Context of walking and loneliness among community-dwelling older adults: a cross-sectional study.

BACKGROUND: Older adults are more likely to experience loneliness than younger people. Moreover, greater loneliness in older adults is associated with poor mental health and increased risk of cardiovascular disease and mortality. Physical activity is an effective intervention for reducing loneliness among older adults. Among physical activities, walking is suitable for older adults, because it is easy and safe to incorporate into daily life. We hypothesized that the association between walking and loneliness depends on the presence of others and the number of people present. The aim of this study is to investigate the association between the context of walking (the number of walkers) and loneliness among community-dwelling older adults. METHODS: This cross-sectional study included 173 community-dwelling older adults aged 65 or older. Context of walking was classified as non-walking, walking alone (days of walking alone > days of walking with someone), and walking with someone (days of walking alone ≤ days of walking with someone). Loneliness was measured using the Japanese version of the University of California Los Angeles Loneliness Scale. A linear regression model was used to investigate the relationship between context of walking and loneliness, adjusted for age, sex, living situation, social participation, and physical activity excluding walking. RESULTS: Data from 171 community-dwelling older adults (mean age = 78.0 years, 59.6% women) were analyzed. After adjustment, walking with someone was associated with lower loneliness than non-walking (adjusted ß: -0.51, 95% confidence interval: -1.00, -0.01). CONCLUSIONS: The study's findings suggest that walking with a companion may effectively prevent or reduce loneliness among older adults.

Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults.

BACKGROUND: Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood. AIMS: The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability. METHODS: This is a prospective study. Participants were 9372 older adults (mean age 73.5 years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records. RESULTS: During the follow-up period (mean duration 23.4 months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93). CONCLUSION: The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.

Web Portals for Patients With Chronic Diseases: Scoping Review of the Functional Features and Theoretical Frameworks of Telerehabilitation Platforms.

BACKGROUND: The COVID-19 pandemic has required an increased need for rehabilitation activities applicable to patients with chronic diseases. Telerehabilitation has several advantages, including reducing clinic visits by patients vulnerable to infectious diseases. Digital platforms are often used to assist rehabilitation services for patients in remote settings. Although web portals for medical use have existed for years, the technology in telerehabilitation remains a novel method. OBJECTIVE: This scoping review investigated the functional features and theoretical approaches of web portals developed for telerehabilitation in patients with chronic diseases. METHODS: PubMed and Web of Science were reviewed to identify articles associated with telerehabilitation. Of the 477 nonduplicate articles reviewed, 35 involving 14 portals were retrieved for the scoping review. The functional features, targeted diseases, and theoretical approaches of these portals were studied. RESULTS: The 14 portals targeted patients with chronic obstructive pulmonary disease, cardiovascular, osteoarthritis, multiple sclerosis, cystic fibrosis diseases, and stroke and breast cancer survivors. Monitoring/data tracking and communication functions were the most common, followed by exercise instructions and diary/self-report features. Several theoretical approaches, behavior change techniques, and motivational techniques were found to be utilized. CONCLUSIONS: The web portals could unify and display multiple types of data and effectively provide various types of information. Asynchronous correspondence was more favorable than synchronous, real-time interactions. Data acquisition often required assistance from other digital tools. Various functions with patient-centered principles, behavior change strategies, and motivational techniques were observed for better support shifting to a healthier lifestyle. These findings suggested that web portals for telerehabilitation not only provided entrance into rehabilitation programs but also reinforced participant-centered treatment, adherence to rehabilitation, and lifestyle changes over time.

Human pancreatic cancer cells under nutrient deprivation are vulnerable to redox system inhibition.

Large regions in tumor tissues, particularly pancreatic cancer, are hypoxic and nutrient-deprived because of unregulated cell growth and insufficient vascular supply. Certain cancer cells, such as those inside a tumor, can tolerate these severe conditions and survive for prolonged periods. We hypothesized that small molecular agents, which can preferentially reduce cancer cell survival under nutrient-deprived conditions, could function as anticancer drugs. In this study, we constructed a high-throughput screening system to identify such small molecules and screened chemical libraries and microbial culture extracts. We were able to determine that some small molecular compounds, such as penicillic acid, papyracillic acid, and auranofin, exhibit preferential cytotoxicity to human pancreatic cancer cells under nutrient-deprived compared with nutrient-sufficient conditions. Further analysis revealed that these compounds target to redox systems such as GSH and thioredoxin and induce accumulation of reactive oxygen species in nutrient-deprived cancer cells, potentially contributing to apoptosis under nutrient-deprived conditions. Nutrient-deficient cancer cells are often deficient in GSH; thus, they are susceptible to redox system inhibitors. Targeting redox systems might be an attractive therapeutic strategy under nutrient-deprived conditions of the tumor microenvironment.

