External aids are applied to support the environment of the patients with memory disorder. This study was performed to examine the effectiveness of external aids among the elderly with dementia. Subjects consisted of 15 institutionalized females of the facility of health care services of the elderly (average age: 83.8 years; NM scale evaluation point, 32.8 in average). They were ordered to perform the following five tests about memory with or without external aids, and their responses were compared. In test 1, (place of objects), the number of correct answers was significantly increased with labels. In test 2 (process), the number of correct answers was slightly increased with labels. In test 3 (people's name), the number of correct answers was significantly increased with memos. In test 4 (estimation of time), with a timer the number of correct answers was slightly increased. In test 5 (route), the number of correct answers was not increased with a tape on the floor or an arrow. These results suggest that external aids may play an effective role in improving memory disorder of the elderly with dementia.

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With a primary purpose of clarifying the motion characteristics of stairclimbing, transfer locus of the center of foot pressure was studied by an F-SCAN among 25 subjects (15 healthy adults and 10 patients). The loci of healthy subjects were divided into two types, started at the toe part, transferred to the heel part, and returned to the toe (type A), and started at the heel part and moved to the toe (type B, similar to walking). All the healthy subjects showed type A during descending stairs, with a significantly larger horizontal sway compared with those during ascending stairs (p<0.01). During ascending stairs, healthy subjects exhibited both types A and B. Patients showed marked difficulties in descending stairs, and their loci tended to become similar to those of healthy subjects with a functional improvement. The results also suggested that a cane may play an important role in stabilizing the standing phase. The present measurement of dynamic foot pressure during stairclimbing revealed partly the complexity of posture control in descending stairs.

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It is generally accepted that basic actions in daily living in order of difficulty are rolling over in bed, sitting up, standing up, and walking. In this study, we examined physical performance of 40 hemiplegic patients after stroke, especially those who showed different order of difficulty, and further investitgated the cause of difference. Twenty nine patients showed the same order of difficulty (same group), and 11 patients exhibited different order (different group). In the different group, 9 patients were incapable of sitting up, but capable of standing up and walking (subgroup 1). In this subgroup, significant differences were observed in hip extension ≤ 0° and trunk rotation restriction ≥ 5°, compared with the same group, and a significant difference was also observed in trunk flexion restriction ≥ 5° in those who were incapable of rolling over in bed or sitting up. These suggest that restrictions of hip and trunk movements may prevent these actions. The difference in order of difficulty was considered to result from subjects' age, low physical performances such as standing up with a physical support, walking between parallel bars, and hemineglect.

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The purposes of this study were to examine muscle activities of hip joint during various bridgings, and to compare the results with those during MMT3. Of 12 healthy males, rectified filtered electromyography of gluteus maximus, gluteus medius, tensor fascia latae, and adductor magnus was recorded. The muscle activities during bridging on both feet were under 20% of the maximum isometric contraction, and those during bridging on one foot were significantly greater than those on both feet, especially in extensor and abductor. Compared with muscle activities during MMT3, those during bridging on one foot was greater, except for adductor magnus. These results suggest the effectiveness of bridging on one foot as a muscle strengthening exercise not only for gluteus maximus, but also for gluteus medius, and tensor fascia latae. It was also indicated that muscle activity greater than during MMT3 is requisite for bridging on one foot.

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The purpose of this study was to analyse kinematically sit-to-stand movement patterns in the functionally impaired elderly adults. 11 young and 18 elderly subjects were participated in this study. Elderly subjects were divided into two groups: healthy and functionally impaired, according to their ability to rise from a 20 cm-high chair. Videotape motion analyses were used to collect kinematic data. Functionally impaired subjects showed: 1) an increase in time to rise and the percentage of the first phase, 2) a decrease in distance between the center of mass and base of support at lift-off, 3) a decrease in the maximum horizontal velocity of center of mass and, 4) an increase in flexion angle of trunk at lift-off. These results suggested that functionally impaired elderly may rise from a chair using a more mechanically stabilised postural control.

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The purpose of this study was to examine the effects of home exercise on muscle strength, physical balance and gait of community-dwelling elderly women. The subjects consisted of a group of 12 healthy women (aged 68.0±4.1 yrs) performing 3-month home exercise (training group), and a control group of 7 women (aged 69.0±3.7 yrs). All subjects completed the tests, including knee extension and flexion strength, functional balance scale, functional reach, postural sway, maximal gait speed and 6 minutes distance, before and after exercise. The exercise, composed of 10 resistance exercises with free weight in sitting or standing, was performed at RPE 15 in 8 or 10 repetitions (1 set) per one exercise. Exercise protocol was 2 or 3 sets of 4 or 5 exercises a day, 2 or 3 days a week, over 3 months. The training group showed significant improvements in functional reach, maximal gait speed (p<0.01), functional balance scale results (p<0.05), and 6 minutes distance, but no change in muscle strength and postural sway. The control group exhibited an improvement in 6 minutes distance. The results revealed the effectiveness of the home exercise in improving functional balance and gait speed of community-dwelling elderly women.

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The purpose of this research was to examine a carryover effect of the exercise at the intensity of 50% AT in the patients with non-insulin dependent diabetes mellitus (NIDDM). Five NIDDM inpatients who had received no pharmacotherapy performed 30-min exercise of bicycle ergometer at the intensity of 50% AT, and their blood glucose level, serum insulin value and lipid were measured before breakfast next morning. The same exercise and measurement was undertaken on the day after the day when the patients had no exercise (rest day). Comparison between the results of rest day and those of exercise day indicated that no carryover effect of the exercise at the intensity of 50% AT was observed in the present subjects.

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Is it shown that the exercise at the intensity of 50% AT has the role by which the blood glucose at a short-term period is controlled for the patients with non-insulin dependent diabetes mellitus (NIDDM) ? Fourteen NIDDM patients were divided into two groups according to their serum insulin level, high and low insulin groups. After the 30-min exercise of bicycle ergometer at 50% AT, their blood glucose and the density of the serum insulin were measured. The decrease in glucose level after the exercise of high insulin group was significantly greater, compared with low insulin group. This suggests that the effect of low intensity exercise on the blood glucose level may depend on the insulin level of each patient. Results obtained also suggest that the exercise at the intensity of 50% AT may have an effective role in controlling blood glucose at a short-term period of NIDDM patient at a high insulin level.

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This paper shows a view point of Physical therapist Practice in Diabetis Mellitus in Japan, and consists of the following articles:
1. The problem of Physical Therapist Practice in Diabetis Mellitus
2. The relationship between Physical Therapist Practice and Diabetis Mellitus in Japan
3. The epidemiology of Diabetis Mellitus in Japan
4. The Current Physical Therapist Practice in Diabetis Mellitus
5. The certified papers in Physical Therapist Practice in Diabetis Mellitus in Japan (ON-LINE database should using internet search)
6. What do Physical Therapist do for Patients with Diabetis Mellitus.

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