[Purpose] In this study, in order to establish the clinical path for Activities of Daily Living (ADL) training, and utilizing Functional Independence Measure (FIM) we estimated the predictable goals (independence levels) of individual items of ADL and the time it would take to achieve them. [Subjects] The subjects were 1,479 hospitalized stroke patients admitted to a rehabilitation ward in the recovery period. [Method] Based on the totals of the FIM motor item scores on admission (FIMM), the patients were divided into 9 groups, and for each group, for each of the individual items of FIMM, we calculated the percentage of patients achieving independence, and analyzed the times needed to achieve independence. [Results] The degree of disability in ADL on admission shows characteristics of achievement of independence and time to achieve independence [Conclusion] These results suggest that knowing a combination of these could serve as an index for ADL training of hospitalized hemiplegic stroke patients in rehabilitation wards in the recovery period.

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[Purpose] To determine the test-retest reliability of an accelerometer-based gait analysis system which measures 3D accelerations of the tibia. [Subjects] The study subjects were 10 healthy individuals. [Methods] Accelerations were measured during comfortable and regulated speed walking using a triaxial accelerometer mounted on the head of the fibula and lateral malleous of the subjects. Peak acceleration, time from the initial contact to peak acceleration and acceleration at initial contact during the stance phase in each direction (vertical, anterior-posterior, and mediolateral) were analyzed. [Results] By the test-retest method the average of intraclass correlation coefficients (1.1), peak acceleration and time from the initial contact to peak acceleration of comfortable speed were better than those of regulated speed. [Conclusion] We conclude that these parameters have reasonable reliability and objectivity for evaluating abnormal motion and instability of the knee joint during comfortable walking.

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[Purpose] We compared traditional teaching methods with those actively using audio-visual materials (AV class) in a lesson consciousness survey, and investigated their relationships with willingness to learn. [Subjects] The subjects were 91 physical therapy students attending a vocational training college. [Method] We gave both traditional classes and AV classes, and performed factor analysis on the results of a lesson consciousness survey undertaken for the AV classes, and compared the sub-item scores for both types of class. We also examined the correlation between sub-item scores for the AV classes and the results of a willingness to learn survey. [Results] Among the results of the factor analysis for the AV classes, Factor 1 (Attitude to class and the future) sub-item scores were higher than for traditional classes. Also, we found that Factor 1 was correlated with willingness to learn, especially self-motivation and suitability for college. [Conclusion] We consider that AV classes are a class model that can raise self-motivation and suitability for college better than traditional classes.

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[Purpose] In this study, we investigated the relationship between arm elevation angle and spinal curvature (thoracic kyphosis and lumbar lordosis) in healthy adults. [Subjects] The subjects were 12 healthy adult males, average age 23.6 ± 5.5 years. [Method] We measured thoracic kyphosis and lumbar lordosis angles with the arms in 5 positions, at the sides, raised at 90, 120, 150° and the maximum elevation, and compared the results of each elevation. [Results] We found that at 150° and maximum elevation the thoracic kyphosis angle showed a significant reduction compared to elevations of 120° or less, and the lumbar lordosis angle was significantly increased compared to arms at the sides. Moreover, this increase in lordosis angle showed a generally linear relation to the arm elevation angle. [Conclusion] The relationship between arm elevation and spinal curvature was one in which the lumbar lordosis angle increased linearly with arm elevation, and at elevations of 150° and above, in addition to lumbar lordosis, thoracic kyphosis decreased significantly, suggesting a mutual contribution from the thoracic and lumbar spines in arm elevation movement.

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[Purpose] We examined the effect of factors in bed-side evaluation on discharge to home after acute stroke, and examined them across age groups. [Subjects] Subjects were 111 patients after acute stroke. [Methods] Patients were divided into 2 groups according to age, age≥75, 60 patients, age<75, 51 patients. We evaluated consciousness, active extension of all fingers in synergy, eating function, sub-items of the Barthel Index (eating and self-care) at bed-side. The evaluations were conducted within 2 days of onset of stroke. [Results] Finger extension and eating function were the factors of discharge to home in the group aged<75, and finger extension was the only factor of discharge to home in the group aged≥75. [Conclusion] The results of this study suggest that active extension of all fingers in synergy is factor of discharge to home across age groups.

