[Purpose] The objective of this study was to examine the differences in personality traits based on the presence of depression in chronic obstructive pulmonary disease (COPD) patients. [Subjects and Methods] The current study involved 39 subjects with COPD. Personality traits of subjects were compared with the presence of depression and effectors of depression, including personality traits, were reviewed. [Results] Fourteen subjects (35.9% of the total) were classified as having depression (Center for Epidemiologic Studies Depression Scale (CES-D)≥16). Subjects who exhibited depression also displayed differences in items of the Yatabe-Guilford personality inventory and demonstrated high values for all St. George's Hospital Respiratory Questionnaire (SGRQ) items. Additionally these personality traits and SGRQ items were partially correlated with CES-D score. Effectors for CES-D were "Nervousness" "Sense of cooperation", and "Symptoms" of SGRQ. [Conclusion] Subjects who exhibited depression displayed traits such as a sense of inferiority, nervousness, lack of cooperation, inactivity, thinking introversion, excessive punctuality and unsociability. Therefore, in COPD patients, consideration of personality traits can be linked to early detection and appropriate treatment of depression via methods such as group cognitive behavioral therapy in respiratory rehabilitation.

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[Purpose] We made rehabilitation diagnosis and treatment records available on a Local Area Network (LAN) in a hospital and investigated their use by nurses. [Subjects and Methods] Questionnaires were distributed to 92 nurses in the department of orthopedics, cardiovascular surgery, neurosurgery, and nerve medicine. [Results] The numbers of returned questionnaires was 66, a response rate of 71.7%. Fifty nurses knew about the page of the rehabilitation department on the LAN, and 16 did not. It had been viewed by 29 nurses. Twenty-one had used it to view records of rehabilitation nursing, and 19 for records of physiotherapy. The reason for utilizing a service which automatically output records of the day before was to collect and communicate patient information. [Conclusion] A lot of nurses utilized the service which automatically outputs the rehabilitation records of the day before.

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[Purpose] The aim of this study was to evaluate the stress behavior of infants with preventricular leukomalacia (PVL) using direct behavioral observation. [Subjects] The participants were 15 infants with and 73 infants without PVL. [Methods] This research examined infants' stress behaviors in response to handling during a Brazelton Neonatal Behavioral Assessment Scale (NBAS) exam. Observation of the stress behaviors was recorded at the bedside. Infants' behaviors were simultaneously videotaped. The assessment was performed at the postconceptional age of 38-40 weeks (term). [Results] The with-PVL group showed significantly higher frequency of stress behaviors in the autonomic (pale/cyanotic, tremor, startle, twitch), motor (arm flexion, legs extension, jerky movements, finger splay, arching, salute, hand clasp, foot clasp, holding on, flaccidity, grimacing) and state-orientation (fuss, panicked or worried alertness, gaze aversion, high pitched cry) subsystems compared with the without-PVL group. [Conclusion] Behavioral observations may help clinicians assess preterm infant neurological status and provide useful information for facilitating the development and adaptability of infants' behavioral organization.

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[Purpose] The aim of the current study was to investigate whether or not motor sequential learning leads a reduction in the temporal processing in terms of the onset of muscle activation and movement initiation as well as final motor response in a serial reaction time (SRT) task. [Subjects] We recruited 24 healthy subjects with no history of neurological or orthopedic problems. The subjects were randomly divided into a training group and a control group. [Methods] In response to five visual stimuli, subjects were instructed to move or press a moveable arm/button, and to return it toward the central position as quickly as possible, according to the corresponding stimuli. Kinetic parameters (i.e. onset of muscle activation and movement initiation, reaction time) were analyzed before and after training/controlled sessions over two consecutive days for each group. [Results] Following motor sequential learning, the temporal processing between the visual stimuli and each of three predetermined onsets were significantly declined. There were no significant changes in the control group. [Conclusion] The reduction in the total process to final motor response resulting from motor sequential learning may be attributed to rapid onset of muscle activation and movement initiation. Furthermore, neuromuscular adaptation played an important role in accomplishing rapid temporal processing after motor sequential learning.