Effects of a wearable device and functional wear on spinal alignment and jump performance.

BACKGROUND/OBJECTIVE: To elucidate the effects of walking exercise using a wearable device and functional wear on spinal alignment and jump performance. METHODS: In total, 27 female college soccer players were randomly divided into two groups: trunk solution (TS) and compression garments (CGs). Spinal alignment, jump performance, and electromyography activity during the jump performance of the two groups were measured after a 20-min walking exercise. The values for each group were compared t pre- and post-intervention. RESULTS: The flexibility of the lower thoracic vertebrae in spinal alignment was increased during extension in the TS group. However, the post-value of the abdominal external oblique muscle during a countermovement jump (CMJ) was significantly lower than its pre-value (p < 0.05). In addition, even though spinal alignment was not affected in the CG group, post-values of the jump height during squat jump and CMJ were significantly higher than their pre-values (p < 0.05). Furthermore, the post-value of the biceps femoris during the countermovement jump with arm was significantly lower than its pre-value (p < 0.05). CONCLUSION: Our study suggested that walking exercise using TS may increase the range of motion of the lower thoracic vertebrae in athletes and reduce the muscular activity of the vastus lateralis during CMJ. Additionally, although spinal aliment is not affected, the jump height may increase using CGs.

Metacytofilin Is a Potent Therapeutic Drug Candidate for Toxoplasmosis.

BACKGROUND: Toxoplasmosis, a parasitic disease caused by Toxoplasma gondii, is an important cause of miscarriage or adverse fetal effects, including neurological and ocular manifestations in humans. Current anti-Toxoplasma drugs have limited efficacy against toxoplasmosis and also have severe side effects. Therefore, novel efficacious drugs are urgently needed. Here, we identified metacytofilin (MCF) from a fungal Metarhizium species as a potential anti-Toxoplasma compound. METHODS: Anti-Toxoplasma activities of MCF and its derivatives were evaluated in vitro and in vivo using nonpregnant and pregnant mice. To understand the mode of action of MCF, the RNA expression of host and parasite genes was investigated by RNAseq. RESULTS: In vitro, MCF inhibited the viability of intracellular and extracellular T. gondii. Administering MCF intraperitoneally or orally to mice after infection with T. gondii tachyzoites increased mouse survival compared with the untreated animals. Remarkably, oral administration of MCF to pregnant mice prevented vertical transmission of the parasite. Interestingly, RNA sequencing of T. gondii-infected cells treated with MCF showed that MCF inhibited DNA replication and enhanced RNA degradation in the parasites. CONCLUSIONS: With its potent anti-T. gondii activity, MCF is a strong candidate for future drug development against toxoplasmosis.

Collaborative Study to Validate Purity Determination by 1H Quantitative NMR Spectroscopy by Using Internal Calibration Methodology.

NMR spectroscopy has recently been utilized to determine the absolute amounts of organic molecules with metrological traceability since signal intensity is directly proportional to the number of each nucleus in a molecule. The NMR methodology that uses hydrogen nucleus (1H) to quantify chemicals is called quantitative 1H-NMR (1H qNMR). The quantitative method using 1H qNMR for determining the purity or content of chemicals has been adopted into some compendial guidelines and official standards. However, there are still few reports in the literature regarding validation of 1H qNMR methodology. Here, we coordinated an international collaborative study to validate a 1H qNMR based on the use of an internal calibration methodology. Thirteen laboratories participated in this study, and the purities of three samples were individually measured using 1H qNMR method. The three samples were all certified via conventional primary methods of measurement, such as butyl p-hydroxybenzoate Japanese Pharmacopeia (JP) reference standard certified by mass balance; benzoic acid certified reference material (CRM) certified by coulometric titration; fludioxonil CRM certified by a combination of freezing point depression method and 1H qNMR. For each sample, 1H qNMR experiments were optimized before quantitative analysis. The results showed that the measured values of each sample were equivalent to the corresponding reference labeled value. Furthermore, assessment of these 1H qNMR data using the normalized error, En-value, concluded that statistically 1H qNMR has the competence to obtain the same quantification performance and accuracy as the conventional primary methods of measurement.