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[Purpose] In this study, in order to clarify the inter-rater and intra-rater reliability in measurements of range of trunk rotation, we investigated the measurement reliability with and without pelvic fixation. [Subjects] The subject was one 28-year-old healthy male, and there were 10 examiners. [Method] For the measurement of trunk rotation, left and right rotation was measured twice, both with and without pelvic fixation. We determined and analyzed intra-rater reliability with the intra-class correlation coefficient (ICC) and inter-rater reliability by the coefficient of variation (CV) derived from the mean and standard deviation of the first and second measurements. [Results] We found the intra-rater reliability was high (p<0.05) both with and without pelvic fixation. For inter-rater reliability without pelvic fixation, left rotation CV was 22% and right rotation CV was 28%; with pelvic fixation the left and right CVs were 17% and 16%, respectively. [Conclusion] We found a wide dispersion in the measurements of trunk rotation range among the examiners.

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[Purpose] It is considered that in knee extension, the hamstring acts in a closed kinetic chain. The objective of this study was to examine the correlation between knee flexion strength measured by a hand-held dynamometer (HDD) and leg extension torque measured by StrengthErgo. [Subjects] The subjects were 22 healthy adults with no impairments of the leg. [Method] We measured as body weight ratios, peak torque during left and right leg extension, and left and right knee flexion strength. Then, we examined the correlations between left and right leg extension torque and knee flexion strength using Spearman's correlation coefficient. [Results] A medium level of correlation was found between left and right leg extension torque and knee flexion strength. [Conclusion] The results suggest the necessity of performing muscle training of the hamstrings for the objectives of raising walking speed or transfer from the supine or sitting positions to standing.

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[Purpose] The purpose of this study was to examine the influence of standing alignment on respiratory function and exercise tolerance. [Subjects] The subjects were 16 healthy adults. [Method] In the standing position, wearing a harness, the thoracolumbar spine was set at three different angles of flexion to the hip. In the standing positions, the distance from the center of gravity (COG) line of each body marker was determined, the respiratory pattern was evaluated using the 5 levels of Kawamata et al., the respiratory function was measured using a spirometer, and exercise tolerance was evaluated using the shuttle walking test. The results were analyzed for relationships with the standing postures. [Results] The respiratory pattern deteriorated with anterior shift of the ear, shoulder, knee and lateral malleous, but improved with forward shift of the greater trochanter. Percent vital capacity and inspiratory reserve volume declined with anterior shift of the upper body COG. Walking distance shortened with anterior shift of the ear and knee. [Conclusion] Respiratory function declined due to the postures, and oxygen uptake of the periphery increased due to excessive muscular contraction, lowering exercise tolerance. We found a strong correlation between standing posture and respiratory pattern, respiratory function and exercise tolerance, suggesting standing posture influences respiratory function and exercise tolerance.

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[Purpose] In the first part of the study (S1), we quantified muscle stiffness and gender differences in healthy persons. In the second part (S2), we clarified the relationship between muscle stiffness and pain in myofascial pain syndrome (MPS) which has muscle knots. [Subjects] The subjects of S1 were 52 healthy adults in their twenties. The subjects of S2 were 44 patients complaining of chronic lumbago, who showed no imaging or neurological findings and had muscle knots in the longissimus thoracis. [Methods] In S1, we measured the stiffness of the longissimus thoracis, and the trapezius and major rhomboid muscles with a muscle hardness meter; gender differences were verified with the t test. In S2, muscle stiffness was measured with the muscle hardness meter, and pain was evaluated using a numerical rating scale. The relationship between muscle stiffness and pain was investigated using Pearson's correlation coefficient. [Results] In S1, for the trapezius muscle, females showed significantly higher values, but no significant differences were seen for the other two muscles. In S2, the correlation between muscle stiffness and pain in muscle knots was weak. [Conclusion] We revealed that females have comparatively higher muscle stiffness in the trapezius muscle than males; however, the level of pain had no influence on muscle stiffness in MPS which has muscle knots.

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[Purpose] We examined a simple method of estimating oxygen consumption of the respiratory muscles (VO₂ resp) using dead space. [Subjects] The subjects were 31 healthy adults who had normal cardiopulmonary function. [Methods] We measured VO₂ resp of diaphragmatic respiration and costal respiration with simple equipment consisting of an expiration gas analyzer and a one-litre tube. We examined whether decrease of VO₂ resp by diaphragmatic respiration could be seen using this equipment. [Results] We confirmed a significant decrease of VO₂ resp in diaphragmatic respiration. [Conclusion] The result indicates we can measure changes in VO₂ resp by respiration pattern using our simple method.