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[Purpose] To quantitatively investigate whether the muscle grades of the Curl-up (CU) and Double-leg-lowering (DLL) test show any electromyographic changes in the upper and lower rectus abdominis (RA) as trunk flexors. [Methods] The muscle activities of both the upper and lower RA in thirty healthy young males were recorded during each muscle grade task of two tests. The percentages of maximum voluntary contractions (%MVC) of the upper and lower RA were compared between each muscle grade and test. The %MVC ratios of the upper and lower RA were calculated to investigate the contribution of each muscle site in two tests. [Results] Although there were significant electromyographic differences among muscle grades in the CU test, there was no significant difference in the DLL test. The %MVC from both sites in the CU test were significantly larger in all muscle grades than in the DLL test. However, the %MVC ratio was consistently ~1.0 in both tests and the contribution of each muscle site did not differ. [Conclusion] These findings suggest that the three grading tasks used in this manual muscle testing procedure may be insufficient to objectively detect muscle weakness in the trunk flexors. The grading criterion for trunk flexors may need remediation.

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[Purpose] In the present study, we analyzed the validity of several methods that are frequently used to assess the foot morphology in the clinical setting. [Subjects] The subjects were 45 healthy subjects and 30 stroke patients. [Methods] The foot volumes of subjects were measured. The relationships between the girth measures and the foot volume were investigated in healthy subjects. The girths were measured using traditional methods on 3 parts of the foot utilizing the figure-of-eight method (FOE). We also evaluated the method of girth measurements for detecting asymmetry of the foot volume in stroke patients. We investigated whether screening tests for edema and atrophy can be applied to the measurement of foot volume. [Results] The correlation between the girths and foot volume was high. This finding suggests that girths may be used as a parameter to estimate the volume of the foot. In stroke patients, when comparing the girth measurements and foot volume differences between hemiplegic limbs and non-hemiplegic limbs, there were significant correlations in FOE difference and S difference. The screening test for edema was found to be applicable, however the screening test for atrophy was not reliable in this study. [Conclusion] These results suggest that girth measurement is insufficient for accurately determining the foot volume and that a combination of the different evaluation methods may be required to properly assess the foot volume.

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[Purpose] The purpose of this study was to investigate the plantar foot pressure distribution of stroke patients while crossing obstacles of different heights. [Subjects] Eight subjects (right hemiplegia) participated in this study. [Methods] Plantar foot pressure was recoded by a RS-scan system (RS scan Ltd., German). One-way ANOVA was used to compare foot data of the various heights. [Results] The peak plantar pressure values of the paretic lower limb during the stance phase showed significant differences among the T1, M1, M2, M3 and M4 regions. However, the peak plantar pressure values of the non-paretic lower limb showed significant differences only in the T1, MF, HM and HL regions. [Conclusion] This study found that when stroke patients attempted to cross an obstacle, crossing the obstacle with the non-paretic lower limb while supporting the body with the paretic lower limb was a more stable and efficient obstacle crossing strategy.

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[Purpose] We attempted to demonstrate the changes in cortical activation with motor recovery in hemiparetic patients who showed mild weakness at onset and excellent recovery, using functional MRI (fMRI). [Methods] Six patients (mean age 49.83 ± 8.75) with corona radiata infarct were recruited for this study. The motricity index for the upper extremity, the Medical Research Council classification for finger extensors, and the modified Brunnstrom classification were used to determine the motor function of the affected upper limb. fMRI was performed twice, after onset and after recovery, at 1.5 T in parallel with hand grasp-release movements at a fixed rate. The laterality index was calculated from the fMRI to assess fMRI the relative activity of the ipsilateral versus the contralateral primary sensorimotor cortex. [Results] There were significant improvements in motor function tests and the laterality index between the first and second fMRI. However, the interval changes of motor function tests were not significantly correlated with those of the laterality index of the affected hemisphere. [Conclusion] The patients who showed mild weakness at onset and excellent recovery had cortical activation that changed towards contralateral motor cortex activation from bilateral motor cortex activation during the recovery phase. This finding has important clinical implications with regard to the motor recovery mechanism and the scientific rehabilitation of stroke patients.

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[Purpose] The purpose of the present study was to analyze the effect of backpack heaviness on trunk-lower limb kinematics at the start of gait. [Subjects] Ten university male students (age=20.3 ± 0.98 years, height=1.69 ± 0.04 m, weight=59.5 ± 5.3 kg) participated in the present study. [Methods] Each subject was asked to stand erect then walk forward in a straight line in four modes: unloaded, and with loads of 10%, 15%, and 20% body weight (BW). A VICON 250 motion analysis system was utilized to study changes in the trunk and lower limb kinematics at the start of gait. [Results] The results show significant trunk backward lean changes between the unloaded mode and loaded modes even with no changes in the center of mass (COM), velocity or displacement. [Conclusion] A 20%BW backpack caused the highest trunk kinematic changes, so backpack weight should be limited to 15%BW. It is also important to be aware of other factors correlated to backpack usage to provide better usage recommendations.

