[Purpose] The present study aimed to examine the relationship between customer satisfaction and the motivation to exercise among outpatients practicing therapeutic exercises. [Methods] The data of 189 subjects who practiced therapeutic exercises were used for analysis. Customer Satisfaction Scale based on Need Satisfaction (CSSNS) was used to measure the degree of customer satisfaction. In order to assess self-determined motivation to exercise, the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) was used. [Results] The results of the calculation of the correlation coefficient and categorical regression analyses show that customer satisfaction and its sub-concept (5 factors: need satisfaction of competence, autonomy, relatedness to participants, relatedness to service providers, and physiological needs) were related to the self-determined motivation to exercise. [Conclusions] These results suggest that, for outpatients practicing therapeutic exercises, customer satisfaction is related to the self-determined motivation to exercise.

View full abstract

[Purpose] The aim of this study was to examine the criterion validity of the Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS) for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) in a bioclean room. [Subjects] The participants were 27 HSCT patients (13 males, 14 females, mean age 47 ± 14.1 years). [Methods] We assessed the relationship between ECOG PS Grade 1-3 and the mean daily steps measured with a pedometer. [Results] The mean daily steps of grades 1 to 3 were 2,411 ± 1,068, 1,205 ± 572, and 597 ± 216 steps/day, respectively, with a statistically significant correlation. [Conclusion] ECOG PS is a simple and valid tool for assessing the overall condition of HSCT patients in a bioclean room.

View full abstract

[Purpose] We have encountered cases of deterioration of infants' motor paralysis after stroke. In such cases, evaluation and treatment in response to the course of motor paralysis becomes important, and in this study, we aimed to clarify the temporal changes of motor paralysis. [Subjects and Methods] We recorded the limb movements of an one-week-old infant with cerebral paralysis with a video camera and performed motion analysis. [Results] The analysis suggested that the motor paralysis of the infant was deteriorating, because the activity of the right upper limb decreased together with the range of movement. This assessment was in complete agreement with clinical observations. In contrast, a healthy infant showed decrease in neither limb activity nor range of movement over the same period, and there were no right and left differences either. [Conclusion] Since voluntary movement receives subcortical influences in the early post-natal stage, voluntary movement is possible in infants with cerebral paralysis before the maturity of the central nervous system. However, with the formation of synapses in cerebral cortex neurons and descending myelin sheath, voluntary movement receives its influence from the injured cerebral cortex, the motor paralysis of the left and right limbs deteriorates, and the voluntary movement decreases.

View full abstract

[Purpose] The aim of this study was to investigate whether or not the upper limbs influence the stepping test or circuit walking. [Subjects] The subjects were 17 healthy women, average age: 19.6 ± 7.9 years. [Method] We measured circuit times at fastest walking speeds in clockwise and anti-clockwise directions, and similarly the distance of one-minute walking. In the stepping test with the eyes closed, we measured rotation angle and direction with the arms free and with the arms fixed at the sides. [Results] In circuit walking, the anti-clockwise direction time was significantly shorter than that of the clockwise direction, and one-minute walking time was longer. In the stepping test, compared to the `arms fixed' condition, the body rotation angle was significantly smaller under the `arms free' condition. [Conclusion] We infer from these results that walking is influenced by upper limb movements, suggesting the necessity of physical therapy which involves the trunk and the upper and lower limbs.

View full abstract

[Purpose] In this study we investigated the reproducibility of the lateral reach test in the sitting position. [Subjects] The subjects were 7 young healthy men, average age: 24.0 ± 3.2 years. [Method] We measured maximum lateral reach of the right side 3 times and determined the angles of the head, shoulder girdle, pelvis and lower thigh. We repeated the measurements 4-7 days later. [Results] The intra-class correlation coefficients (ICC) of lateral reach were 0.679 at the first measurement and 0.858 at the second measurement. Intra-day reproducibility was found, but the inter-day ICC was 0.377 casting doubt on the reproducibility. In the comparison of reach distance, the distance of the second measurement showed a significantly higher value than that of the first. [Conclusion] In the measurements of body angles, the angle of the pelvis at the second measurement was significantly larger than that of the first, suggesting that pelvis angle influences the maximal reach distance.