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[Purpose] In this study, we examined the absolute reliability of two different tandem gait tests with minimal detectable change (MDC). [Subjects] The subjects were 28 healthy adults (mean age 63.4 ± 7.7 years). [Methods] The subjects walked 5 m with tandem gait, and we examined tandem gait time (TGT) and tandem gait index (TGI: add TGT to double-missed steps). We calculated standard error of measurement (SEM) of TGT and TGI in 4 different ways. Moreover, we examined measurement error of TGT and TGI by 95% confidence intervals of minimal detectable change (MDC₉₅) obtained from SEM. [Results] MDC₉₅ of TGT were 3.4-3.5 sec, and of TGI were 4.1-4.3. [Conclusion] We consider that the changes of TGT and TGI in this study were measurement errors, as the variances of measurement error found by the calculation method were too small for clinical application.

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[Purpose] We investigated how continuing education was conducted in medical facilities for qualified as physical therapists (PT), and clarified the problems and future issues. [Subjects and Methods] We sent a questionnaire about continuing education to 300 medical facilities. The survey was answered by 113 facilities. [Results] In more than 70% of facilities newcomers were taught by an instructor, and about half of the facilities implemented educational projects. However, the facilities that had a rating sheet and a standard for appointing an instructor were few. [Conclusion] We infer from the results that the continuing education of PT is performed based on the experience of each instructor. We think that PT need a goal and guideline for their education.

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[Purpose] The purpose of this study was to estimate the step length from tri-axial acceleration signals and to verify the validity and reliability of the step length estimation using newly developed software. [Subjects] Subjects were 40 young healthy adults. [Methods] To study the validity and to identify the initial contacts from accelerations, correlations between the step length estimates and the corresponding intervals of footprints were examined under two conditions (barefoot and a leg length discrepancy model). The reliability of the step length estimation was tested using inter-rater correlation. [Results] The step length estimates were highly correlated with footprint intervals (Spearman's rho, 0.97). High inter-rater correlations of the step length estimation were also found for both barefoot and the leg length discrepancy model. [Conclusion] These results suggest the possible application of the estimation of step length using a tri-axial accelerometer in clinical settings.

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[Purpose] The aim of this study was to investigate the effect differences in left and right lower limb function had on ground reaction force in heavy load lifting from the half knee squat position. [Subjects] The subjects were 30 students, mean age 20.5 ± 3.6 years. [Method] We defined the dominant leg as the leg used to kick a ball. We measured the isometric knee extensor strength of both the dominant and non-dominant sides, and the ground reaction force in lifting a heavy load from the floor from a half knee squat position with both the dominant and non-dominant side knee forward at the start position. [Results] We found no significant difference between knee extensor strength of the dominant and non-dominant sides. Likewise, between the two leading knee positions, there were no significant differences between the ground reaction force components (Fx, Fy, Fz) in the heavy lifting task. No significant correlation was found between left and right muscle strength and Fx or Fy. A significant correlation was found between Fz and extensor strength, and the correlation was stronger when the dominant knee was forward. [Conclusion] From the results, when the dominant leg performs an action, we infer that it possibly reflects the true muscle strength; in a sense it's an adept leg. In contrast, the non-dominant leg in action cannot reflect only the true muscle strength, as other factors such as intricacy and cooperation are needed in order to arrive at the movement, and it can be considered a less adept leg.

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[Purpose] We estimated two parameters based on control engineering, namely natural frequency (ω) and damping ratio (ζ) estimated by using modeling of standing posture in tilting-recovery motion, and examined the relation between the characteristics of motion, standing balance and the estimated parameters. [Subjects] Twelve healthy volunteers participated in the experiment. [Methods] Movements at the ankle and hip joints in tilting-recovery motion were measured under four conditions of standing stability. The parameters ω and ζ were estimated by applying measured joint movement data to a one-link model having only an ankle joint, or a two-link model having ankle and hip joints, and the relation with characteristics of motion corresponding to change of stability were analyzed. [Results] The unstable characteristics of standing balance appeared as change of hip movement, and the correlation of stability with the two parameters in the two-link model was evident. [Conclusion] The results suggest that the parameters ω and ζ obtained by considering hip movement reflect dynamic balance in standing posture.

