Can the loco-check be used as a self-check tool for evaluating fall risk among older subjects? A prospective study.

BACKGROUND: Japan has now become a super-aged society. Notably, as the Japanese society ages, the prevalence of falls, which represent an aging-related problem, has increased. Locomotive syndrome (LS) is a condition of decreased mobility due to locomotive organ disorder. The loco-check is simple tool to detect early-stage LS. The loco-check comprises seven items relating to daily activities. Higher numbers of affirmative answers in the loco-check are negatively associated with physical functions. The purpose of this study was to examine the potential correlation between the number of affirmative answers given on the "loco-check" survey and the likelihood of experiencing at least one fall during the following one-year period. METHODS: This prospective study included 154 cases (35 men, 119 women), all aged 65 years or older, answered the loco-check at baseline. As part of their normal treatment process, the participants made monthly visits to the out-patient department; thus, at each of these visits for the following 12 months a medical doctor interviewed each patient to determine whether they had experienced a fall during the previous month. RESULTS: The mean age of the sample was 77.3 years, and the median number of affirmative answers given was 2.0. The number of affirmative answers significantly correlated with the cases which had a fall event within the follow-up period. Specifically, an increase in one "yes" answer on the loco-check increased the relative risk of fall (odds ratio: 1.32; 95% Confidence interval (CI): 1.03-1.70). In addition, the risk of fall was high in cases which showed the number of affirmative answers given on the loco-check ≥4 (odds ratio: 9.26; 95% CI: 1.05-81.7). CONCLUSION: The number of affirmative answers given on the loco-check is positively correlated with a fall event within the following year.

Regeneration of peripheral motor nerve gaps with a polyglycolic acid-collagen tube: technical case report.

OBJECTIVE: After previous success in regenerating canine peripheral nerves over 80 mm gaps using a bioabsorbable nerve guide tube, we have extended this method to the treatment of patients experiencing various types of nerve injury. This report describes the treatment of two cases of motor nerve disorder. METHODS: The bioabsorbable nerve tube was a cylindrically woven polyglycolic acid (PGA) tube filled with collagen. A peripheral motor nerve defect (the frontalis branch of the facial nerve) was reconstructed using this PGA-collagen tube in two patients who experienced posttraumatic unilateral eyebrow ptosis for 3 months. RESULTS: Five months after surgery, both patients regained their ability to voluntarily lift their eyebrows symmetrically. Electrophysiological examination at 5 months revealed recovery of compound muscle action potential and disappearance of distal latency on the affected side. CONCLUSION: This is the first clinical report of motor nerve recovery achieved using the PGA-collagen nerve guide tube. The results suggest that use of a PGA-collagen tube is a promising option for the repair of motor nerve defects.