Toe functions have little effect on dynamic balance ability in elderly people.

[Purpose] The purpose of this study was to examine the toe function of elderly people and the association with the dynamic balance ability for the developing effective fall-prevention measures. [Subjects and Methods] Seventy-eight participants in a community health service were included in this cross-sectional study. The Timed Up and Go Test and Four Square Step Test were used to test dynamic balance ability. The toe functions related to dynamic balance ability were toe flexion strength, presence or absence of restricted range of motion of the hallux, presence or absence of hallux pain, and hallux valgus angle. [Results] Factors related to the Timed Up and Go Test results were toe flexion strength, age, and presence or absence of hallux pain. Their standard partial regression coefficients were -0.400, 0.277, and -0.218, respectively. Factors related to the Four Square Step Test results were toe flexion strength and age. Their standard partial regression coefficients were -0.334 and 0.277, respectively. [Conclusion] Toe functions appear to have little impact on dynamic balance ability in elderly people who have mild toe dysfunction. Approaches that address not only the toes, but trunk functions, and other leg joints should be investigated for improving the dynamic balance ability.

One-Leg Standing Time of the Affected Side Moderately Predicts for Postdischarge Falls in Community Stroke Patients.

BACKGROUND: The purpose of the present study was to investigate the predictive accuracy of one-leg standing time at hospital discharge on falls in stroke patients. METHODS: This was a retrospective cohort study. Participants included stroke patients (n = 65) who could walk when discharged from inpatient rehabilitation ward. To investigate the relationship between one-leg standing time and falls, logistic analysis was utilized with a criterion variable including the presence or absence of falls after 1-year hospital discharge as well as explanatory variables including Brunnstrom stage, knee extension strength on the affected side, Barthel Index, 10-m walking speed, and one-leg standing time on both sides. The accuracy of prediction by one-leg standing time was measured by the area under the curve of the receiver operating characteristic curve. RESULTS: Among the 65 patients, 38 (58.5%) experienced a fall 1 year after discharge. One-leg standing time of the affected side was not significantly associated with the falls (odds ratio: .89; 95% confidence interval: .79-1.01). When the fall incidents were assessed by area under the curve of the receiver operating characteristic curve, one-leg standing time of the affected side was observed to have increased marginally to .93 (95% confidence interval: .87-.99) as compared to the traditional prediction mode area under the curve (area under the curve .88; 95% confidence interval: .81-.97). CONCLUSIONS: One-leg standing time of the affected side may be considered as a moderately effective and simple assessment method for predicting postdischarge falls in a clinical setting.

Different cutoff values for 10-m walking speed simply classification of walking independence in stroke patients with or without cognitive impairment.

[Purpose] The aim of this study was to determine the threshold for classifying walking independence in stroke patients with and without cognitive disorders. [Subjects] The subjects were 130 patients with initial stroke hemiplegia. [Methods] The following factors were analyzed for associations with walking independence: Brunnstrom stage, one-leg standing time on the paralytic side, one-leg standing time on the non-paralytic side, and 10-m walking speed. We classified the patients with Mini-Mental State Examination (MMSE) scores ≥24 points into the high-score group and those with MMSE scores of ≤23 points into the low-score group and examined the main factors and cutoff values associated with walking independence in each group. [Results] The high-score group included 69 subjects (53.1%), and the low-score group included 61 subjects (46.9%). The primary factor associated with high MMSE scores among the stroke patients was the 10-m walking time. Using a cutoff level for the 10-m walking speed of 41.4 m/min resulted in a positive likelihood ratio of 6.3. The primary factor associated with low MMSE scores among the stroke patients was the 10-m walking time. Using a cutoff level for the 10-m walking speed of 48.0 m/min resulted in a positive likelihood ratio of 7.6. [Conclusion] The cutoff value for the 10-m walking speed can be used to evaluate walking independence in patients with stroke among patients with high or low MMSE scores.

[An analysis of fall accidents in ambulance service records of fire department in Japan: investigation of time and location].

PURPOSE: The aim of this study was to examine fall accidents in Japan by analyzing records of ambulance responses. METHOD: The survey period was one year, from January to December, 2007. During this period, a total of 31,002 ambulance responses to fall accidents were recorded by 37 fire departments throughoutiapan. The ambulance responses to fall accidents were analyzed in terms of sex, age, place, time of fall, and degree of injury. RESULTS: The number of ambulance responses per population sample of 1000 people was 1.9 cases among people ranging in age from 20 to 64, 6.3 cases for people ranging in age from 65 to 74 and 15.9 cases for people aged 75 years or over. When excluding males in the 75 year or older group, more falls occurred from December to February than in the other seasons. There were also more falls in December than in any other month. In addition, more falls occurred in houses than at other locations. Roadside locations followed houses regarding the location of falls for males. In addition, public places were the second most common location for females. The degree of injury was higher for females than for males. Females 75 years of age or older sustained 2.8 times more serious injuries than females ranging from 20 to 64 years of age. CONCLUSION: The causes and other characteristics of fall accidents were thus found to vary according to sex and/or age.