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[Purpose] The purpose of this study was to clarify the relationships between the cross test and static balance as well as other dynamic balance test, and examine the sway path plots obtained in the cross test. [Subjects] The subjects were 73 students attending a vocational training college. [Method] Using measurement of center of gravity sway, we measured static standing balance with the eyes open and closed, and in one-leg standing, and performed the cross test and functional reach test. Then, we investigated the relationships among them. [Results] We found correlations among static standing balance with eyes open and closed and one-leg standing. No correlation was found between the cross test parameters and any of the other measured parameters, but correlations were found between the rectangular area minus the circumferential area of the sway path obtained in the cross test and static standing balance with eyes open and closed. [Conclusion] Many factors, including static balance, contribute to the parameters of the cross test, however the results suggest the possibility that the outline of the sway path plot reflects the static balance.

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[Purpose] We aimed to investigate the relationship between the sway characteristics of the center of foot pressure (COP) and the activities of the muscles involved in ankle rotation during the crossover step. [Subjects] Seventeen healthy young subjects participated in the study. [Methods] We defined the single-stance phase and landing phase during the crossover step on the basis of the vertical ground-reaction force values obtained using a separation-type load meter. Then, we used the load meter to measure the COP sway (COP-RMS) and the velocity of COP sway (COP-V) in the single-stance phase and the landing phase. In addition, we obtained electromyograms of the tibialis anterior, soleus, peroneus longus, and abductor hallucis. Single regression analysis was used to calculate the relationship between the sway characteristics of COP and the activities of the muscles. [Results] In the single-stance phase and the landing phase, a significant regression equation was obtained for the relationship between COP-V for the medial-lateral direction and the activities of the peroneus longus; we also obtained a significant regression equation for the relationship between COP-V of the anterior-posterior direction and the activities of the soleus. [Conclusion] The activities of the muscles involved in ankle rotation controlled the velocity of COP sway in the crossover step. In addition, we also observed that muscle activity in the medial-lateral/anterior-posterior direction was associated with COP-V.

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[Purpose] We investigated the changes due to posture in activities of the lateral abdominal muscles by ultra-sound sonography and electromyography. [Subjects] The subjects were 9 healthy adults. [Method] After measuring the muscle thicknesses and activities in quiet breathing and maximum expiration in the supine position, we measured them again in 6 sitting positions: with the trunk upright (U), forward (F)- and backward (B)-tilted with both the spine curved (C) and extended (E). [Results] At maximum expiration, electomyograms showed significant differences only for the internal oblique muscles between UE and FC, UC and BC. In quiet breathing, we found significant differences in muscle thickness of the internal oblique muscles between UE and FC, FE and BC. [Conclusion] We consider that upright sitting with the trunk extended is a posture in which the internal oblique muscles are not active in postural maintenance. From the electromyograms at maximum expiration, we consider this posture is one in which it is easy to show the function of the internal oblique muscles as respiratory muscles.

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[Purpose] The purpose of the present study was to examine the cross-validity of the Customer Satisfaction Scale based on Need Satisfaction (CSSNS), which is currently being developed in the field of health-care services. [Subjects and Methods] The subjects were 287 individuals using rehabilitation services, of whom one group used the services of a medical institution (medical group, n = 206) and the other, a day-care institution (day-care group, n=81). Data collection was conducted using the questionnaire survey method. In order to examine the factorial invariance of the CSSNS, a multi-group analysis was conducted using the data of the two groups. Multi-group analyses were conducted on 15 items that were included in the oblique model of the CSSNS and were confirmed in previous studies. [Results] The results revealed that the two groups differed in terms of age and the period of using the service. In the case of the oblique model of the CSSNS, the values of factor loadings and the variance-covariance matrix of factors were found to be identical in the two groups and fitted the data (χ²(185)=293.775, p<.000, CFI=.949, RMSEA=.045, AIC=463.775). [Conclusion] The factorial invariance of the oblique model of the CSSNS was significant. Hence, the cross-validity of the CSSNS was confirmed in the oblique model.

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[Purpose] The purpose of this study was to investigate the relationship between going outdoors and physical function of elderly persons certified as in need of care. [Subjects] The participants were 359 elderly people (mean age 82.2 ± 7.0 years; 119 men and 240 women) enrolled in the Tsukui Ordered Useful Care for Health (TOUCH) program. [Methods] Subjects performed the chair stand test 5 times, the timed up-and-go test (TUG), and independence of the stair climbing/descending test, and completed the mental status questionnaire. Going outdoors by participants during a one-month period was investigated retrospectively by family members. [Results] Multiple logistic regression analysis revealed that TUG was significantly associated with going into town [OR 1.04 (95%CI 1.01-1.08)]. Of the other tests, only independence of the stair climbing/descending was significantly associated with going outside the town [OR 1.74 (95%CI 1.06-2.86)]. [Conclusion] The results suggest that gait performance is associated with going outdoors for elderly people. Stair climbing/descending was a key factor in going outside the town which has more complex circumstances.

