【Purpose】Falls self-efficacy is related to behavior modification as factors controlling behavior. In the elderly female after the fracture of the proximal femur, this study examined the difference of falling self-efficacy between prolonged hospitalized group and discharged group and also examined factors influencing self-efficacy from the

aspect of life-space.

【Method】The subjects were 46 elderly women who were treated surgically for a hip fracture at an acute care hospital, who subsequently underwent rehabilitation. The subjects were divided into 2 groups: patients who were hospitalized for a prolonged period and patients who were discharged in 4 weeks. We followed the course up to the 8th week after surgery and examined the inter-group difference, measuring falling self-efficacy (MFES), the motor function, psychological function, and Life-Space Assessment (LSA). Furthermore, we performed multiple regression analysis to analyze factors that most affected falling self-efficacy.

【Results】There were no significant differences in age, Body Mass Index (BMI), Mini-Mental State Examination (MMSE) score, prehospitalization Activity of Daily Living (ADL)-Functional Independence Measure (FIM) score, and prehospitalization LSA score between the two groups. The results indicated that discharged patients tended to have a significantly higher MFES score 8 weeks postoperatively and a significantly higher post-discharge LSA score. Thus, multiple regression analysis was performed with the MFES score 8 weeks postoperatively as a dependent variable and experience with falls, physical and psychological function 8 weeks postoperatively, and the post-discharge LSA score as independent variables. The results indicated that the postdischarge LSA score and the FIM score 8 weeks postoperatively affected falls self-efficacy.

【Conclusion】In addition to the ability of daily living activities, the extent of the range of behavior and the high frequency of behavior after discharge were related to improvement falling self-efficacy of the elderly female after the fracture of the proximal femur.

【Objective】This study was conducted to analyze the effect of fall experience on whole waveform of toe-height trajectory during swing phase of barefoot walking. We also focused on the effect of participant’s sex.

【Methods】Participants were 88 elderlies (56 non-fallers and 32 fallers) aged 60 to 77. The principal component analysis (PCA) was conducted using a 166 x 202 input matrix constructed from the participants’ time-normalized average and standard deviation of the toe-heights during swing phase (101 data × 2 parameters). Two-way (age x sex) multivariate analysis of variance were conducted on the principal component scores (PCSs) of principal component vectors (PCVs) 1 through 11.

【Results】We identified a PCV that exhibits a significant fall experience effect (PCV 3, F (1, 165) ＝ 5.936, p ＜ 0.05, ES ＝ 0.031) and significant fall experience / sex interaction (PCV 7, F (1, 165) ＝ 7.573, p ＜ 0.01, ES ＝ 0.044). These findings suggest that the toe-height trajectory related to PCV 3 and PCV 7 is the important characteristic that affects the risk of falling while walking. We therefore recombined the toe-height trajectory corresponding to PCV 3 and PCV 7, and found that the local minima of toe height during swing-phase for fallers tend to appear earlier than non-fallers. Further, the variability of the toe height trajectory during late-swing phase for fallers was larger than that for non-fallers regardless of sex.

【Conclusions】These results indicate that we should focus whole toe-trajectory as well as minimum toe clearance to understand the gait characteristics of fallers.

【Purpose】The aim of this study was to investigate and clarify the locations, causes, and resulting injury sites of falls by community-dwelling older adults based on 8 years of emergency dispatch records from 2008 to 2015 held by the fire departments in an industrial city with a population of 310,000 and aging rate of 24.5%．

【Method】Words and phrases related to 1) fall location, 2) cause of fall, and 3) site of injury were extracted, sorted, and tabulated for 3,721 individuals (mean age, 80.7 ± 7.7 years) from emergency dispatch records taken by ambulance attendants. From the tabulations, ratios were calculated for the cause of the fall and the site of injury from the fall for falls in rooms and on roads, respectively. Chi-square tests were performed to test for differences in ratios between falls in rooms and falls on roads with a significance level of p ＜ 0.05.