View full abstract

[Purpose] The aim of this study was to investigate the effect of wrist extension of the dominant and non-dominant hands on movement-related cortical potentials. [Subjects] The subjects were 11 healthy persons who were right-handed according to the Edinburgh Handedness Inventory. [Method] The subjects performed volitional wrist extension of both hands, 50 times each, and the movement-related cortical potentials were recorded using Cz of the International 10-20 System. Electromyograms of the extensor carpi radialis muscle were recorded, and the rise of the waveform was used as the trigger. The items determined were the emergence time of the motor-related cortical potential and the maximum amplitude. [Results] A significant increase in the maximum amplitude of the movement-related cortical potential of the non-dominant hand was found, compared to the dominant hand. [Conclusion] The results suggest the difference in motor learning experience of the dominant and non-dominant hands influences the form of the motor-related cortical potentials.

View full abstract

[Purpose] This study examined the inter-rater and intra-rater reliability of measurement of isometric shoulder internal and external rotation strength using a hand-held dynamometer (HDD). [Subjects] For intra-rater reliability, the subjects were 21 healthy persons (8 men and 13 women), and for inter-rater reliability, the subjects were 17 healthy persons (9 men and 8 women). [Method] For intra-rater reliability, an examiner performed measurements of isometric shoulder internal and external rotation strength twice with an interval of two days. For inter-rater reliability, two examiners measured isometric shoulder internal and external rotation strength. Making allowance for fatigue, measurements by different examiners took place after an interval of at least 30 min, and at random on the same day. [Results] The inter-rater and intra-rater reliability were analyzed using Student's t test, which showed no significant differences, and intra-class correlation coefficients, which gave good results. [Conclusion] Measurements of isometric shoulder internal and external rotation strength using a HDD fixed to the upper limbs and trunk by a belt gave good results for both inter-rater and intra-rater reproducibility.

View full abstract

[Purpose] The purpose of this study was to verify the reliability of measurement of maximum voluntary isometric contractions of the hip muscles with strength of trunk fixation by a hand-held dynamometry. [Subjects] In this study, 10 healthy subjects (10 men: age range, 19-23 y, 20 lower extremities) participated after giving their informed consent. [Methods] Measures of peak isometric strength were obtained for hip muscles by 2 investigators by using the original anchoring station and fixation by the subjects. To maintain a measurement posture, we instructed to subjects by oral. Intra-class correlation coefficients (ICC) were used to determine reliability. [Results] Intra-rater ICC (1, 1) were 0.76 (hip flexors), 0.92 (hip extensors), 0.90 (hip abductors), 0.96 (hip adductors), 0.81 (hip external rotators), 0.88 (hip internal rotators). Inter-rater ICC (2, 1) were 0.88 (hip flexors), 0.93 (hip extensors), 0.90 (hip abductors), 0.97 (hip adductors), 0.76 (hip external rotators), 0.86 (hip internal rotators). [Conclusion] These results show that this study protocol can be performed clinically with good to excellent reliability.

View full abstract

[Purpose] In this study, we investigated falls by cerebrovascular attack patients, and the factors that influenced the falls. [Subjects] The subjects were 41 cerebrovascular attack patients aged between 45 and 87. [Methods] The falls of cerebrovascular attack patients were investigated. We evaluated the motor and the sensory functions and attention. The relation with each factor and the falls was examined, and the factor with the strongest relation with falls was examined. [Results] Attention, and motor and the sensory functions showed significant decreases in the fall group, but there were no differences between age and the paralyzed side related to falls. [Conclusion] The results show that the risk factors of fall in cerebrovascular attack patients are attention and the motor, and sensory functions.

View full abstract

[Purpose] The purpose of this study was to demonstrate the relationships between students' characteristics and learning effectiveness in problem-based learning (PBL). [Subjects and Methods] The subjects were nineteen third-year students in the physical therapy university course. The student self-evaluation and the verbal contribution in PBL were measured as indicators of PBL effects. After two months PBL implementation, the relationships between PBL effects and the students' characteristics, such as academic grade, personality, habit of self-study, self-study hours, and students' satisfaction were examined using Spearman's rank correlation coefficient. [Results] Significant correlations between student self-evaluation and academic grade, personality, habit of self-study, self-study hours and students' satisfaction were demonstrated. The correlation between verbal contribution and student self-evaluation and academic grade, self-study hours and students' satisfaction were also significant. [Conclusion] Relationships between PBL effects and students' characteristics were suggested by the results.

