Psychological distress caused by decreased physical activity (PA) is a growing concern among the elderly due to public health measures since the coronavirus disease (COVID-19). We aimed to (1) assess how public health restrictions impact PA, subjective well-being (SWB), and health-related quality of life (HRQoL) of community-dwelling elderly, and (2) investigate risk factors that lead to a decline in PA. Self-administered questionnaires assessed the changes in PA, SWB, HRQoL. Multivariate logistic regression analysis was performed to identify significant associated risk factors for decreased PA. Of 165 participants (valid response rate, 41.3%; mean age, 78.5 ± 8.0 years), 47.3% became less active, 23.0% became more active, and 29.7% maintained PA levels. There was a significant decrease in SWB at baseline and follow-up after COVID-19 restrictions in the less active group (p < 0.01). Higher levels of moderate or strenuous exercise/sports activity at baseline (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01–1.24), and lower mental component HRQoL scores at baseline (OR, 0.96; 95% CI, 0.93–0.99) were associated with an increased risk of decreased PA. Public health restrictions impact the PA of the elderly, especially those who had higher levels of exercise/sports activity and lower HRQoL before COVID-19. Decreased PA was strongly associated with lower SWB.

This observational study investigated the relationship between balance, mobility and falls in 72 hemiplegic stroke inpatients, with the aim of developing a model for predicting fall risk. Fall history was recorded by interview, balance was assessed using the Berg Balance Scale (BBS) and activities of daily living were evaluated using the Functional Independence Measure (FIM). Variables differing between fallers and non-fallers were identified, and a stepwise regression analysis was performed to identify a combination of variables that effectively predicted fall status. Fallers (occasional and repeat; n = 27) had a shorter time from stroke onset, lower FIM scores on admission and discharge, lower BBS and Mini-Mental State Examination scores, a greater age and longer length of hospital stay compared with non-fallers (all differences were significant). A logistic model for predicting falls showed that BBS at admission was significantly related to falls, with fallers having lower BBS scores at admission (cut-off

This research received no external funding. Acknowledgments:We would like to thank Toshihide Seto and Sachiko Okuda in the Department of General Affairs and staff in the Department of Rehabilitation for their great contribution to the mailing of the questionnaire and the compilation of the survey data.

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ObjectivesTo present the fall characteristics of athletes playing wheelchair rugby (WR) and wheelchair basketball (WB) using official videos from the Rio 2016 Paralympic Games and compare the key fall characteristics among the team wheelchair sports event.MethodsEighteen WR and 10 WB game videos for men (MWB) and women (WWB), including 8 teams per sport, were obtained from the official International Paralympic Committee of the Rio 2016 Paralympic Games. The videos were analysed to assess the number of falls, playing time of fall, playing phase, contact with other athletes, the direction of the fall and the body part first in contact with the floor during the fall.ResultsIn total, 359 falls (96 for WR, 172 for MWB and 91 for WWB) occurred with a mean of 5.3, 17.2 and 9.1 falls per match, respectively (p<0.05). Significant differences among the three sports were detected in the playing time (p=0.011), presence of contact (p=0.037), direction (p<0.001) and body part first in contact with the floor (p<0.001). For WR, the falls were primarily lateral and caused by contact, occurring in the second half of the match. WB falls tended to be in the first half for women and the second half for men. Most falls were contact falls in the forward direction.ConclusionBy observing the situational details, we described that a number of falls due to contact occurred during these team sports events, especially MWB. In addition, each sport exhibited characteristics attributable to differences in gender, degree of impairment and game rules. The directions of the falls and characteristics of the affected body parts indicate differences in impairments depending on the sport. A fall to the side or back may indicate a risk of injury.

INTRODUCTIONAn observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.METHODS A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status. RESULTSOf the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS. CONCLUSIONThe results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.

In this study, we performed 6-minutes walking tests using a portable gas analyzer in patients with post-stroke hemiparesis, and examined the effects of ankle-foot orthosis (AFO) application on the walking ability and energy expenditure during walking. The subjects were 18 patients with post-stroke hemiparesis, who were admitted to the rehabilitation care unit of our rehabilitation center, and could walk. We performed 6-min walking tests with and without AFO application in these patients, and examined the walking distance and velocity, oxygen consumption (VO2), and heart rate (HR) during walking. The oxygen consumption per meter (VO2m −1 ) and physiological cost index (PCI) were determined as the efficiency of kinetic energy. The difference in the VO2 during walking was not significant between application and non-application of the AFO, but the differences in the walking distance and velocity and the VO2m −1 and PCI were significant. It was suggested that improvement of the walking ability and reduction of energy expenditure during walking were possible in motion-impaired patients with post-stroke hemiparesis by AFO application.

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