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[Purpose] This study sought to clarify differences in brain activation during the motor cognition by directing subjects' voluntary attention toward an internal or external focus in response to verbal instructions. [Subjects] The subjects were eight right-handed healthy adults. [Methods] The study sought to verify differences in brain activation using functional near-infrared spectroscopy (fNIRS). [Results] A significant increase in oxygenated hemoglobin in the right prefrontal cortex and right parietal region was seen when voluntary attention was directed toward an internal focus with the right hand, and a similar increase in the left prefrontal cortex and left parietal region was seen when voluntary attention was directed toward an external focus with the left hand. [Conclusion] The results suggest that during motor cognition, functional differences of the right and left cerebral hemispheres are present in the form of lateralization in the same cerebral hemispheres as the movements. That is, the right fronto-parietal region takes charge when voluntary attention is directed toward an internal focus with the right hand, while the left fronto-parietal region does so when voluntary attention is directed toward an external focus with the left hand.

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[Purpose] We assessed the upper body-raising ability of elderly persons, and compared it with their physical and psychological functions. [Subjects] The subjects were 475 community-dwelling elderly persons: 106 males, 369 females, average age 74.5 ± 5.9. [Method] We compared 6 items of physical function, including muscle strength and walking ability, and 3 items of psychological function, including subjective health and purpose in life, and compared them between gender and ability to raise the upper body. [Results] The proportion of males, 65.1%, who could raise the upper body was significantly greater than that of females, 41.5%. Significant differences were found for all of the 6 items of physical function, and those who could raise the upper body showed better values than those who could not. Among the psychological items, a significant difference was found for subjective health, and those who could raise the upper body perceived themselves as being more healthy. [Conclusion] The results show that ability to raise the upper body is not just a simple test which well-reflects physical function, but one which can possibly ascertain the overall health levels of the elderly, including subjective health.

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[Purpose] This study investigated whether the metaboreflex influences the baroreflex sensitivity. [Subjects] Data were collected from 10 healthy subjects. [Methods] All subjects performed a 30% maximum voluntary contraction, and then performed two consecutive five-minutes exercise periods. Each exercise period was followed with or without post exercise ischemia (PEI), in randomized order. ECG and blood pressure were recorded continuously. In addition, baroreflex sensitivity (BRS) was assessed using time domain analysis (sequence) of systolic blood pressure and the R-R interval. [Results] Under both conditions, HR did not change after exercise compared with rest. However, after exercise with PEI, SBP in the PEI was significantly higher than at rest, while there was no significant change after exercise without PEI. In addition, BRS values did not change in either condition. [Conclusion] The present results suggest that the muscle metaboreflex dose not influence BRS.

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[Purpose] The purpose of this study was to examine the sustainment of the effect of inspiratory muscle training on the force and the endurance of the inspiratory muscle, dyspnea and general exercise training. [Subjects] The subjects were 12 healthy young adults (23.3 ± 4.3 years old, 5 male, 7 female). [Methods] 40%PImax inspiratory muscle training using PowerBreath^TM was conducted for one month by the subjects. The force and endurance of the inspiratory muscle, dyspnea and general exercise training were evaluated before and 4 weeks, 8 weeks, 12 weeks and 16 weeks after the training. [Results] The force and the endurance of the inspiratory muscle, dyspnea and general exercise training were increased significantly after 40%PImax inspiratory muscle training and these effects decreased over time. [Conclusion] The results of this study suggest that the effect of 40%PImax inspiratory muscle training is sustained over the same period as the training period but returns to the baseline 3 months after the inspiratory muscle training.

