the other hamstrings tendons in the same way,and the bilateral popliteal angles were measured in the same way. The popliteal angle in the combined group was 125.8 degrees anteriorly and 136.0 degrees posteriorly, showing a significant difference（p＜0.01）. The anterior and posterior popliteal angle in the thermal group were 124.2 degrees and 130.6 degrees, respectively, with a significant difference （p＜0.01）. The change in the combined group was 10.2 degrees, and the change in the thermal group was 6.4 degrees, a significant difference （p＜0.05）.The addition of vibration stimulus to hyperthermia greatly improved the flexibility of the hamstrings. The addition of vibration stimulation seemed to be beneficial in improving the flexibility of the hamstrings.

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In this study, we investigated the effect of different measurement positions on the reproducibility of isometric abductor muscle strength. The subjects were 20 healthy subjects. The abductor muscle strength was measured in the sitting and supine positions. In both cases, a pressure sensor was placed on the outer side of the distal end of the right thigh, and both thighs were fixed with a belt. After each exercise, the subjects performed isometric abduction exercise with maximal effort for 3 seconds. The abductor muscle strength was measured in the same way in different posture after a break. The same measurement was performed on different days to examin intra-assay reproducibility. The sitting abductor muscle strength was 29.1±8.4kgf on the 1st day and 28.8±7.2kgf on the 2nd day, and there was no significant difference. The intraclass correlation coefficient between the two abductor muscle strengths was 0.924. The abductor muscle strength in the supine position was 27.4±8.7kgf on the 1st day and 25.1±8.1kgf on the 2nd day, showing a significant difference (p＜0.05). The intraclass correlation coefficient between the two abductor strengths was 0.889. There was a significant correlation of r=0.937 between the sitting and supine abductor strengths on the 1st day (p＜0.01).These results suggest that the method of measuring abductor muscle strength in the chair sitting position has better reproducibility than that in the supine position. In addition, the abductor muscle strength in the supine position can be predicted from the abductor muscle strength in the chair sitting position.

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