The LSH concept can measure with high reliability and concurrent or discriminant validity, and it is a different concept from outdoor life-space mobility. Life-space mobility at home may be an important factor associated with physical functions related to mobility and functional status, and measuring LSH may be useful to assess current indoor life-space activity in older adults who have difficulty performing outdoor activities.

Abstract. [Purpose] We conducted a noncontrolled intervention study in community-dwelling individuals with chronic stroke hemiplegia as subjects to examine the effectiveness of a 6 month low-frequency combined functional training program on enhancing factors related to physical performance, such as leg muscle strength, postural balance, and gait function. We also examined whether medium-term changes in physical performance correlated with time from stroke onset or degree of hemiplegia. [Subjects and Methods] Twenty-two individuals with chronic stroke hemiplegia who were using an adult day-care facility were enrolled in a combined functional training program consisting of stretching, muscle strengthening, postural balance training, and gait training once or twice a week for 6 months. The main outcomes measured were indices of physical performance -such as leg muscle strength (measured at about 1 repetition maximum [1RM] on a leg press machine), the functional reach test, the timed "up and go" test, comfortable gait speed, and maximum gait speed -and the Brunnstrom recovery stage (BRS).[Results] After 6 months of intervention, significant improvements were observed in all of the above-mentioned outcome measures of physical performance. No significant correlations were found between the percentage changes of physical performances after the intervention and time from stroke onset or BRS.[Conclusion] The 6 month low-frequency combined functional training program at an adult day-care facility results in medium-term improvements in leg muscle strength, postural balance and gait performance in community-dwelling individuals with chronic stroke hemiplegia.

Abstract.[Purpose] The purpose of this study was to examine the reliability and clinical usefulness of a subjective risk rating of specifi c tasks (SRRST) for assessing risks of falls in frail elderly people. The participants were 30 elderly individuals who utilized day-care services. [Subjects and Methods] Participants were investigated the SRRST, grip strength, one repetition maximum of leg-press machine (1RM), one-leg standing time (OLS), functional reach, timed up and go test (TUG), and 10 m-walking speed, Barthel index, Tokyo Metropolitan Institute of Gerontology index, and history of falls in the previous year. The SRRST is comprised of 7 dichotomous questions screening of fall risk during activities of daily living such as walking, transferring, and wandering, and was scored twice a week by four raters.[Results] Intra-rater reliabilities of the SRRST were high (ICC (1,1) = 0.727 to 0.914, ICC (1,2) = 0.842 to 0.955), and inter-rater reliabilities of the SRRST were moderate to high (ICC (2,1) = 0.513, ICC (2,4) = 0.808). In comparison to the non-faller group, the faller group showed signifi cantly lower 1RM and higher the SRRST. The SRRST showed moderate correlations with the OLS and TUG.[Conclusion] The SRRST showed moderate to high reliability and concurrent validity for assessing the fall risks in frail elderly people.

Abstract.[Purpose] The purpose of this study was to examine the effects of low-frequency combined functional training over a 3-month period on lower extremity muscle strength and gait performance in community-dwelling people with chronic post-stroke hemiplegia.[Subjects] The subjects were 23 individuals with chronic post-stroke hemiplegia, utilizing the services of an adult day-care facility.[Methods] All subjects performed functional training programs consisting of stretching, strengthening, postural balance training, and gait training once or twice a week for 3 months. Leg muscle strength measured using a leg press machine at one repetition maximum (1RM), comfortable gait speed (CGS), maximal gait speed (MGS), and the difference between MGS and CGS (ΔGS) were assessed before and after intervention.[Results] Comparison of each outcome before and after intervention revealed significant increases in 1RM, CGS, MGS, and ΔGS. The change rate of ΔGS was correlated only with that of MGS.[Conclusion] Three-month combined functional training was effective at enhancing lower extremity muscle strength and gait performance, and ΔGS was increased by enhancement of MGS in community-dwelling people with chronic post-stroke hemiplegia.

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