View full abstract

[Purpose] We investigated the influence ankle dorsiflexion range has on center of foot pressure (COP) during squat action and the ability to perform it. [Subjects and Method] We performed measurements of the ankle dorsiflexion range and center of gravity sway during squat action by 42 healthy adults (average age, 20.1 ± 2.4 years). [Results] Among the 42 subjects there were 27 who could perform the squat action. A significant correlation, r=0.718, was found between the range of ankle dorsiflexion and anteroposterior COP displacement in squatting. The ranges of ankle dorsiflexion for those who could and could not squat were 18.9 ± 4.6° and 9.6 ± 3.5°, respectively, significantly larger for those who could squat. The number of those who could squat became smaller as the range of ankle dorsiflexion got smaller, and at less than 10° none of the subjects (9) could squat. Conversely, at more than 20°, all subjects (13) could perform the action. [Conclusion] The results suggest that when the range of ankle dorsiflexion is insufficient, COP displacement is forced to move posteriorly in squatting, and when the dorsiflexion range is below a set limit, the action becomes impossible.

View full abstract

[Purpose] We compared the degree of lengthening between the proximal and distal regions of the semitendinosus muscle during stretching with different joint positions. [Subjects] Seven healthy men participated in the study. [Methods] Each subject performed two stretching trials: 1) Straight leg raise (SLR) stretching, 2) Hip flexion and knee extension (HFKE stretching). Ultrasonography was used to assess the muscle architecture. [Results] In the proximal region of the semitendinosus, the distance ratio between ischial tuberosity and tendinous intersection per muscle length of HFKE stretching was significantly larger than that of SLR stretching. In the distal region, the pennation angle of SLR stretching was significantly smaller than that of HFKE stretching, and the muscle thickness was not different between the two stretching conditions. [Conclusion] These results indicate that the proximal region is lengthened more by HFKE stretching than by SLR stretching, and the distal region is lengthened more by SLR stretching than by HFKE stretching. This finding suggests that the lengthened regions can be changed by the position of the joints during stretching of bi-articular muscles.

View full abstract

[Purpose] The purpose of this study was to investigate the relationships among motor functions, activities of daily living (ADL), and social attributes that influence independence over a period of 8 years. [Subjects] The subjects were 44 men and 166 women (average age: 77.1 years), community-dwelling elderly, belong to a seniors club at the time of the baseline survey conducted in 2000. [Methods] The survey was conducted by interview. There were 13 functional capacity test items and 3 social attribute items in the survey. Motor function tests included handgrip strength, sit-reach, one-leg standing time with eyes closed and maximal walking speed over 10 m. [Results] The percentage of subjects who were independent in instrumental activities of daily living (IADL) at the time of the follow-up survey was 60%. For men, a previous medical history, handgrip strength, maximal walking speed over 10 m and 2 domains of functional capacity were significantly higher in the independent group. For women, age (60-74 years), pain, productivity, handgrip strength, sit-reach, one-leg standing time with eyes closed, maximal walking speed over 10 m and 3 domains of functional capacity were significantly higher in the independent group. [Conclusion] The results suggest that efforts to maintain motor function and functional capacity may be useful for maintaining active independence of the elderly.

View full abstract

[Purpose] We investigated the reproducibility of measurements of spinal curvature using Spinal Mouse on clothed and naked skin. [Subjects] The subjects were 20 healthy men. [Method] We measured spinal curvature using Spinal Mouse on naked skin and one layer of clothing, twice for each condition, and determined the intra-class correlation coefficient (ICC). [Results] The ICC of thoracic kyphosis was 0.974 for the naked condition and 0.892 for the clothed condition. The ICC of lumbar lordosis was 0.939 for the naked condition and 0.883 for the clothed condition. In the comparison of the naked and clothed conditions, no significant differences were found. Furthermore, the measurement difference between the two conditions was of the order of 1.5°, suggesting that when it is difficult to take the measurement on the naked skin, a reliable measurement can be obtained over clothing.

