Based on the viewpoint of human-centered design fostered by ergomomics, this article introduces several methods to help elderly people lead an independent life, by indicating concrete survey results and experimental cases. It also describes a design model of user-machine-environment, and a model of environmental adaptability examined by the human-environment system.

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The purpose of this study is to introduce the characteristics of aging research, factors relating to life-span development, aging research relating to intelligence and research relating to the personalities of the elderly. In regard to the characteristics of aging research, I comment on the characteristics of the research methods of cross-sectional studies, longitudinal studies and sequential studies as well as their advantages and disadvantages. In regard to the factors relating to life-span development, I point out the importance of historical and cultural influences on development and aging and comment on evolutionary history-graded, ontogenetic age-graded and non-normative influences. In regard to aging research relating to intelligence, I discuss recent findings in intelligence research based on the report of Schaie. In regard to research relating to the personalities of the elderly, I introduce the five-factor model and point out the possibility of differences in results due to differences in personality tests.

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The purpose of this paper is to examine effective physical therapy for the elderly people in the long-term care facilities by reviewing functional evaluation methods and fall prevention programs. It is important to identify the problems peculiar to the elderly by way of the comprehensive assessment to improve the physical functions. This paper identified the area of measurement in clinical performance tests and the purpose of functional evaluation. No previous researches have clearly explained conclusive method of preventing falls among the institutionalized elderly persons, but it was considered important to work on the problems of physical functions as well with an environment, demonstrated by the evaluations.

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In Japan, a typical aged society, countermeasures for osteoporosis and fractures due to aging are acutely needed from not only medical but also social viewpoints. The present article deals with basic considerations on physical therapy for transcervical fracture, and introduces the process of postoperative physical therapy aiming at early mobility. It also demonstrates the results of survey on "functional prognosis" in order to make an appropriate treatment plan. Physical therapy intervention for preventing osteoporosis and falls and preoperative physical therapy at the early stage of transcervical fracture are now needed. In addition, physical therapy is needed for the motor function of the elderly, which includes whole factors of motor function after discharge and life prognosis.

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In the recent years, diagnosis and treatment for acute myocardial infarction have rapidly developed, which is followed by changes in considerations on acute rehabilitation. Even in the elderly patients, treatment program aiming at the early mobility, early discharge, and early social return is now realized, provided that they are highly active preoperatively and have no symptoms of heart failure nor serious arrhythmia postoperatively. On the other side, the elderly patients with myocardial infarction are characterized by low preoperative ADL, gait difficulties, and serious complications. For those patients, with a goal of regaining preoperative ADL, it is necessary to prepare the individual exercise therapy program under the sufficient risk management.

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`Medicine with a patient as the central figure' can be realized by the respect of patient's right in order to provide medicine of higher quality, and by the positive participation of patients into treatment with the aim of having a regard for responsibility to play a role in the treatment. The author convinces that "Basic Concept and Policy" of Saitama Medical School Hospital provides not only the sound medical system of a hospital, but also the highest strategy for the aged society that Japan now faces. "Medical System Reform" of this year has a painful side, but may offer the best opportunity of reconstructing the rehabilitation for elderly and disabled people. This is because "Medical System Reform" forced physical therapists to reconsider our treatment. By providing equal treatment based on appropriate evaluation and plans, patients can activate own latent abilities. Physical therapists can then help patients return to their community as early as possible.

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Physical therapy for cerebrovascular disorder in the early stage needs flexibility according to disease patterns. Especially in the case of infarction, we should pay attention to the expansion of lesions due to a lowering of blood pressure. For elderly patients, with the aim of preventing disuse syndrome, we should provide physical therapy treatment from the early stage and apply walking aids positively, taking overload to respiration-circulation system or bone-joint system into consideration. With respect to gait, we should offer movement exercise based on appropriate motion analysis that mirrors human postural reflex and chain of loads. Functional disorder and possible recovery are considered to depend on brain lesions and disorder degrees, and physical therapy program should therefore be scrutinized. Rehabilitation for the elderly is apt to be affected by social factors, and we should make efforts to avoid long-term hospitalization.

