The purpose of this study was to demonstrate the effect of different test conditions (gait distance, gait speed), age, and intellectual function on interpretation of results and reliability for the Timed “Up and Go” Test (TUG), and to identify the clinical significance of this test. Subjects comprised 81 elderly people (mean age: 80.1 ± 8.5), all of whom utilized facilities for the elderly. TUG were performed with distance set at 3m or 5m and gait speed set at comfortable or maximal. Each test condition of the TUG was evaluated twice consecutively in one day in order to investigate reliability and correlation with other indices of hierarchical structure; Functional Balance Scale as a balance performance test, Barthel Index as an ADL evaluation scale, and TMIG-Index of Competence as an evaluation scale for Instrumental ADL. As TUG score varied depending on test conditions, when interpreting documented results of TUG it is suggested that test conditions be determined. The intraday reliability of TUG was generally high; however It was decreased at the condition of 5m distance walked under comfortable speed. Furthermore, TUG was highly correlated with indices of functional limitation, activity limitation, and participation restriction in descending order of degree of correlation. It was strongly suggested that ambulatory ability is affected by physical factors, social factors, and environmental factors.

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Vital capacity (VC), maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), peak cough flow (PCF) were measured in succession 8.5 ± 4.3 times (range 4-20 times) for over 20.0 ± 18.7 months (range 2.3-70.3 months) in thirty five patients (average age 59.4 ± 12.1 y.o.) with amyotrophic lateral sclerosis (ALS). All measured values declined with progress of the disease.
Mean rate of change per month (MRC/mo) for percent-predicted VC (VC%) correlated with MRC/mo for PImax (r = 0.840, p < 0.0001), PEmax (r = 0.721, p = 0.0002) and PCF (r = 0.666, p = 0.0025).
Eleven patients were offered non-invasive ventilation (NIV) and eight patients were offered tracheal ventilation (TV). MRC/mo for VC% in spontaneous breathing period was slightly greater in the absolute value than that in NIV period. The declining rate of VC% seemed to be eased by NIV.
Fourteen patients with decreased VC% below 25% in spontaneous period were divided into four groups as follows.
Group A: VC% decreased rapidly in 1 to 2 years after onset (n = 3, MRC/mo for VC% = -18.32%).
Group B: VC% decreased almost linearly, but not so rapidly as group A (n = 7, MRC/mo for VC% = 5.99%).
Group C: VC% maintained about 50% in 4 to 5 years after onset, and rapidly decreased after that stable period ( n = 2, stable period MRC/mo for VC% = 0.07%, declining period MRC/mo for VC% = -11.66%).
Group D: VC% maintained 25% or more after onset over 8 years and declined slowly (n = 2, MRC/mo for VC% = -1.95%).
The results indicate that VC is the most important measurement for periodical evaluation and that declining patterns of VC% may be useful to expect respiratory dysfunction.

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An Increasing number of facilities are offering rehabilitation programs for patients undergoing aortic dissection repair to allow them to quickly regain activities of daily living (ADL) and early mobilization. However, the literature which examined the progress of operation region place independence program and ADL inhibiting factor in detail is few. Though it was not this time sufficient symptom example number, the progress of operation region place independence program and ADL inhibiting factor were examined from undergoing ascending aortic arch replacement of 7 examples, thoracic aorta replacement of 4 examples, and abdominal aorta replacement of 23 examples. Chair sitting position start average days ± standard deviation in the post operation were undergoing ascending aortic arch replacement 10.6 ± 5.3, thoracic aorta replacement 5.0 ± 1.0, and abdominal aorta replacement 3.0 ± 1.1. Average days ± standard deviation to patient discharge were undergoing ascending aortic arch replacement 44.9 ± 18.1, thoracic aorta replacement 31.7 ± 20.6, and abdominal aorta replacement 22.6 ± 18.9. Disease state management in the post operation and management of the persistence dissociation space were ADL inhibiting factors on undergoing ascending aortic arch replacement. Management of the pleural effusion was the ADL inhibiting factor on thoracic aorta replacement in the post operation, and digestive symptoms such as the anorexia were ADL inhibiting factors on an abdominal aorta replacement.