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[Purpose] The purpose of this study was to examine the flexion-relaxation phenomenon (FRP) of the lumbar erector spinae muscles (ES) during asymmetric forward bending with lumbar flexion and rotation in healthy young males. [Subjects] Ten healthy young males (mean age 22.0 ± 0.8 [SD] years) participated in this study. [Methods] Subjects were asked to perform three tasks: forward bending without lumbar rotation (Task 1), forward bending with lumbar rotation from the standing position with rotation (Task 2) and forward bending with lumbar rotation from the standing position without rotation (Task 3). Muscle activities from both ES and the lumbar motion were recorded by electromyography and an electromagnetic system. The onset of the FRP was identified with the data from these devices. [Results] The FRP of bilateral ES occurred nearly simultaneously during Task 1. There was a significant difference between the sides of ES for the onset of FRP during Task 2 (p<0.01). The FRP of the rotated side did not occur during Task 3. [Conclusion] Our findings suggest that the onset and appearance of the FRP of the ES differ between symmetric and asymmetric forward bending in healthy young males. Also, the FRP of the ES is influenced by the rotation direction during asymmetric forward bending.

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[Purpose] In this study, we examined the influences of times spent in daily activities on physical activity (PA) of young persons who will be approaching middle and old age after 2020. [Subjects] The subjects were 78 healthy male students. [Method] We calculated total energy consumption from the number of paces measured by a pedometer and times spent in daily activities from a questionnaire survey regarding PA. [Results] From multiple regression analysis of time factors of living activities, which were the background living activities of young people, we found a significant difference only between exercise time and stationary leisure time, and this showed an influence on PA. [Conclusion] Establishing a specific exercise time alone cannot maintain PA. It is important to raise the intensity of activities in leisure time, and we predict it would have a big influence on continuance of exercise.

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[Purpose] The purpose of this research was to clarify the relationships between life motivation and ADL and physique for elderly hospitalized patients. [Subjects] The subjects were 71 hospitalized elderly with Functional Independence Measure (FIM) scores of 5 or more for feeding (recovery stage ward: 12 males, 24 females, average age 79.6 ± 11.1; chronic stage ward: 10 males, 25 females, average age 83.2 ± 7.6). [Method] Life motivation was obtained from the Vitality Index scores and divided into high and low score groups based on scores of 8 and above, and 7 and below, and analyzed with determinations of FIM and body mass index (BMI). [Results] We found significant differences between the high and low score groups for all items of FIM in the recovery stage. In the chronic stage, we found significant differences in the movement items of grooming, toilet transfer and excretion of FIM, all cognition items of FIM, and BMI. [Conclusion] We consider that life motivation is associated with general ADL ability in the recovery stage, and with basic human activities such as excretion or appearance in the chronic stage.

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[Purpose] The objective of this study was to clarify the relationship between trunk function of hemplegic stroke patients and activities of daily living (ADL). We also compared the hemiplegic side function with FIM movement and cognition items and investigated the differences in trunk function between different types of lesions. [Subjects] The subjects were 56 recovery stage hemiplegic stroke patients, average age 66.3 ± 10.7 years. [Method] Trunk function was assessed using the Functional Assessment for Control of the Trunk (FACT), ADL by Functional Independence Measure (FIM), and function of the hemiplegic side by the Brunnstrom stage. [Results] A very high correlation was obtained for the total scores of FACT and FIM. Only FIM cognition items had a high correlation with trunk function. We compared the lesion sites of start of the middle cerebral artery, putamen and thalamus, but no correlation was found with the thalamus. [Conclusion] The results suggest, ADL of hemiplegic stroke patients has a stronger relationship with trunk function than hemiplegic side function, that it is also related to cognitive function, and that trunk function differs with lesion site.

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[Purpose] The aim of this study was to investigate the influence of motor imagery during cast immobilization of the knee joint on range of motion (ROM) after cast removal. [Subject] The subject was 77-year-old female presenting with an insufficiency fracture of the patella. We performed cast immobilization with the knee in extension for 39 days, as a conservative treatment, from the thigh above the knee to above the ankle. [Method] After performing passive exercises with the healthy knee at 30, 60 and 90° of flexion, we asked the patient to recall the motor images at each of the flexion angles on both the healthy and injured sides. To evaluate motor imagery, we used the recall times of motor images on both the healthy and injured sides, and evaluated pain with a visual analog scale VAS. The motor imagery intervention was performed on 24 days, and we performed the measurements on intervention days 1, 6, 12, 18 and 24. [Results] Motor image recall times and VAS pain decreased with the number of intervention days. Moreover, the knee flexion angle after removal of the cast was 95°. [Conclusion] The results suggest that in cast immobilization of the knee, motor imagery intervention helps to prevent limitation of ROM after cast removal.

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