Objective: This study aimed to confirm the utility of a simplified measurement for leg press strength using a pull-type hand-held dynamometer (referred to as pull-type HHD).

Methods: The participants were 108 older people men and women. Measurements with pull-type HDD were performed for leg press strength, knee extension strength (referred to as KE) and knee flexion strength (referred to as KF). Leg press strength measurements were performed in two settings with a knee flexion angle of 60° and 30° (referred to as LP60 and 30). Indicators of mobility were the presence or absence of locomotive syndrome (referred to as locomo), and the maximum and the comfortable walking speeds. Intra-rater reliability of each muscle strength was verified using an intraclass correlation coefficient, ICC (1,1) and a Bland-Altman analysis. Correlations of each muscle strength with the locomo, and each gait speeds were verified by a multivariate analysis.

Results: For all measurements, the ICC (1,1) values were 0.92 or larger and fixed error was observed in each muscle strength. Significant factors were extracted: LP60 for the locomo, LP60, KE and KF for the maximum gait speed, and KE for the comfortable gait speed.

Conclusion: LP60 measurement by pull-type HHD is useful as a method to reflect locomo and maximum walking speed.

Purpose: In recent years, the effect of visual function and recognition for body function on the movement of elder subjects has been investigated. The purpose of this study was to clarify the effect of body function and the recognition for body function on the movement strategy in an obstacle avoidance task designed for older adults.

Methods: Twenty older adults and 12 young adults participated in this study. They were told to walk along a 5-m pass and go through the gap with various width. The movement was recorded using a 3D motion capture system and the duration of gaze was measured using an eye mark recorder. Older participants were categorized based on physical assessment findings:, Low risk (LR) group and High risk (HR) group. To identify the level of recognition for body function, older participants were asked to assess whether they could go through the gap without rotating the body. According to the answer, these participants were further categorized as, correct and incorrect.

Results: Our findings showed that, in the LR and HR groups, the stride length reduced while passing through narrow gaps (gap width < body width), and the angle of rotation was greater in the HR group than in the LR group.

Conclusion: The results suggest that body function and body recognition influenced the kinematic changes and obstacle gaze time in obstacle avoidance movements performed by older adults.

Objective: The purpose of this study was to use the experiential learning process theory to identify specific experiences that promote the development of highly skilled physical therapists (PTs) and to determine the particular knowledge gained from those experiences. This information will then be used to suggest experiential learning support methods for PTs.

Method: The subjects of this study were 3 highly skilled PTs. Qualitative research methods and the Matsuo experiential learning framework were utilized.

Results: At the beginning of their careers, accomplished PTs developed their “attitudes regarding topics such as interpersonal relationships, society, and lifestyle” from their hands-on experience of promoting social participation in patients with disabilities. From the beginning to the middle of their careers, their “unpredictable, negative experiences” exposed them to topics such as the “harsh reality of the field of medicine.” They also obtained a better understanding of “the effectiveness of using fundamental physical therapy techniques to improve the condition of critically ill patients.” Finally, from the middle to the end of the careers, their “experience supporting trainees and newcomers” “reinforced their knowledge and skills after self-reflection.” Additionally, they gained more knowledge about topics such as “communication” from their “experience of conducting interventions with a multidisciplinary team of health care professionals.”

Conclusion: We consider that highlighting the experiences that promote the success of highly skilled PTs, and allowing less skilled PTs to gain that experience, can help support their experiential learning.

Objective: The aim of this study was to cross-sectionally investigate the associations among respiratory function and muscle strength, locomotive function, cognitive function, and body composition in Japanese community-dwelling elderly individuals.

Method: The participants in this study were 347 Japanese community-dwelling elderly individuals aged 65 years or older. All the participants could independently perform activities of daily living. Individuals who had any respiratory disease or heart disease were excluded from this study. For the assessment of respiratory function, the forced vital capacity (FVC) and forced expiratory volume in 1.0 second (FEV1.0) were measured. For muscle strength and locomotive function, the grip strength, leg muscle strength, chair stand test, timed up and go test (TUGT), and comfortably paced and maximum-paced 5-meter walking times were assessed. The trail-making test part A (TMT-A) was assessed for cognitive function. Moreover, the skeletal muscle index and fat mass per body weight were measured for the index of body composition. The associations among respiratory function and muscle strength, locomotive function, cognitive function, and body composition were analyzed using multiple regression analysis adjusted for the following confounding factors: age, sex, height, weight, and smoking status.

Result: As the results of multiple regression analysis, accounting for the effect of confounding factors, the FVC was significantly associated with grip strength, TUGT, and TMT-A results. Similarly, the FEV1.0 was significantly associated with grip strength and TMT-A results.

Conclusion: It was suggested that respiratory function is comprehensively associated with muscle strength, locomotive function, and cognitive function in Japanese community-dwelling elderly individuals.

Objective: The goal of this study was to identify the factors that affect a patient's ability to put on socks three weeks after total hip arthroplasty surgery.

Methods: One hundred fifteen patients with total hip arthroplasty using the posterior approach were enrolled in this study. We investigated gender, age, range of motion (hip flexion, extension, adduction, abduction, and external rotation; knee flexion; thoracic spine flexion; and lumbar spine flexion), and the ability to put on socks in hip-abduction-in-flexion positions. The range of motion was used as the independent variable in a decision tree analysis with the ability to put on socks three weeks after surgery as the dependent variable.