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The purpose of this study was to examine the isokinetic muscular strength of the shoulder muscles during different velocity movements from slow to fast and to investigate the effect of velocity of movement on the muscle strength of TUBS patients. Thirteen sports injured patients and 12 healthy volunteers were evaluated by use of a Biodex isokinetic dynamometer. Isokinetic measurements were performed at 60, 180 and 360 deg/sec in two planes: (1) internal rotation/external rotation in 90 degrees of shoulder abduction and 90 degrees of elbow flexion (2nd IR/ER), and (2) abduction and adduction in coronal plane. 2nd IR strength values of sports injured patients were lower than those of healthy volunteers at all velocities. The strength ratios between external rotation and internal rotation were not in normal range in the patients group. These results suggest a dysfunction of the rotator muscles in the patients group. Furthermore, abductor strength values of patients at 180 and 360 deg/sec were significantly lower, and the adductor strength value of patients at 360 deg/sec was also lower than that of healthy subjects. Our results showed that some of the injured sport players had insufficient muscular strength in abduction and adduction in the fast velocities while strength was normal in the slow or intermediate velocities.

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The purpose of this study was to investigate the relationship between the degree of dementia and the difficulty of ADL items.
Subjects were 145 frail elderly persons (mean age 83.2 ± 7.7) who were institutionalized in a geriatric health services facility.
We based on Nishimura's Mental State Scale for the Elderly (NM Scale) on the degree of dementia and “Independence” of motor items of the Functional Independence Measure (FIM) on the difficulty of ADL items.
Cosequently there was a significant relationship between the degree of dementia and “Independence” of 11 items except “tub/shower transfers stair climbing". As for “Independence” of these 11 items there was no significant difference between the normal/border group without dementia and the mild dementia group. There was significant deterioration on 8 items in the moderate to the mild, and on 9 items in the severe to the moderate. In addition there was no difference between the normal/border and the mild with regard to the order of “Independence” of ADL items. After the level of moderate dementia, “Independence” deteriorated markedly m self-care-items except “eating", “bladder/bowel management” and the order of “Independence” also collapsed.
These results suggest that the difficulty of ADL items in the elderly with dementia may increase, particularly self-care items except “eating” and “bladder/bowel management” after the level of moderate dementia, and that the order of the difficulty may collapse.

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The present study examined physical and cognitive (attention) factors associated with falls among the elderly with disability staying at home (N = 110; men N = 17, female N = 93, mean age 83.1 years). We surveyed their levels of attention with the Trail making test - Part A and physical functions. Subjects were divided into those who had experienced falls (Fall group, N = 28), those who had been close to falls (Near to fall group, N = 33) and those who had not experienced falls (Non-Falls group, N = 49).
The result showed that Fall group and Near to fall group had lower scores of Trail making test compared with Non-Fall group, and Fall and Near to fall groups had lower self-perception of body functions. Fall group had lower scores of the maximum stride length, walking speed, foot-gripping force, and ankle range of motion compared with the other groups. Logistic regression analysis indicated that Fall group had less ankle range of motion, less foot-gripping force, and lower Trail making test - Part A scores compared with those of Non-Fall and Near to fall groups. These results suggest that not only physical factors are related to falls, but also attention is an important factor for the elderly with disability.

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Physical therapy was introduced to reduce the burden of daily assistance provided to a child with cerebral palsy. The patient was a 12-year and 9-month-old boy with spastic quadriplegia. Retrospective research was performed over the course of 3 years and 3 months, including 2 months around admission. The aim of this research was to examine the effect of physical therapy on the child's motor function, and to identify specific contributory factors to any improvement in motor function. Changes in motor function were investigated after classifying the intervention period into 5 terms according to type of physical therapy. Results showed that after commencement of physical therapy, maintaining a sitting position became possible and this function was found to be kept. This study delineated the physical therapy execution conditions, and which part of the physical therapy most influenced the patient's motor function was shown more objectively as data.

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