View full abstract

[Purpose] In an exercise loading method using repeated sit-to-stand, we investigated the relationship between physical characteristics and physiological load. [Subjects] The subjects were a group of 31 healthy young persons and a group of 17 elderly persons with respective average ages of 20.1 and 66.1. [Method] The measurement items were oxygen uptake at set physiological exercise intensities, and the physical characteristics of height, weight, sitting height, and lower limb strength. After sitting quietly at rest for 3 minutes, the subjects performed the stand-up exercise at work rates from 6 to 30 times a minute for 3 minutes in a ramped load protocol. Relationships between oxygen uptake and physical characteristics were investigated using Pearson's correlation coefficient at a level of significance of less than 5%. [Results] For the young persons group a significant correlation (r=0.74) was found between oxygen uptake and height at the work rates attained for stand-ups; for the elderly persons group, a significant correlation (r=0.54) was found for sitting height. [Conclusion] When setting the same stand-up work rates for different subjects, it is necessary to consider the relationship of height and sitting height to the distance moved. Also, the fact that the related items were different with age grouping, suggests that they should be investigated by age.

View full abstract

[Purpose] We propose a method of physical therapy education for rehabilitation of amputees which should respond to the remarkably changing course of this condition. [Method] We performed a survey by mailing questionnaires regarding education related to rehabilitation of amputees to physical therapy training schools in the Kinki region. In addition, we surveyed the experience of those responsible for case studies of amputees in clinical practice training. [Results] Average lesson time relating to rehabilitation of amputees was 58.9 hours, and physical therapists were mostly responsible for providing these classes, though there were some schools where only prostheticians gave the classes. The educational objective was raise to high levels after clinical practice training. The physical therapist's role was considered most important in managing the amputee's stump and practicing fitting of prosthetics. [Conclusion] We consider that physical therapy education for rehabilitation of amputees requires ideas for a curriculum that includes clinical practice training as well as reflecting an understanding of current amputee treatment.

View full abstract

[Purpose] The purpose of this study was to examine the differences in trunk movement between young and older people in sit-to-stand motion (STS). [Subjects] One group consisting of 19 persons aged under 33 and another group of 21 healthy older persons participated in the study. [Methods] Biomechanical data were collected from force plates (AMTI) and a motion analysis system (Vicon Peak), and we compared the young group with the older group under comfortable and maximum speed conditions. [Results] Significant differences in center of mass (COM) speed, COM-heel distance, trunk movement and hip joint moment were found between the two groups in the maximum speed condition. Trunk flexion and extension movement of the older group decreased more than in the young group, suggesting that trunk movement contributes to production and control of momentum in STS.

View full abstract

[Purpose] We assessed the differences in effects on knee joint mobility and pain of passive and active assisted exercise methods for total knee arthroplasty patients. [Subjects] The subjects were 34 rheumatic patients who received the same type of artificial knee from the same surgeon by the same surgical method. [Method] The subjects were divided at random into active assisted (n=17) and passive (n=17) exercise groups and provided with physical therapy. Physical therapy length, number of sessions and amount were made the same. The measurement items were passive flexion and extension angles, number of days to achieve 120° flexion, number of days of continuous passive motion (CPM), and pain during exercise. We performed inter- and intra-group comparisons on all items. [Results] Significant inter-group differences were found for passive flexion angle, days to 120° flexion, days of CPM, and pain during exercise. Significant intra-group differences were found for passive flexion and extension angles. For all the measurement items, the active assisted exercise group showed improvement trends that were better than those of the passive exercise group. [Conclusion] Active assisted exercise was effective for improving knee joint mobility and reducing pain during exercise; however, it is necessary for the physical therapist to provide thorough explanation and guidance to the subject. Exercise methods which reduce pain require and effectively improve mobility substantiation on a scientific basis.

