Background: Not only the reduction of muscle strength or balance, but also the reduction of the agility are regarded as important factors of falls in elderly people. If an agility test for elderly people is established, the precision of the fall prediction rises and can be used for individual training. Objectives: To develop a new performance test focused on agility for elderly people and to evaluate the usefulness of this test. Design: Cross-sectional study. Setting: The Welfare Center of Kagami Town, Kagami Town Office, etc., Kochi, Japan. Participants: 828 community-dwelling, independent adults aged 20–99 years with no obvious cognitive or functional disability, were randomly recruited from Kagami town and the surrounding areas. Measurements: The Ten Step Test (TST, a new performance test), motor reaction time (MRT), knee extensor isometric strength, single leg standing time (SLST), and some other tests were used to evaluate the criterion-related validity and the content validity. TST was developed as a modified version of other step tests which require the subjects to place the whole foot on a block, then return it to the floor. In addition, female participants over 70 were asked whether or not they had fallen in the past year. Results: Excellent reliability for TST was found for interrelation (intra-class correlation coefficients, ICC = 0.96), and re-test reliability was sufficient (ICC = 0.86). Evidence for criterion-related validity was found through high single correlation with the timed supine-to-stand (r = 0.68) and high single correlation with MRT (r = 0.59). In addition, content validity was found through low correlation with knee extensor strength (–0.35) and SLST (–0.36) in 112 women over 70 years of age. The error rate by TST to predict falls (35.2%) was lower than the error rate by muscle strength (44.4%) and the balance (38.7%). TST confirmed decline after 50 years of age, and it conformed to a cubic curve. Conclusion: The findings indicate that TST is a reliable measure of agility, and it can help to predict the risk of falls. The decline of agility accelerates after 50 years of age. It shows that the decline of agility differs from the decline of leg muscle strength and balance.

The ability to maintain a one-leg standing position and the relation between plantar two-point discrimination and standing time on one leg were assessed. Participants were 1,241 apparently healthy people aged 2–92 years. Participants were asked to stand on one leg with eyes open (EO group) or closed (EC group) for up to 120 seconds. Coefficients of determination (COD) between subjects' ages and results for both groups were calculated by quadratic and cubic functions. The slope of the tangent line drawn against the resultant curve was calculated by a differential formula. COD for the quadratic function were 0.65 (EO) and 0.33 (EC); age at maximum values in both groups was 37 years. COD for the cubic function were 0.77 (EO) and 0.52 (EC); maximum values were at ages 30 (EO) and 28 (EC) and minimum values at ages 88 (EO) and 77 (EC). The ability to remain standing on one leg with eyes closed appears to begin deteriorating in the late 20s. Age and plantar two-point discrimination distance had a significant positive correlation, and the two-point discrimination distance and standing time on one leg had a significant negative correlation. Decreased plantar sensation appears to be related to the decline in duration of one-leg standing.

Abstract.[Purpose] Agility includes three factors: rapidity of reaction, rapidity of directional change, and velocity of muscle contraction. We proposed the Ten-Step Test (TST) as a new performance test for agility. In our previous study, the criterion-related validity of TST was evaluated by comparing TST with a timed supine-to-stand test which reflects motion speed. However, timed supine-to-stand doesn't include rapidity of reaction. The purpose of this study was to evaluate the criterion-related validity of TST using motor reaction time (MRT).[Subjects] One hundred fifty-two community-dwelling adults were recruited.[Methods] TST requires the subjects to place one foot at a time, ten times on a block 10 cm in height while standing. TST was conducted twice, and the quickest time of the two trials was used for analysis. MRT was measured as the time between a touch on the malleous and the response of the ankle dorsi-flexion in a sitting position. For evaluating the relationship between TST and MRT, the conformity of the regression formulae of aging changes and correlation coefficients were analyzed. TST was also compared with the Functional Reach Test (FRT) and muscle strength of the knee.[Results] Both TST and MRT showed a quadratic rather than a linear relationship with age. The single correlation coefficient between TST and MRT was 0.59. [Conclusion] Age-related changes of TST and MRT showed a similar curve. These curves showed a significant increase after the age of 50, and the correlation coefficient between TST and MRT was high. The findings suggest that TST includes a factor related to motor reaction.

[Purpose] To examine the ability of young and elderly individuals to control the timing and force of periodic sequential foot tapping. [Subjects and Methods] Participants were 10 young (age, 22.1 ± 4.3 years) and 10 elderly individuals (74.8 ± 6.7 years) who were healthy and active. The foot tapping task consisted of practice (stimulus-synchronized tapping with visual feedback) and recall trials (self-paced tapping without visual feedback), periodically performed in this order, at 500-, 1,000-, and 2,000-ms target interstimulus-onset intervals, with a target force of 20% maximum voluntary contraction of the ankle plantar-flexor muscle. [Results] The coefficients of variation of force and intertap interval, used for quantifying the steadiness of the trials, were significantly greater in the elderly than in the young individuals. At the 500-ms interstimulus-onset interval, age-related effects were observed on the normalized mean absolute error of force, which was used to quantify the accuracy of the trials. The coefficients of variation of intertap interval for elderly individuals were significantly greater in the practice than in the recall trials at the 500- and 1,000-ms interstimulus-onset intervals. [Conclusion] The elderly individuals exhibited greater force and timing variability than the young individuals and showed impaired visuomotor processing during foot tapping sequences.

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The purpose of this study was to verify the benefits of a physical exercise workshop in which we have participated over the past four years in a care preventive project that effectively uses human resources functioning in the community. [Subjects] The subjects were 95 persons (20 men and 75 women, mean age: 77.8±6.1 years) who participated in the exercise class over the 4 years. [Methods] To verify the overall physical benefits of the exercise class, the measurements of subjects' physical strength before and after the exercise were scored, and compared on a total-score basis. In the scoring process, the reference values of physical strength determined from the results of a physical examination performed by the municipal authority were used. To explore factors underlying the benefits of the exercise class, the measurements of subjects' physical strength at the start of the exercise were compared between those with and without physical benefits. [Results] A significant increase in the total score was observed between the pre-and post-exercise class periods. The total score at the start of the exercise class was significantly lower in those with physical benefits, suggesting that the benefits of the exercise were greater in those with low levels of physical strength at the start of the exercise class. [Conclusion] The benefits of the community-based physical exercise class for the elderly were identified. The results suggest that the exercise class could be effectively managed by selecting participants whose physical strength levels were uniformly low.

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