【Results】Of the 3,721 subjects, 1,552 fell in rooms (mean age, 82.0 ± 7.5 years) and 583 fell on roads (mean age, 78.4 ± 6.8 years). Separated by sex, 1,072 women (mean age, 82.8 ± 7.5 years) and 480 men (mean age, 80.1 ± 7.2 years) fell in rooms. Meanwhile, 268 women (mean age, 79.7 ± 6.9 years) and 315 men (mean age, 77.4 ± 6.6 years) fell on roads. Ratios for cause of fall and site of injury were calculated for falls in rooms and on roads, respectively. For falls in rooms, causes of the fall were stumbling (24.0%), dizziness (22.4%), and slipping (20.6%). For falls on roads, causes were stumbling (44.8%), dizziness (21.5%), and slipping (10.4%). Chi-square tests for differences in ratios between groups revealed significant differences for slipping and stumbling (p ＜ 0.01). No difference in the ratio of dizziness was evident between groups. For falls in rooms, the site of injury was the head (22.4%), arm (9.7%), lower back (27.5%), leg (33.5%), and unknown (6.8%). For falls on roads, the site of injury was the head (60.7%), arm (12.5%), lower back (4.9%), leg (12.1%), and unknown (9.8%). Ratios between two groups differed significantly (p ＜ 0.05, p ＜ 0.01).

【Conclusion】In rooms, older women fell more frequently and the site of injury was most often the leg or lower back. On roads, men fell more frequently and the site of injury was most often the head.

【Purpose】The purpose of this study was to investigate whether main fall risk assessment is useful predictor of backward falls.

【Methods】A total of 61 community-living elderly who were able to walk indoors participated in this study. The participants were classified into three groups: Group I included participants who had experienced no falls in the past year, Group II those who had experienced any falls other than backward falls in the past year, and Group III those who had experienced backward falls in the past year. All the participants completed the Five-Times-Sit-To-Stand Test (FTSST) and the Timed Up & Go Test (TUG), and had their normal walking speed and one-leg standing time measured. The foot landing position of the lifting leg in one-leg standing was measured five times, as well as whether landing was forward, backward or middle. The Steel-Dwass method was used for comparing each evaluation result among the three groups. Chi-square of independence test was also used to verify whether the foot landing position in one-leg standing was related to the fall direction.

【Results】In the comparison between Group I and Group III, FTSST was 14.2 ± 4.7s in Group I, 19.4 ± 6.3s in Group III, normal walking speed was 0.8 ± 0.2m/s in Group I, 0.6 ± 0.1m/s in Group III, TUG was 12.6 ± 4.7s for group I and 16.9 ± 5.7s for group III. These three measures indicated significantly lower level in group III (p ＜ 0.05). There were no significant differences between Groups I and II in these measures. Furthermore, no significant differences were observed between the three groups in one-leg standing time. Regarding the landing position of the lifting leg in one-leg standing, no correlations were found between the three groups.

【Conclusion】Currently, it is difficult to predict backward fall only by fall risk assessment that is often used. Backward falls may be more likely to occur in elderly people with decreased leg muscular strength, and lower standing up, walking, and turning ability.

　This paper describes points to note when conducting intervention studies, especially randomized controlled trials, on fall prevention.

　General information is also provided on basic requirements for an investigator to engage in medical research, including rules to observe, considerations in research design, methodological aspects of a controlled trial for nonpharmacological treatment, conflicts of interest and authorship, and association between foods with function claims and fall-prevention intervention. Priorities for appropriately designing, conducting and reporting data in a randomized controlled trial were compiled by referring to the CONSORT 2010 checklist, the SPIRIT checklist, the extended CONSORT checklist for trials with nonpharmacologic treatment, and the 15 check items recommended by Prof. Origasa.

　Conducting studies by adhering to these points will improve the quality of trial and reporting, which will lead to the provision of sufficient and useful information to readers.