View full abstract

[Purpose] This study investigated the effects of various relaxation methods on physical reactions. [Subjects] The subjects were 11 normal males (n=5) and females (n=6). [Methods] Breathing number (BN), heart rate (HR), diastolic and systolic blood pressure (DBP, SBP), finger-floor distance (FFD), the range of straight leg raising (SLR), and the number of correct answers in a calculation task (NCA) were measured for all subjects before and after abdominal respiration (AR), progressive muscle relaxation (PRM), listening to music (LM), and smelling a fragrance (SF). [Results] AR affected all measured parameters except for DBP. It decreased BN, HR, SBP, and increased FFD, SLR and NCA significantly. [Conclusions] This result suggests that AR is the most suitable method to use in rehabilitation because it can be used without equipment and is easily performed by subjects.

View full abstract

[Purpose] We examined the effect on physical and mental function of elderly persons of a group rhythm exercise designed with "safety, enjoyment, and length" as the primary considerations for elderly persons certified under the less severe grades of the long-term care insurance. [Subjects] The subjects were 20 persons (average age, 79.5 ± 7.2) certified between Need Support level 2 and Need Care level 2 who were attending a day-care service facility. [Method] The subjects were randomly allocated to an intervention and a control group. The intervention group performed an individual exercise program and the group rhythm exercise; the control group performed only the individual exercise program. To assess the effect, before the intervention and at 3 and 6 months afterwards, participants received a physical examination, performed strength tests and answered a questionnaire. [Results] In both groups a significant improvement in lower limb strength was seen. Furthermore, in the intervention group, significant improvements in mental function, walking ability and balance ability were also seen. [Conclusion] The results suggest that the group exercise could possibly become a beneficial exercise therapy for improving the mental and physical functions of elderly persons.

View full abstract

[Purpose] The aim of the present study was to investigate changes in the thickness of abdominal muscles with different states of contraction and postures in healthy subjects. [Subjects] The subjects were fifteen healthy male university students (18-20 yrs) with no history of neurological or orthopedic disease. [Method] Ultrasound equipment was used to measure the change in abdominal muscle thickness upon contraction and relaxation with and without a belt and in the standing and seated positions. [Results] Significant differences were found in the thicknesses of the internal oblique and the transverse abdominis muscles upon contraction and relaxation regardless of the belt condition (with or without) and the two postures. The comparison of the change upon contraction found a significant increase in the thickness of the external oblique when using the belt and a decrease in that of the transverse abdominis. [Conclusion] These results suggest that wearing an abdominal belt artificially increases abdominal pressure and tends to increase external abdominis activity, but that the effect on the transverse abdominis is limited.

View full abstract

[Purpose] We quantitatively assessed the sitting up ability of community-dwelling elderly persons and investigated its relationships with upper and lower limb strength and trunk function. [Subjects] The subjects were 7 men and 12 women (average age, 76.3 ± 8.3) attending a day-care rehabilitation facility. [Method] We measured grip strength (upper limb function), quadriceps femoris strength (lower limb function), sitting balance (trunk function) and walking speed and analyzed their correlations with the time required for sitting up. [Results] We found significant correlations for sitting up time with sitting balance, grip strength and walking speed. [Conclusion] The results suggest that the sitting up movement of elderly persons with comparatively high levels of independence of activities of daily living involves upper limb and trunk function.

View full abstract

[Purpose] We examined the perception held in clinical practice, that the greater the number of exercise units the better the outcome in a retrospective survey which investigated the relationship between Activities of Daily Living (ADL) outcome and the number of exercise units performed in exercise limited to 2 hours, with the objective of obtaining basic data for studies of the effects of exercise limits of 3 hours. [Subjects] The subjects were 362 patients who were admitted and discharged from the Recovery Stage Rehabilitation Ward of the Fujita Health University Nanakuri Sanatorium in 2005. [Method] We examined the total number of occupational and physical therapy exercise units during the hospital stay and calculated the daily average, analyzed the discharge to home rate and investigated their correlation with the Motor Items Score of the Functional Independence Measure (FIM-M) and the return to home rate. [Results] Total exercise units was negatively correlated with FIM-M at admission and discharge from the ward, and gain in FIM-M showed a positive correlation. The group which performed on average 5-6 units per day did not show better results compared to those performing less, but they had a higher return to home rate. [Conclusion] Performing the upper limit of exercise (6 units) did not always lead to a high ADL outcome. When investigating the relationship between exercise dose and outcome, the effects of restrictions of exercise dose and lifestyle when not at exercise should also be considered.