Results: Decision tree analysis revealed that the range of motion (ROM) of hip flexion and external rotation, and thoracic spine flexion were factors affecting the ability to put on socks. In addition, it was found that patients with total hip arthroplasty are more likely to put on socks if hip external rotation ROM and thoracic spine ROM are good even if hip flexion ROM is poor.

Conclusions: Improvement of hip flexion and external rotation ROM, and thoracic spine flexion ROM are important for a patient's ability to put on socks in the early postoperative period following total hip arthroplasty.

Purpose: The purpose of this study was to investigate the predictors of basic mobility for acute cerebral infarction (CI) patients at discharge.

Methods: The participants were 259 patients with acute CI registered at 5 hospitals. Patients were evaluated medical characteristics, neurological impairments, balance disorders, and activity of daily living (ADL). Basic mobility which is a dependent variable used the revised version of the ability for basic movement scale (ABMS-II) Multiple regression analysis was used to identify independent variables related to basic mobility.

Results: In multiple regression analysis, National Institutes of Health Stroke Scale, scale for contraversive pushing, consciousness disorder, recurrence of CI, presence of hemorrhagic infarction, and pre-modified Rankin Scale were identified as predictors of dependent variable.

Conclusions: It was suggested that these indice may predict basic mobility in acute phase and may considered useful to effective programs of physical therapy.

Objective: This study aimed to investigate physical and mental factors associated with home-based life space in disabled elderly at home.

Methods: In the present study, 61 elderly persons (82.7 ± 6.2 years; male, n = 13) who underwent day-care service at two health service facilities for the elderly participated. We measured the home-based Life Space Assessment (Hb-LSA) [Maximal Life Space (Hb-M), Life space using equipment (Hb-E), Independent Life Space (Hb-I)], grip force, muscle strength of quadriceps, one-leg standing, Timed-Up and Go test (TUG), Barthel index (BI), Activities-of-Daily-Living Self-Efficacy Scale (ADLSES), depression scale and self-rated health. Subjects were divided into those who moved to outside with using equipment (outside group, N=25), those who moved to neighborhood with using equipment (neighborhood group, N=36).

Results: The results showed that neighborhood group had better TUG, BI and ADLSES compared with outside group.

Conclusion: The present findings suggest physical performance and confidence in performing activities of daily living are important for enhancing the life-space for disabled elderly at home.

Objective: The purpose of this study was to examine the association between objectively measured moderate-to-vigorous physical activity (MVPA) and falls in community-dwelling older adults stratified by balance function.

Methods: Subjects were independent community-dwelling older adults (n = 602) aged over 65 years, stratified by balance function at baseline. Daily time spent in MVPA, locomotive activity, and non-locomotive activity were measured using a tri-axial accelerometer. Self-reported incidence of falls at a 2-year follow-up survey was measured as the outcome.

Results: The risk of falls in the middle MVPA group was lowest among participants with high balance function. The risk of falls in the middle and high MVPA groups was significantly higher than that in the low MVPA group among participants with low balance function. Additionally, among low balance function participants, the risk of falls in the high locomotive activity group was significantly higher than that in the low locomotive activity group.

Conclusion: The association between MVPA and falls exhibited differences among independent community-dwelling older adults with different levels of balance function.

Objective: The purpose of this study was to determine the spinal alignment and spinal range of motion in patients with end stage hip osteoarthritis (OA).

Methods: Eleven patients with end stage OA (OA group) and 16 healthy elderly individuals (control group) were included in this study. The static spinal alignment and dynamic range of motion were measured by the Spinal Mouse® on the standing position and all fours.

Results: The alignments of the thoracolumbar spine in the standing position were not significantly different between the two groups. A significant decrease in the lumbar spine range of motion was observed in the OA group in the standing and on all fours positions compared to that in the control group, but there was no significant difference in the thoracic spinal range of motion.

Conclusions: Patients with end stage hip OA showed no differences in static thoracolumbar alignment and reduced dynamic lumbar range of motion compared to those in healthy elderly patients.

Objective: To clarify the independent predictors of home discharge in patients with acute exacerbation of heart failure (HF) who underwent cardiac rehabilitation (CR).

Methods: This was a single-center retrospective cohort study. In this study, 305 patients aged 60 years or older, who were admitted with acute exacerbation of HF, were included in the analysis. The patients were divided into a Home group and Non-Home group based on discharge disposition. Basic characteristics, HF severity, knee extension strength (KES), Short Physical Performance Battery (SPPB) and Barthel Index (BI) at the commencement of rehabilitation and at hospital discharge were compared between groups. Additionally, multivariate logistic regression analysis and a receiver operating characteristic curve were used to evaluate independent predictors of home discharge and cut-off value.

Results: At the commencement of CR, KES, SPPB, and BI were significantly higher and age was significantly lower in the Home group. However, there were no significant differences in HF severity and nutritional status between the groups. At hospital discharge, KES, SPPB, and BI were significantly higher in the Home group. Multivariate analysis showed that predictors of home discharge and its cut-off value were KES at the commencement of CR (≥12.1 kg), SPPB at the commencement of CR (3/4 points), and BI at hospital discharge (≥80 points).

Conclusion: These results may contribute to the early detection of older patients who may be difficult to discharge to home and to setting appropriate CR goals.