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[Purpose] In the present study, gait analysis was conducted using a compact accelerometer for analyzing the peak acceleration value of the lower extremity during walking by juvenile patients suffering from chronic sports knee injury to the knee extensor mechanism, through lower extremity malalignment and other causes. [Subjects] The painful knees group included 13 subjects with 13 lower extremities, while the control group included 12 subjects with 12 lower extremities and normal healthy lumbar regions and lower extremity. [Methods] We mounted a tri-axial accelerometer on the lateral malleolus ankle joint and the head of the fibula. The peak acceleration values of the forward and backward components, perpendicular component and mediolateral component during the stance phase were analyzed from acceleration waveforms. [Results] Backward-peak and revised medial-peak of the sensor mounted on the head of the fibula and lateral-peak of the sensor mounted on the lateral malleolus ankle joint were significantly large in the painful knees group as compared to the control group. [Conclusion] Significant increase in peak acceleration as observed in the painful knees group shows that strong stress is generated in the forward-backward and mediolateral directions in knee joints. This is in agreement with the condition of dynamic malalignment such as varus-valgus movements of knee joints, which are considered to be the causes of knee extensor mechanism disorders.

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[Purpose] The purpose of this study was to investigate the effects of upper body muscle strength training on anthropometric measurements and cardiopulmonary function in healthy obese women. [Subjects] Sixty-three obese women (age: 37.96 ± 2.25 years, height: 158.99 ± 5.76 cm, body weight: 83.65 ± 11.24 kg, body mass index: 33.11 ± 4.31 kg/m²) volunteered to participate in this study. [Methods] The participants were divided into 3 groups. The aerobic (A) group performed diet plus aerobic exercise on a bicycle ergometer for 45-60 min, 3 times a week for 8 weeks, while the aerobic-strength (AS) group performed strength training with the barbell and their body weight plus diet and aerobic exercise. C group was the control. The spirometer test, gas analysis and anthropometric measurements were performed for all three groups before and after training. SPSS 11.0 statistical software was used to perform all the analysis. Comparisons were made using one-way ANOVA. [Results] The present findings show that, there were significant differences between pre- and post-training measures of anthropometric parameters and cardiopulmonary function in the study groups. After 8 wk of training, forced vital capacity (FVC) and maximum voluntary ventilation (MVV) of the AS group showed a significant increase (16.19% and 13.77%). Furthermore, VO₂ max parameters of the A and AS groups showed a significant increase (8.48-6.15%). [Conclusions] Diet and aerobic training in obese women significantly improved their morphological structure and aerobic capacity. However, diet plus aerobic and strength training significantly increased muscle strength of the upper body and accessory respiratory muscles. Therefore pulmonary functions parameters such as FVC and MVV values increased.

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[Purpose] The purpose of this study was to investigate the relationship between the muscular strength of the lower extremity and the trunk acceleration during a backward stepping reaction performed by the elderly. [Subjects] The study population comprised 11 elderly subjects (average age, 75.5 ± 6.9 years). [Methods] Using a separation-type force plate and a small tri-axial accelerometer, we measured the vertical reaction force and the acceleration at the seventh cervical (C7) and the second sacral (S2) vertebrae in backward stepping reaction. Furthermore, we measured the muscular strength of the lower extremity using a hand-held dynamometer, and examined the relationship between the acceleration value of C7 and S2 and the muscular strength. [Results] Correlation analysis revealed that the acceleration values of C7 and S2 showed significant positive correlations with the muscular strengths of the hamstrings, tibialis anterior, and triceps surae. [Conclusion] These results suggest that the muscles controlling the dorsi/plantar flexion of the ankle and pelvic stability contribute to acceleration of the trunk in the backward stepping reaction.