Leucinostatin Y: A Peptaibiotic Produced by the Entomoparasitic Fungus Purpureocillium lilacinum 40-H-28.

Leucinostatin Y, a new peptaibiotic, was isolated from the culture broth of the entomoparasitic fungus Purpureocillium lilacinum 40-H-28. The planar structure was elucidated by detailed analysis of its NMR and MS/MS data. The absolute configurations of the amino acids were partially determined by an advanced Marfey's method. The biological activities of leucinostatin Y were assessed using human pancreatic cancer cells, revealing the importance of the C-terminus of leucinostatins for preferential cytotoxicity to cancer cells under glucose-deprived conditions and inhibition of mitochondrial function.

Association Between Objectively Measured Physical Activity and the Number of Chronic Musculoskeletal Pain Sites in Community-Dwelling Older Adults.

OBJECTIVE: Physical inactivity is recognized as a pandemic health problem. The association of pain with physical activity, particularly when measured objectively, in older adults is unclear. This study investigates the association of number of chronic musculoskeletal pain sites and pain severity with objectively measured physical activity in community-dwelling older adults. DESIGN: Observational study. SETTING: Community. SUBJECTS: We analyzed 267 community-dwelling older adults (mean age = 75.3 years, 67.0% women). METHODS: Number of chronic musculoskeletal pain sites and pain severity were measured using a self-reported questionnaire. Mean steps per day and mean minutes of light physical activity per day and moderate to vigorous physical activity per day were measured using an accelerometer. Linear regression models were applied to analyze the association of number of chronic musculoskeletal pain sites and pain severity with physical activity. RESULTS: The results suggest that a higher number of chronic musculoskeletal pain sites is associated with lower step count (beta = -333.5, 95% confidence interval = -655.9 to -11.0, P < 0.05) and moderate to vigorous physical activity (beta = -2.5, 95% confidence interval = -4.7 to -0.4, P < 0.05) even after adjustment for age, gender, years of schooling, obesity, alcohol habits, smoking status, number of comorbidities, recent surgery, and depressive symptoms. CONCLUSIONS: Our results suggest that the number of chronic musculoskeletal pain sites is associated with low physical activity in older adults. Therefore, low physical activity due to chronic musculoskeletal pain should not be overlooked.

Development and validation of Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score) derived from acceleration and angular velocity data at heel and lower trunk among community-dwelling older adults.

BACKGROUND: Although some gait parameters from inertial sensors have been shown to be associated with important clinical issues, because of controversial results, it remains uncertain which parameters for which axes are clinically valuable. Following the idea that a comprehensive score obtained by summing various gait parameters would sensitively reflect declines in gait performance, we developed a scoring method for community-dwelling older adults, the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score). The aim of this study was to examine the internal consistency and the construct validity of this method. METHODS: In this cross-sectional study, the gait performance of 378 community-dwelling older people (mean age = 71.7 ± 4.2 years, 210 women) was assessed using inertial sensors attached to the heel and lower trunk. Participants walked along a 15-m walkway, and accelerations, angular velocity, and walking time were measured. From these data, walking speed, mean stride time, coefficients of variation of stride time and swing time, and autocorrelation coefficients and harmonic ratios of acceleration in vertical, mediolateral, and anteroposterior directions at the lower trunk were calculated. Scoring was performed based on quartile by gender (i.e., scored from 0 to 3) for each of the 10 gait parameters. The C-GAITS score was the sum of these scores (range: 0-30). Lower extremity strength, balance function, fall history, and fear of falling were also assessed. RESULTS: An exploratory factor analysis revealed that the C-GAITS score yielded four distinct factors explaining 57.1% of the variance. The Cronbach's alpha coefficient was 0.77. A single linear regression analysis showed a significant relationship between total C-GAITS score and walking speed (adjusted R2 = 0.28). Results from bivariate comparisons using unpaired t-tests showed that the score was significantly related to age (p = 0.002), lower extremity strength (p = 0.007), balance function (p <  0.001), fall history (p = 0.04), and fear of falling (p <  0.001). CONCLUSIONS: Good internal consistency and appropriate construct validity of the C-GAITS score were confirmed among community-dwelling older adults. The score might be useful in clinical settings because of ease of use and interpretation and capability of capturing functional decline.