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The use of handrail is very important for maintaining the independence of the aged. However, how the handrail can be used for the different physical conditions of individuals has not fully been studied. Considering the lack of studies in this area, this research aimed to collect basic findings for the development of the handrail and positions, which maximizes physical functions of individuals. We measured the grip strengths during the movement from sitting in a chair to a standing position by holding the handrail in order to find out the relationship between grasping conditions and grip strengths. As a result, the grip strength changed depending on the position of the wrist joint and shapes of handrails. The grip strength was the greatest when the shape was appropriate, and the position of the handrail kept the wrist joint in the mid position, while it decreased in the ulnar flexion position.

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We have recently had more opportunities of examining the reliability of investigation and measurement in the studies of physical therapy, and subsequently have problems in the application. The purpose of the present study is to examine the characteristics of the four kinds of coefficient of reliability; Intraclass Correlation Coefficient (ICC), Cronbach's coefficient alpha (α coefficient), Cohen's coefficient of agreement (κ coefficient) and Kendall's coefficient of concordance (W coefficient). The purpose is also to clarify appropriate application of them by performing simulations. ICC can be widely applied, but depends on the variance of examiners, examinees, and repetition of measurements, thereby needing a description of SEM. Fleiss's κ coefficient is applied in the case of three and more examiners, but in comparison with normal κ coefficient, Fleiss's κ coefficient is used in the case of two examiners. It is desirable to use both W coefficient and κ coefficient for making up each disadvantage. The studies of physical therapy often deal with the data of degree or name measures, and κ coefficient and Kendall's coefficient of concordance are applied more often, compared with ICC. Each coefficient has both advantages and disadvantages, and it should be applied under the considerations of several precautions. The important things are to observe the data carefully and not to insist on the coefficient or significance itself.

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In order to study the present situation of knowledge on blood pressure and the factors of variation among physical therapy students, a questionnaire was administered to 288 students of from second to fourth year (143 males and 145 females, average age: 22.0 years) of our university. The number of questions was 15, and the replies were made by the multiple selection method. The results were examined in the relation between the reply and a school year by χ² test, and p<0.05 was considered significant. Only 4 questions in 15 showed a significant relation between the replies and school year. This indicates that there are a lot of questions on knowledge of blood pressure and the factors of variation, which is not influenced by a school year.

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We examined the respiratory muscle electromyographic activity under various resistive loads by the respiratory muscle training apparatus. Of seven healthy adult males, the maximum respiratory mouth pressure and respiratory mouth pressure during five degrees of inspiratory and expiratory resistances were measured, and electromyographic activities were recorded by an electromyogram recorder throughout the measurement. Electromyographic activity of the maximum voluntary contraction was also recorded. Muscles used for the study were inspiratory muscles (m, sternocleidomastoid, m, trapezius) and expiratory muscles (m. externus obliquus abdominis, m, rectus abdominis). The level of each electromyographic activity was expressed in the percentage of that of the maximum voluntary contraction. There was a linear relationship between respiratory mouth pressure and load. Two-way layout analysis of variance revealed a significant main effect of two factors, electromyographic activity and load, but electromyographic activity of each muscle differed in quantity. The electromyographic activity of sternocleidomastoid muscle revealed the highest value in the inspiratory load, and all muscles exhibited a linear increase with an increase in load. On the other hand, expiratory muscles of externus obliquus abdominis revealed high value from low load, but other muscles did not reveal significant activity with an increase in load.

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The purposes of this study were to examine the roles of toe in dynamic postural control during horizontal and vertical movements, and to elucidate the relationship between dynamic postural control and toe grasp power in healthy young subjects. Three kinds of non-weight bearing insoles, that without weight on a great toe, that without weight on the second to fifth toes, and that without weight on all toes, and an insole of weight bearing were prepared. Center of foot pressure was measured during forward functional reach, and body sway was measured during crouching and standing motions as an index of dynamic postural control during vertical movement. Both in horizontal and vertical movements, a great toe exerted the function of supporting the shifted center of gravity, and the second to fifth toes had the function of re-centering the shifted center of gravity. These suggest a possible role of a great toe and the second to fifth toes in dynamic postural control during horizontal and vertical movements. Toe grasp power of a great toe and the second to fifth toes were measured separately by the hand-held dynamometer improved for toes. Analysis of the relationship between dynamic postural control and toe grasp power suggests that toe grasp power may reduce the body sway area. It is also suggested that toe grasp power may have an effect on dynamic postural control during vertical movement, and that strengthening of the toe grasp power may potentially decrease the risk of falling.

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