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[Purpose] The purpose of this study was to identify which manual therapy technique was effective against muscle tenderness and stiffness of myofascial pain syndrome and then, based on the result, to determine the cause of myofascial pain syndrome. [Subjects] The subjects were 23 men and 67 women who had an average age of 65.5 ± 19.0 years. All subjects had normal results in imaging and neurological examinations but complained of chronic pain along with muscle tenderness and stiffness. [Methods] Using a muscle hardness meter, the muscle hardness of the tender, stiff muscles was measured before, immediately after, and 1 week after manual therapy. The subjects were divided into two groups according to the therapy given myotherapy/massage, to provide direct stimulus to the muscle, or joint facilitation/joint mobilization, to improve functional joint disorders. Statistical analysis was conducted using repeated measures ANOVA, and multiple comparisons were performed. [Results] A significant difference in muscle hardness was seen between pre-treatment and post-treatment. A significant difference in muscle hardness was seen between before and 1 week after manual therapy, but not between post-treatment and 1 week after. A significant difference was seen between the direct stimulus to muscle technique and the functional joint disorder technique. Post-treatment muscle hardness decreased more with direct muscle stimulus than with the functional joint disorder technique, and muscle stiffness was decreased even 1 week after treatment. [Conclusion] Manual therapy for muscle tenderness and stiffness of myofascial pain syndrome was effective at reducing muscle stiffness. Moreover, techniques that provide direct stimulus to the muscle are better at reducing voluntary muscle stiffness than techniques that improve functional joint disorders.

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[Purpose] We tested the efficacy of an intervention training acute stroke patients to walk backwards on a treadmill. Subjects were randomly allocated to three groups of Partial Body Weight Support treadmill backward walking group, Partial Body Weight Support treadmill forward walking group and Control in order to compare the efficacy of the interventions among the groups. [Subjects] The subjects were 36 acute stroke patients. [Methods] They were randomly allocated to the three groups using an envelope method. After 3 weeks of intervention. We investigated by multiple comparisons among the three groups using change scores for each of the outcome measures. [Results] The Berg Balance Scale showed no significant differences. The Rivermead Mobility Index showed a significant difference between the backward walking group and the forward walking group, and between the backward walking group and the Control. Walking speed was significantly different between the backward walking group and the Control. No differences were seen for other itemes. [Conclusions] As a result of 3-week intervention, a significant improvement was observed in walking speed and the Rivermead Mobility Index, suggesting that Partial Body Weight Support treadmill backward walking training for patients in the early phase of acute stroke is effective at improving mobility.

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[Purpose] Many studies have implicated the nerves connecting the basal ganglia to the supplementary motor area (SMA) in response to visual stimuli, but there have been few reports on the involvement of other areas of the brain. [Subjects] The subjects were 10 right-handed healthy adults (8 men, 2 women; mean age, 29.7, range: 22-47yrs) with no significant medical history or current medical problems. [Methods] We compared neural activities in the brain by functional MRI (fMRI), during a hand grasping task performed in response to periodic and aperiodic visual stimuli. [Results] Activity was significantly more extensive during performance of the aperiodic task. [Conclusion] We conclude that movement induced by unpredictable stimuli causes increased activity in the premotor cortex. Increased attention demanded by the unpredictable nature of the stimuli caused increased activation in the SMA, prefrontal cortex and cerebellum. Rehabilitation exercises paying attention to unpredictable visual stimuli may significantly influence and increase activity in the brain.

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[Purpose] The aim of this study was to determine the functional level of activity and postural control after rehabilitation of anterior cruciate ligament reconstructed knees and compare them with non-operated limbs and healthy limbs in control subjects. [Subjects] Twenty-seven patients participated in the study: 17 had undergone reconstruction with a bone-patellar tendon-bone and 10 with a semitendinosus graft technique. The same rehabilitation protocol was used for all of the patients. Besides the patients, 18 healthy volunteers participated as a control group. [Methods] Both groups were tested for one-leg standing (eyes open and closed), static (eyes open and closed) and dynamic postural control on The Kinesthetic Ability Trainer-KAT 2000 (OWM Medical, Carlsbad, California, USA) at the 3, 6 and 12 month post-operation. Functional outcomes of the rehabilitation were evaluated by Lysholm scoring. [Results] There were no significant differences for the eyes open static stabilometry test between operated and non-operated limbs of the patients. On the other hand, there were statistically significant differences for the closed eyes static balance test between the operated and non-operated limbs at 3 and 6 months after surgery. There were significant differences for the eyes open static balance test between the 3rd and 6th, and 6th and 12th months and for the eyes closed test of non-operated limbs between the same months as well. No statistically significant differences were noted in the dynamic balance tests between the patients and the control group. Lysholm scores of the patients obtained at 6 and 12th months after surgery were significantly better than those at 3 months after surgery. Different operation techniques revealed no significant differences in any test performed at any time. [Conclusions] Performing a postoperative sportive rehabilitation including specific proprioceptive training sessions has positive effects both on clinical status and postural control of the patients.