Boronic-Acid-Catalyzed Regioselective and 1,2- cis-Stereoselective Glycosylation of Unprotected Sugar Acceptors via SNi-Type Mechanism.

Regio- and 1,2- cis-stereoselective chemical glycosylation of unprotected glycosyl acceptors has been in great demand for the efficient synthesis of natural glycosides. However, simultaneously regulating these selectivities has been a longstanding problem in synthetic organic chemistry. In nature, glycosyl transferases catalyze regioselective 1,2- cis-glycosylations via the SNi mechanism, yet no useful chemical glycosylations based on this mechanism have been developed. In this paper, we report a highly regio- and 1,2- cis-stereoselective SNi-type glycosylation of 1,2-anhydro donors and unprotected sugar acceptors using p-nitrophenylboronic acid (10e) as a catalyst in the presence of water under mild conditions. Highly controlled regio- and 1,2- cis-stereoselectivities were achieved via the combination of boron-mediated carbohydrate recognition and the SNi-type mechanism. Mechanistic studies using the KIEs and DFT calculations were consistent with a highly dissociative concerted SNi mechanism. This glycosylation method was applied successfully to the direct glycosylation of unprotected natural glycosides and the efficient synthesis of a complex oligosaccharide with minimal protecting groups.

Stereospecific ß-l-Rhamnopyranosylation through an SN i-Type Mechanism by Using Organoboron Reagents.

Stereospecific ß-l-rhamnopyranosylations were conducted using a 1,2-anhydro-l-rhamnopyranose donor and mono-ol or diol acceptors in the presence of a glycosyl-acceptor-derived borinic or boronic ester. Reactions proceeded smoothly to provide the corresponding ß-l-rhamnopyranosides (ß-l-Rhap) with complete stereoselectivity in moderate to high yields without any further additives under mild conditions. Mechanistic studies of the borinic ester mediated glycosylation using 13 C kinetic isotope effect (KIE) measurements and DFT calculations were consistent with a concerted SN i mechanism with an exploded transition state. In addition, the present glycosylation method was applied successfully to the synthesis of a trisaccharide, α-l-Rhap-(1,2)-ß-l-Rhap-(1,4)-Glcp, derived from Streptococcus pneumoniae serotypes 7B, 7C, and 7D.

The relative and absolute reliability of maximum phonation time in community-dwelling Japanese people.

BACKGROUND AND AIMS: The aim of the present study was to examine the approximate value of maximum phonation time in community-dwelling Japanese people and to set the range of error after ascertaining relative and absolute reliability. METHODS: Participants in the present study were adults living in Kobe and Himeji City, Hyogo Prefecture, Japan. Participants were seated in the upright sitting position and were asked to produce an /a/ sound at their normal speaking volume for as long as they possibly could. The examiner measured the time until the sound became inaudible. Two trials were performed. RESULTS: The subjects in the final analysis comprised 380 adults (246 women, 134 men; age, 72.7 ± 5.9 years). The values of trial 1 and trial 2 were analyzed with intraclass correlation coefficient (ICC(1,1)), and Bland-Altman plot. Average values of the women, men, and both sexes combined were 16.1, 18.7, and 17.0 s, respectively. Average values of age groups 60-69, 70-79, and 80-89 years were 17.9, 16.8, and 15.9 s, respectively. The ICC(1,1) was 0.87 (P < 0.001). Both fixed bias and proportional bias existed. Limits of agreement (LOA) were -5.0 to 7.7 and % change ranged from -27.1 to 41.8 %. CONCLUSIONS: These normative data indicated that sufficiently reliable values could be measured in two trials. LOA showed that the second value tended to be higher. In determining the effect of treatment, one must consider that the value will be slightly higher at re-test.

The association between fear of falling and smoothness of lower trunk oscillation in gait varies according to gait speed in community-dwelling older adults.

