Differences in Improvement of Physical Function in Older Adults with Long-Term Care Insurance with and without Falls: A Retrospective Cohort Study.

(1) Background: This study examined the differences in changes in physical function with and without falls after daycare use among frail older adults with long-term care insurance (LTCI). (2) Methods: In this retrospective cohort study, 82 of 96 consecutive daycare center users met the inclusion criteria. The participants were divided into two groups based on the presence or absence of falls 6-12 months after use. Participant characteristics in the fall and non-fall groups and physical function at baseline and six months in each group were compared. Using analysis of covariance, we analyzed physical function and its changes between the two groups, and cut-off values were calculated using receiver operating characteristic curves. (3) Results: Gait speed, timed up-and-go test, and 30 s chair stand test (CS30) improved significantly over six months in the no-fall group (n = 70) and all participants (n = 82) (p < 0.01). Gait speed in the fall group (n = 12) improved significantly over six months (p = 0.04). The fall group had significantly lower adjusted ΔCS30 scores than the no-fall group (p = 0.03), with a cutoff value of 2 (p = 0.024). (4) Conclusions: In older adults with LTCI, physical function with and without falls after daycare use differed by ΔCS30, with a cutoff value of 2.

The significance of information and communication technology education via tablets in college of physical therapy.

[Purpose] This study aimed to clarify whether collaborative learning could be promoted via information and communication technology education using tablets at college of physical therapy. [Participants and Methods] An online survey was conducted to evaluate collaborative learning among 81 first-year students at the Department of Physical Therapy actively using tablets in classes (six specific categories). [Results] The Friedman test had significant results, and a significant primary effect was observed between each questionnaire item. Following this, the Bonferroni test was performed for multiple comparisons, with significant differences were observed among certain items. [Conclusion] We reported employing tablets in the classroom positively impacted collaborative learning. Here, among the evaluations of collaborative learning, the items with the best results corresponded mainly to communication activation between students.

Reproducibility and validity of the 50-meter walking test in community-dwelling elderly.

[Purpose] This study aimed to investigate the reproducibility and validity of the 50-m walking test. [Subjects] Reproducibility was investigated in 19 community-dwelling elderly women (mean age, 76.3 years), and validity was investigated in 31 community-dwelling elderly individuals (12 men and 19 women; mean age, 75.7 years). [Methods] The time taken to walk 50 m, the time taken to walk each 10-m section (laps 1-5), the time taken to walk 10 m, and grip strength were measured. In addition, the functional reach test (FRT), one-leg standing test, and timed up and go (TUG) test were performed. [Results] In a reproducibility analysis, the interclass correlation coefficient (1,1) was 0.97. In a Bland-Altman analysis, no systematic error was found. The measured values from the 50-m walking test included a measurement error of 1.5 s, and the acceptable margin of error was confirmed to be 3.1 s. In a validity analysis, the 50-m walking test score was significantly correlated with the 10-m walking and TUG test scores. [Conclusion] Our results suggest that the 50-m walking test score may be a useful index of the walking ability of community-dwelling elderly.

Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care.

[Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care.

Factors that delay COPD detection in the general elderly population.

BACKGROUND: In patients with COPD, early detection and rapid treatment are essential to prevent its progression and exacerbations. OBJECTIVE: To identify factors that delay COPD detection. METHODS: We conducted a cross-sectional study of elderly COPD patients and healthy subjects in rural Japan. We measured respiratory and physical function (hand grip force, maximum inspiratory pressure, maximum expiratory pressure, total trace length, and toe grasp force), walking ability, and quality of life (QOL, measured with a visual analog scale). We conducted spirometry in 408 subjects, whom we divided into 2 groups: those whose ratio of FEV(1) to forced vital capacity (FVC) was < 70% (the airway-obstruction group, n = 60), and those whose FEV(1)/FVC was ≥ 70% (the healthy-subjects group, n = 348). To avoid confounding, we then matched 60 subjects from the healthy-subjects group to the 60 in the airway-obstruction group for age, sex, height, and smoking history, so both groups had 60 subjects. RESULTS: Physical function was significantly inferior in the airway-obstruction group. Variables reflecting instantaneous walking ability (maximum walking speed and walking time in the 10-m hurdle walk) were significantly inferior in the airway-obstruction group, but there were no significant differences in 6-min-walk test, which reflects walking endurance, or in QOL. CONCLUSIONS: Walking endurance, QOL, and proximal muscle strength in the extremities of patients with COPD were well preserved, which prevented detection of COPD and hampered the subjects' motive for seeking medical care. In consequence, lack of awareness impeded the early detection of COPD. In primary healthcare for the general elderly population, spirometry is much easier to conduct than physical function tests, so we recommend that spirometry screening programs for early-stage COPD detection and staging.