Purpose: We sought to investigate the predictive and prospective validity of tandem gait tests to assess dynamic balance.

Methods: Overall, 493 community-dwelling people, including 367 women and 126 men (mean age, 62.6 years), were instructed to walk heel-to-toe on a line of 50 mm width tape. Tandem gait time (TGT), defined as the expended timing of 5-m tandem gait, was measured, and tandem gait index (TGI), calculated as TGT plus twofold of number of misstep(s). Age-related differences between three age groups were analyzed: <65 years, 65–74 years, and >75 years. Multiple logistic regression analysis was performed using falls in the future two years as a dependent variable, and each of the physical examination items as independent variables.

Results: No significant differences in TGT or TGI were seen between any age groups in men, except in the <65 years group vs the >75 years group. There were significant in differences in TGT and TGI in women across all age groups. Men had significantly greater TGT and TGI scores than women in all age groups. TGI was identified as the only independent factors predicting prospective patients at risk of falls with multiple logistic regression analysis. The cut-off value for TGI was determined to be 24.0 (odds ratio, 1.06).

Conclusions: Based on these results, TGI has sex- and age-related predictive validity and prospective validity in elderly patients.

Objective: The purpose of this study was to clarify the characteristic of pain catastrophizing and the relationship between pain catastrophizing and related factors in preoperative patients with lumbar spinal stenosis.

Methods: This cross-sectional study included 45 preoperative patients (25 males, 20 females; mean age 68.4 years) with lumbar spinal stenosis. Demographic data, leg pain, back pain, the scores on the Pain Catastrophizing Scale (PCS) and the Timed Up and Go test, walking velocity, grip strength, muscle mass, and walking distance were assessed. Patients were divided into two groups based on their PCS score: the higher PCS group (PCS score ≥ 30) and the lower PCS group (PCS score < 30).

Results: The mean PCS score was 34.7. In the multivariate analysis adjusted for confounding factors, walking velocity was a significant relevant factor for PCS in these patients (OR = 0.036; 95% CI, 0.001– 0.937; p = 0.046).

Conclusions: These findings suggested that walking velocity may be related to pain catastrophizing in preoperative patients with lumbar spinal stenosis.

Purpose: Nonspecific low back pain (NLBP) that cannot reliably be attributed to a specific disease or spinal abnormality has been reported in individuals who have disorder in local trunk muscles such as transversus abdominis. Though there are studies on side bridge endurance test (SBET) continuation time as an index that showed isometric endurance is shortened in individuals with NLBP, there are few reports on the fatigue of local trunk muscles. Incidentally, from T2 weighted image of magnetic resonance imaging, T2 values enable the fatigue of local trunk muscles to be evaluated. The purpose of this research is to clarify the fatigue of local trunk muscles in NLBP individuals during SBET from T2 value.

Methods: The participants were divided into two groups, the control group without low back pain and the NLBP group. The measurement items were SBET continuation time and T2 value of local muscles at pre and post SBET. A two-way analysis of variance and simple main effect was conducted. The independent variable was the group and the dependent variable was T2 value of pre and post SBET continuation time.

Results: SBET continuation time was low in the NLBP group. Relationship was shown in the T2 value of local trunk muscles. Simple main effect showed in pre and post SBET and T2 value of post SBET was high in the NLBP group.

Conclusion: The findings of the investigation showed there was a decrease of isometric endurance in trunk muscles and a decline of local trunk muscle endurance at SBET in the NLBP group.

Purpose: To investigate the relationship between pulmonary function and posture adjusted for motor function, in patients with knee osteoarthritis.

Methods: Twenty eight patients with knee osteoarthritis and 35 community-dwelling elderly women participated in this study. Motor function was evaluated by knee extension muscle strength and the Timed Up and Go test performance time at maximum walking speed. Pulmonary function was evaluated by vital capacity and forced expiratory volume in 1 second. Posture was evaluated by neck flexion angle, thoracic kyphosis angle, lumbar lordosis angle and knee flexion angle in the sagittal plane. Relationship between the variables was analyzed with the Pearson correlation coefficient because of reports stating that pulmonary function, posture and motor function influence one another. Hierarchical multiple regression analysis adjusted for age, height, weight, and motor function were carried out to estimate the independent relationship between each pulmonary function and various components of posture. Pulmonary function was used as the response variable, and the explanatory variables were the components of posture.

Results: Knee flexion angle was significantly associated with forced expiratory volume in 1 second (β = –0.56, p = 0.003) in patients with knee osteoarthritis. Posture was not significantly associated with pulmonary function in the community-dwelling elderly women.

Conclusion: Worsening pulmonary function was significantly associated with increase in knee flexion angle in patients with knee osteoarthritis, when adjusted for age, height, weight, and motor function.

Purpose: Endurance training improves vascular endothelial dysfunction and exercise capacity in patients with chronic heart failure (CHF). However, CHF patients with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D) often avoid endurance training for fear of ICD shock. Recent studies have shown that stretching exercises enhance antioxidant activity and improve vascular responses. We aimed to assess the effects of four weeks of stretching exercises on oxidative stress and vascular endothelial function in CHF patients with an ICD or CRT-D.

Methods: Thirty-two sedentary CHF patients (men, 83%; mean age, 69 ± 9 years; left ventricular ejection fraction, 30 ± 9%) with an ICD or CRT-D were randomly divided into a group that performed four-week stretching exercises (stretching group), and a group that continued a sedentary lifestyle (control group). We compared the reactive hyperemia peripheral arterial tonometry index (RHI) and 6 minute walk distance (6MWD), and sit-and –reach test (SR), between the two groups before and after the four-week study period.

Results: In the stretching group, a significant increase in the RHI, 6MWD, and SR were observed after the study period compared to before (p<0.01, p<0.05, and p<0.01). No significant changes were observed in the control group.

Conclusion: Four weeks of stretching exercises may increase exercise capacity through improve of vascular endothelial dysfunction in sedentary CHF patients with an ICD or CRT-D.