The purpose of this research was to examine the method of comprehensively assessing the preventative approach to long-term care. After adding the evaluation of life-space to the evaluation of the preventative approach to long-term care, and demonstrating the relationship between motor function, functional capacity and life-space, we attempted to research the effect of a more accurate approach to preventative long-term care. The results: it was considered necessary to combine evaluations, excepting that for motor function, as the effect of the preventative approach to long-term care influenced the functional capacity of daily living and life-space but did not change the evaluation of the motor function. Moreover, it was thought that because life-space and motor function exercise a mutual influence, the evaluations of life-space and motor function are mutually complementary. Furthermore, because the functional capacity of daily living exercised an influence over life-space, the usefulness of the evaluation of life-space was demonstrated. From this, it was understood that a more accurate evaluation of the preventative approach to long-term care could be performed by adding the evaluation of life-space to the evaluations of motor function and the functional capacity of daily living. It is now possible to conveniently evaluate the effect of the preventative approach to long-term care that up till now had been difficult to grasp. It is thought that an appropriate contribution from physical therapy can be offered.

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The purpose of this study was to investigate the validation of a physical activity assessment method using wrist-worn equipment (Microstone Inc. model ViM ver.2.1.0) in 27 healthy young male subjects. The protocol of this experiment was 9 min. of sitting at rest followed by walking or runnig free-style on a treadmill at a speed of 2.4 km/hr increasing to 3.6, 4.8, 6.0, 7.2 km/hr every 3 min. with no rest. Energy expenditure was compared among an expiratory gas analytical instrument (Minato Medical Science Study, Inc. model AE-280), the wrist-worn accelerometer and a hip-worn accelerometer (Suzuken Inc. model Lifecorder). There were significant correlations between energy expenditure measured by the expiratory gas analytical instrument and the wrist-worn accelerometer (r=0.84, p<0.01), and the hip-worn accelerometer (r=0.92, p<0.01). In a Bland-Altman-plot, the graphs of both the wrist-worn accelerometer and the hip-worn accelerometer vs. expiratory gas analysis were distributed over a range that was approximately equal. Both the wrist-worn accelerometer and the hip-wearing accelerometer are useful for measuring physical activity in elderly persons, and we may use them according to differencs in ability for measuring physical activity.

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Linear polarized near-infrared ray (LPNR) irradiation is used in deep heating modalities. Because of its properties, we consider it could be used to control spasticity after cerebrovascular disease (CVD). However, little study has been reported about its effects. The purpose of this study was to determine the effects of LPNR irradiation on spasticity after CVD. The subjects were thirty-nine patients after CVD. They were randomly divided into three groups (each group thirteen persons). The N group was given irradiation of the tibial nerve of popliteal space, G group was given irradiation of the gastrocnemius, and C group was not irradiated. R1 and R2 of the Modified Tardieu Scale of ankle dorsiflexion in knee extension and flexion positions were measured four times at before and after irradiation, after irradiation at fifth day and five days after at the last irradiation. R1 mainly reflects the neural components of spasticity. R2 mainly reflects non-neural components. The immediate effects, cumulative effects and carry over effects were analyzed based on each result. In the N group, R1 of knee extension and flexion positions with immediate effects were significantly different from C group. In G group, R1 of knee flexion position with cumulative effects was significantly different from C group. The R2 of knee extension and flexion positions in N and G groups with immediate effects were significantly different from C group. Furthermore, the R2 of knee extension position in N and G groups with cumulative effects were significantly different from C group. We concluded that LPNR irradiation has immediate effects and cumulative effects of control in spasticity after CVD. However, we found that LPNR irradiation has no carry over effects.

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The purpose of this study is to introduce “Kiku-chan exercise for longevity”, an exercise program that prevents dependence on long-term care for general elderly people in a local community, and to report changes in their physical functions and mental activities before and after the intervention with the exercise program class operated mainly by the community. Participants of the class were 21 elderly people who belong to a local club for the elderly (average age: 74.1 ± 3.7 years old). A health exercise trainer from another organization instructed them for 3 months. To evaluate physical functions, 10 m full-speed walking time, one foot standing time with eyes open, grip strength, sit-and-reach stretch, timed up & go test (TUGT), and 6 minutes walk test were conducted. While, to evaluate activities of daily living and mental activities, Falls Efficacy Scale (FES), MOS Short-Form 36-Item Health Survey (SF36) were conducted as well as a questionnaire to assess subjective fitness level, and also a group interview was implemented. Pain level was assessed using Numeric Rating Scale (NRS). As a result, significant improvements were observed in 10 m full-speed walking time, TUGT, 6 minutes walk test, and grip strengths in the aspect of physical functions. As for the aspect of mental activities, a significant change in subjective fitness level as well as tendencies of improvement in other items was observed. Consequently, it was suggested that an indirect exercise program in the population approach has a potential to change mental and physical status of elderly people.

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