[Objective] This study investigated the applicability of a 3-m zigzag walk test for the prediction of falls and examined the relationships among fall history, the 3-m zigzag walk test, 10-m walk, and age. [Subjects] A total of 50 elderly individuals (23 males and 27 females) aged 65 and over, who were able to walk independently, were studied. [Methods] Four poles made of PET bottles were placed on a 3-m walkway in a straight line to create a zigzag course, and the time needed to walk it was measured. The best results on days 1 and 2 were adopted for the fall and no-fall groups, and intra-rater reproducibility was evaluated by calculating the intra-class correlation coefficient and performing the paired t-test. For comparison of the time needed to walk the zigzag between the 2 groups, the unpaired t-test was performed. The relationships between the times needed to walk the 3-m zigzag and 10 m and age were analyzed by calculating the correlation coefficient with fall history as the dependent variable, in multiple logistic regression analysis with the times needed to walk the 3-m zigzag and 10 m and age as independent variables. For the optimal classification of the fall and no-fall groups, cutoffs were calculated based on the ROC curve. [Results] The paired t-test results did not show differences between measurements, and the ICC was 0.97 in the fall, and 0.94 in the no-fall groups. The fall group needed significantly more time than the no-fall group to walk the 3-m zigzag. Further, the Pearson product-moment correlation coefficient revealed a significant correlation between the times needed to walk the 3-m zigzag and 10 m, while no correlation was observed between the time needed to walk the 3-m zigzag and age (r=0.225). The time needed to walk the 3-m zigzag was extracted as a factor associated with fall history in multiple logistic regression analysis, with an odds ratio of 0.377. Its significance as a variable was p<0.01. In the Hosmer-Lemeshow test of the study model, the rate of discrimination between the predicted and actual values was 82.0%. [Conclusion] The cutoff time to walk the 3-m zigzag was estimated to be 10.5 seconds, suggesting that this model may be a valid index for the prediction of falls.

The arterial distribution to the rotator cuff muscles was studied in 14 upper extremities of Japanese cadavers and its diversity was correlated with the variable arterial origin. The supraspinatus was supplied with arterial branches from the suprascapular artery (SPS), the infraspinatus with those from SPS and from the circumflex scapular artery (CS), and the teres minor with those from the posterior circumflex humeral artery and from CS, and the dorsal aspect of the subscapularis with those from SPS and from CS, whereas the ventral aspect of the subscapularis was supplied with branches from several variable origins. On the basis of origin and course, SPS was classified into proximal and distal types (pSPS and dSPS) and the subscapular artery was classified into superficial and deep types (sSBS and dSBS). The boundary between the distribution areas of SPS and CS in the infraspinatus and the dorsal aspect of subscapularis were variable and influenced primarily by the types of SPS with larger distribution areas of SPS in the cases of dSPS, and secondarily by the types of SBS with larger distribution areas of CS in the cases of dSBS. The kinds of branches and their distribution areas to the ventral aspect of the subscapularis were influenced by both the types of SPS and SBS. The present study revealed the main distribution areas of arteries in the rotator cuff muscles and their variation, and predicted the weakly vascularized areas in these muscles, which corresponded well to the localization of trigger points that elicit referred pain.

[Purpose] We conducted a care prevention course for potentially dependent elderly and investigated its effect on their health-related QOL and motor function.[Subjects] The subjects were 45 potentially dependent elderly persons (11 men, 34 women) who enrolled for the care prevention course.[Methods] The care prevention course lasted 3 months and was conducted once a week for 12 weeks. Each session lasted 2 hours and consisted of a lecture, stretching, muscle strength training and whole body exercise. The assessments used were motor function and the SF-36 questionnaire.[Results] At pre-intervention, no significant differences were found in motor function or the SF-36 score between those with and without a history of falls. Significant improvements in motor function of both groups were found post-intervention, and a significant improvement in the SF-36 score was found post-intervention for the group without a history of falls, but not for the group with a history of falls. [Conclusion] We consider that the lack of improvement in health-related QOL in the group with a history of falls was due to the psychological impact of the falls. Thus, we consider that care prevention interventions for the elderly with a history of falls need to address not only motor function, but also psychological aspects.

[Purpose] We investigated the results of an intervention based on applied behavior analysis for a case presenting with difficulty in walking and hip joint pain.[Subjects] The subject was a 52-year-old female who was finding it increasingly difficult to walk because of increasing pain arising from osteoarthritis of both hips, who visited us as an outpatient 4 months after hospitalization at another facility. [Method] We performed behavior analysis after baseline measurements of pain experienced during walking and number of steps taken each day. We made a behavioral intervention of keeping a personal record and sticking to the prescribed target for the number of steps to be taken every day. We investigated the effectiveness of the intervention over 7 sessions with approximately 3 months between sessions through use of walking aids, pain experienced during walking and number of steps taken.[Results] As the intervention progressed, the dispersion in the number of steps taken and the pain experienced in walking decreased; walking aids changed from two crutches to a T-cane.[Conclusion] The present intervention, utilizing applied behavior analysis for a case experiencing chronic intense pain when walking due to hip osteoarthritis, of daily step limits directed by a physical therapist was observed over the long term, and we consider it influenced the improvement of walking ability and pain. Key words: hip osteoarthritis, hip joint pain, applied behavior analysis