BACKGROUND: Fear of falling (FoF) is common in community-dwelling older adults. FoF and increased walking speed are associated with lower trunk oscillation during gait in older adults. We hypothesized that older adults with FoF would struggle to walk safely when instructed to walk faster than usual. METHODS: Participants included 260 community-dwelling older adults aged over 65 years (mean age = 71.9 ± 3.9 years) who were able to walk independently without an assistive device. Participants were instructed to walk along a 15-m smooth horizontal walkway at self-selected normal and fast gait speeds. During the middle 10 m of the walk, oscillation of the lower trunk and stride times were measured with two accelerometers. We examined associations between gait variables, including harmonic ratio (HR) in vertical, mediolateral (HR-ML) and anteroposterior (HR-AP) directions as indicators of smoothness of lower trunk oscillation, as well as stride time variability (STV) and FoF. RESULTS: Gait-speed- and STV- adjusted models showed that FoF was significantly associated with HR-ML in the normal-gait condition (HR-ML: ß = - .135, p = .040), while FoF was significantly associated with HR-AP in the fast-gait condition (HR-AP: ß = - .154, p = .017). CONCLUSIONS: FoF-related changes in gait vary with gait speed. In older adults with FoF, lower trunk oscillation was less smooth in the lateral direction when they walked at their usual pace. In addition, lower trunk oscillation was also less smooth in the direction of travel when they walked at a faster pace than their usual walking speed.

Cycling Wheelchair Provides Enjoyable Pedaling Exercises with Increased Physiological Indexes.

The cycling wheelchair (CWC) can be used as a pedaling exercise machine. However, physiological indexes in the CWC at various pedaling rates and the difference between the CWC and the existing pedaling machines such as the portable ergometer (ERG) are unclear. The aim of this study was to measure physiological indexes in the CWC at various pedaling rates and compare the CWC to the ERG, focusing on psychological stress. The present non-randomized crossover study included ten healthy men (22.3 ± 1.2 years) who performed pedaling exercise with the CWC and the ERG. Both experiments were composed of three pedaling exercise sessions (40, 60, and 80 rpm). Physiological indexes, consisting of oxygen consumption, heart rate, perceived breathlessness and leg fatigue, and salivary amylase activity (SAA), an index of psychological stress, were measured. The metabolic equivalent (METs) and the rate of change in SAA from rest to immediately after each pedaling session (ΔSAA) were calculated. In the CWC, all physiological indexes significantly increased with pedaling rates. The METs were 2.2 ± 0.3, 2.7 ± 0.4, and 3.5 ± 0.4 at 40, 60, and 80 rpm, respectively. In comparison between the CWC and the ERG, ΔSAA was lower in the CWC than in the ERG at 60 and 80 rpm. Our results indicate that the CWC pedaling can provide low or moderate intensity exercises with adjusting pedaling rates and is less stressful than the ERG. Thus, the CWC is a useful pedaling machine to promote regular and enjoyable exercises.

Asteltoxins from the Entomopathogenic Fungus Pochonia bulbillosa 8-H-28.

New asteltoxins C (3) and D (4) were found in the extract of the entomopathogenic fungus Pochonia bulbillosa 8-H-28. Compound 2, which was spectroscopically identical with the known asteltoxin B, was isolated, and structural analysis led to a revision of the structure of asteltoxin B. Compounds 2 and 4 have a novel tricyclic ring system connected to a dienyl α-pyrone structure. Compound 3 has a 2,8-dioxabicyclo[3.3.0]octane ring similar to that of asteltoxin (1). Compound 3 showed potent antiproliferative activity against NIAS-SL64 cells derived from the fat body of Spodoptera litura larvae, while 2 and 4 were inactive.

Quinofuracins A-E, produced by the fungus Staphylotrichum boninense PF1444, show p53-dependent growth suppression.

Quinofuracins A-E, novel anthraquinone derivatives containing ß-D-galactofuranose that were isolated from the fungus Staphylotrichum boninense PF1444, induced p53-dependent cell death in human tumor cells. The structures of quinofuracins A-E, including absolute configurations, were elucidated by extensive spectroscopic analysis and chemical transformation studies. Quinofuracins were classified into three groups according to the aglycone moieties. 5'-Oxoaverantin was present in quinofuracins A-C, whereas averantin and versicolorin B were identified in quinofuracins D and E, respectively. These quinofuracins induced p53-dependent growth suppression in human glioblastoma LNZTA3 cells.