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[Purpose] This study examined the activities of the rectus abdominis (RA), external abdominal oblique (EO), transversus abdominis and internal abdominal oblique (TrA/IO) while abdominal hollowing (AH) was performed in four different positions (crook lying, prone lying, four-point kneeling, wall support standing). [Subjects] Experiments were conducted on 36 healthy male adults (mean age=24.44 years) who voluntarily agreed to participate in the experiments. [Methods] Each subject was instructed regarding maximal voluntary contractions (MVC) and AH. While the MVC and AH of individual muscles were being performed, the activity of the muscles was measured using surface electromyography (EMG). The activity of the muscles while performing AH was normalized to percentages of MVC. [Results] TrA/IO showed significant differences among the positions and showed the highest muscle activity for prone lying. [Conclusion] The contraction of the TrA/IO was shown to be the highest muscle activity in prone lying. Therefore, we consider that various kinds of technique can eliminate EO activity during performing AH in prone lying.

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[Purpose] This research was carried out to evaluate the effects of Manual Breathing Assist Technique (MBAT) and shaking on the ventilation of central nervous system (CNS) disease patients. [Subjects and Methods] The subjects were thirteen healthy individuals (normal group) and twenty-one CNS diseases sufferers without upper airway obstruction (subject group). We evaluates of Tidal Volume (TV), Peak Expiratory Flow Rate (PEFR) and Expiratory Time (Te) under rest respiration, MBAT, and shaking conditions. Administration of MBAT and shaking was performed by a single physiotherapist. [Results] Two-way factorial analysis of variance showed a significant interaction effect for TV between the subject group and the normal group, while PEFR showed no significant interaction. TV of the normal group was increased about 65% by MBAT and about 110% by shaking, compared to TV under rest respiration. While TV of the subject group was increased about 10% by MBAT, no increase was observed under the condition of shaking. [Conclusion] Significant differences in TV and Te were observed between the subject group and normal group in terms of the effects of MBAT as well as shaking. Both MBAT and shaking were effective methods for increasing PEFR.

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[Purpose] The aim of the present study was to determine whether the expression of mitogen-activated protein kinase (MAPK) isoforms is related to cast-immobilization-induced atrophy in rat skeletal muscles. [Subjects] The subjects were 24 male Sprague-Dawley rats aged 7 weeks old. [Methods] The rats were randomly divided into a control group (n=4) and four experimental groups (n=20). The experimental groups were submitted to 3, 7, 14, or 21 days of cast-immobilization to provoke disuse atrophy. [Results] The weights and cross-sectional areas of the cast-immobilized muscles were significantly lower than those of the non-immobilized controls. The PKB/Akt and ERK1/2 phosphorylation in atrophied muscles was significantly lower than those in the non-immobilized controls. However, cast immobilization increased the phosphorylation of p38 MAPK and SAPK/JNK. [Conclusion] These results suggest that cast immobilization-induced atrophy may be mediated by the activation of the ERK1/2, p38 MAPK, and SAPK/JNK pathways, and that the MAPK isoforms are differently regulated by the PKB/Akt pathway during atrophy in the gastrocnemius muscle.

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[Purpose] The purpose of this study was to investigate the durability of the effect on the dynamic control structure after performance of the Approximation technique (ApT) administered to the lower extremity. Body sway was measured on a stabilometer under two conditions: one without a stimulus, and the other with a disturbance stimulus. [Subjects] The subjects were 38 healthy males, 19 to 27 years of age. [Methods] Participants in the experimental group stood on two scales, and we performed ApT from the iliac crests toward the long axes direction of lower extremities on each leg for one minute in turn and confirmed the approximation with a 10 kg load. Experimental group performed the stabilometer in an unstable environment and we measured the center of gravity sway after the intervention. The control group was measured without performing the maneuver. [Results]Significant differences in Area of Ellipse (AoE) and locus length per unit area (L/A) after ApT for lasted for 70 minutes. [Conclusion] We conclude ApT is a useful improved stability of center of gravity for 70 minutes.

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