View full abstract

[Purpose] The purpose of this study was to investigate the influence of stretching exercise on the excitability of the soleus muscle using a gym ball. [Subjects] Ten healthy males aged 24.7 ± 3.9 years without pathologies in the leg and/or trunk participated in this study. [Methods] Excitability of the soleus muscle was measured indirectly using the H-reflex. In a control test, the subjects rested in the supine position for a minute. In the exercise test, the same subjects were asked to practice the stretching exercise for a minute. The soleus H-reflex amplitude was measured before and after rest or exercise in the supine position. The H-reflex amplitude before and after was compared under each condition. [Results] In the exercise test, the H-reflex after exercise was significantly lower than the H-reflex before exercise, while in the control test, there was no significant difference between the H-reflex before and after rest. [Conclusion] The result shows that the stretching exercise using the gym ball controlled the excitability of the soleus muscle.

View full abstract

[Purpose] The purpose of this study was to clarify the competencies of Physical Therapists (PTs) and Occupational Therapists (OTs) toward QOL of persons with cerebrovascular disease (CVD) and the difference by profession and rehabilitation according to the onset phase. [Subjects and Methods] A questionnaire was prepared on the competencies toward QOL of persons with CVD for PTs and OTs. The questionnaire was sent by mail to 348 PTs and OTs. [Results] We found 7 relevant factors: "Respect of self-selection", "Guide of supervised administration", "Introduction of self-help group", "Treatment of persons as a whole", "Acceptance of family", "Practical use of social resources", and "Improvement of living function by self-decision". OTs were more affirmative than PTs about "Treatment of persons as a whole". There were differences in "Respect of self-selection" and "Practical use of social resources" according to the onset phase. [Conclusion] These results suggest that PTs and OTs were responsive to respect of self-selection and the practical use of societal resources for persons with CVD, in the recovery process form the onset phase.

View full abstract

[Purpose] We investigated the trunk muscles, activities for stabilizing the spine against load by arm movement. [Subjects] Eight male subjects participated in this study. [Methods] Subjects performed 1) a pushing forward task (load perpendicular to the trunk) and 2) a pushing downward task (load parallel to the trunk) at different load magnitudes with isometric arm extension. Electromyography (EMG) of rectus abdominis (RA), oblique internus abdominis (OI), oblique externus abdominis (OE), lumbar mutifidus (LM), and longissimus thoracis (LT) were recorded with surface electrodes. [Results] Activity of RA, OE and OI increased with load magnitude in both tasks. RA was influenced by load direction. The activity of RA in the downward pushing task was larger than in the forward pushing task. Activities of LM and LT were influenced by load magnitude, but these muscles activities were low. [Conclusion] The RA muscle is the only muscle influenced by direction of load to the trunk.

View full abstract

[Purpose] Most falls by the older adults occur due to external perturbation such as slip or trip. Thus, the assessment of responses to external perturbations may identify the older adults with potential risk of fall which cannot be identified using existing physical tests. The purpose of this study was to identify the differences of postural responses to external perturbation between older and young adults using a newly developed device to measure the postural response to lateral perturbation while walking. [Subjects] The participants were 13 older (age: mean 77.9 ± 3.9) and 15 young adults (age: mean 20.1 ± 3.1). [Methods] The responses to the lateral perturbation were measured by a sway meter when the participants walked on the device at a comfortable pace and we compared the results between older adults and young. [Results] The older adults showed significantly smaller acceleration in secondary responses than the young adults. [Conclusion] The result suggests that the smaller secondary response might reflect the difference in response to external perturbation between older and young adults.

View full abstract

[Purpose] The purpose of this study was to investigate the immediate effect of a passive range of motion exercise. [Subjects] The subject was a 96-year-old female patient with both a cerebrovascular disease and a persistent vegetative state. [Methods] We assessed physical reactions to the passive range of motion exercise using a single case design. [Results] The result of this investigation suggests that the passive range of motion exercise stimulated the brain of the patient and increased the reaction rate of the upper extremities. [Conclusion] We conclude that the passive range of motion exercise can immediately improve the reactions of upper extremities for an elderly patient with both a cerebrovascular disease and a persistent vegetative state.

View full abstract