Multi-chronic musculoskeletal pain is a useful clinical index to predict the risk of falls in older adults with normal motor function.

BACKGROUND: The number of chronic musculoskeletal pain sites (nCMSP) is reportedly associated with risk of falls. Older participants in community-based research show a wide range of physical functions, but few studies have focused on the risk of falls in older adults with normal motor function (NMF). Clarification of the effects of pain on dual-tasking performance is also important, given the strong link between falls and dual-tasking. AIMS: The objectives were to investigate the associations between: (1) nCMSP and falls; and (2) nCMSP and dual-task performance in older adults with NMF. METHODS: A total of 112 older adults with NMF (44 men, 68 women; 73.4 ± 4.6 years) were classified as fallers (n = 22) or non-fallers (n = 90) according to their fall history. Musculoskeletal pain in the lower body was assessed using questions ascertaining pain in musculoskeletal sites (back, hip, knee, foot, or toe). Participants were assigned to three pain groups according to nCMSP. Basic physical performances and gait performances (normal gait, fast gait, or dual-task gait) were measured. RESULTS: The nCMSP represented a significant risk factor for falls according to logistic regression modeling after adjusting for the five chair stand test and fear of falls. The nCMSP was not associated with any gait variables. DISCUSSION: Potential fall risk may be increased by nCMSP, even in older adults with NMF. Pain-related reduction in attention resources may not represent a risk factor for falls among older adults with NMF. CONCLUSIONS: The nCMSP represents a potential risk factor for falls in older adults with NMF.

An unusual terpene cyclization mechanism involving a carbon-carbon bond rearrangement.

Terpene cyclization reactions are fascinating owing to the precise control of connectivity and stereochemistry during the catalytic process. Cyclooctat-9-en-7-ol synthase (CotB2) synthesizes an unusual 5-8-5 fused-ring structure with six chiral centers from the universal diterpene precursor, the achiral C20 geranylgeranyl diphosphate substrate. An unusual new mechanism for the exquisite CotB2-catalyzed cyclization that involves a carbon-carbon backbone rearrangement and three long-range hydride shifts is proposed, based on a powerful combination of in vivo studies using uniformly (13)C-labeled glucose and in vitro reactions of regiospecifically deuterium-substituted geranylgeranyl diphosphate substrates. This study shows that CotB2 elegantly demonstrates the synthetic virtuosity and stereochemical control that evolution has conferred on terpene synthases.

Association between toe flexor strength and spatiotemporal gait parameters in community-dwelling older people.

BACKGROUND: The toe flexor muscles perform a crucial function to control foot movement and assist with propulsive force when walking. However, the association between toe flexor strength and spatio-temporal gait parameters is largely unknown. Spatiotemporal gait parameters represent gait characteristics, and are good measures of the functional status and degree of safe ambulation among community-dwelling older adults. Herein, we examined the association between the toe flexor strength and spatiotemporal gait parameters in community-dwelling older adults. METHODS: Ninety-three community-dwelling older people (mean age: 73.2 ± 4.2 years, 53 women) participated in this study. The strength of the toe flexor muscles was assessed using a toe strength measuring instrument and a strain gauge. The measurements were performed once on each foot, and the average of the right and left was used in the analysis. Gait analysis was performed on a 15-m walkway under usual- and fast-pace conditions. The medial 10-m walking time was measured and walking speed was calculated. Acceleration and angular velocity of the right heel were measured using a wireless miniature sensor unit and used to compute cadence, percent of swing time in gait cycle (%swing time), and stride length. RESULTS: In multiple regression analyses adjusted for age, sex, body height, body weight, and hand grip strength, no associations between toe flexor strength and spatiotemporal gait parameters at usual pace were found. Conversely, under the fast-pace condition, decreased toe flexor strength was significantly associated with slower walking speed (ß = 0.22, p = 0.049), lower%swing time (ß = 0.34, p = 0.009), and shorter stride length (ß = 0.22, p = 0.011) after adjustment. CONCLUSION: In community-dwelling older people, decreased strength of toe flexor was correlated with slower walking speed, shorter periods of single-limb support phase, and shorter stride length during fast-pace walking. These data provide further support for an important role of toe flexor muscles in walking.